New guidelines for cardiovascular emergencies

New guidelines for cardiovascular emergencies

New guidelines for cardiovascular emergencies with numerous changes
Every second counts in emergencies of the cardiovascular system such as a heart attack. In addition, the interplay between lay helpers and acute medicine or rescue workers is crucial, according to the current announcement from the Charité-Universitätsmedizin Berlin. This was also taken into account in the current revision of the international guidelines for cardiovascular emergency medicine and resuscitation, for the German summary of which the cardiologist and emergency physician Professor Dr. Martin Möckel from the Berlin Charité was responsible.

The international guidelines for cardiovascular emergency medicine and resuscitation are revised every five years. According to the Charité, medical experts from all over the world took part in the current revision process under the leadership of the "International Liaison Committee on Resuscitation". "Against the background of international experience, new standards for cardiopulmonary resuscitation and other help in emergencies have been defined for professional helpers as well as lay helpers," reports the Berlin Charité.

Guidelines for first aiders and healthcare professionals
Because every second counts in an emergency and every move is important, the existing resuscitation guidelines are continuously checked and adapted to the current state of knowledge. New guidelines for cardiopulmonary resuscitation and cardiovascular medicine are now available, which include some changes based on the experience of globally active specialists. The guidelines serve as the basis for first aid training and contain procedures for lay helpers as well as for medical professionals, according to the Charité.

The Berlin Charité lists the following as innovations in the guidelines:

  • The concept introduced in 2010 to start cardiac massage during resuscitation has been confirmed, however a slightly increased frequency of 100 to 120 times per minute is recommended for cardiac massage in the event of cardiac arrest in adults.
  • The primary use of an automated external defibrillator (AED) is permitted if it is immediately available.
  • Trained lay helpers should administer the antidote naloxone in the event of an overdose of opioids, i.e. sleeping pills and pain relievers.
  • In the event of cardiac arrest for which a cardiovascular lesion is suspected, angiography, i.e. imaging, of the coronary arteries is now considered appropriate for medical care if it is carried out in an emergency. This can also happen when the patient is passed out and increases the chances of survival.
  • For targeted temperature management, a target body temperature of 32 to 36 degrees Celsius is now recommended in the first 24 hours after cardiovascular arrest in persistent spontaneous comatose patients, instead of the previously recommended cooling down to 32 to 34 degrees Celsius.

Interaction between first aiders and medical professionals is crucial
With all innovations in the guidelines, the interaction between laypersons and medical professionals remains decisive, "says the rescue chain can only be successful if there is a perfect interaction between first aiders and medical specialists - regardless of whether it is an emergency in a hospital or outside." , the expert continues. Therefore, for the first time, the guidelines recommend differentiated rescue chains inside and outside the clinic. The ubiquitous availability of mobile phones is also taken into account, emphasizes Professor Möckel. "In addition to numerous other details in resuscitation practice for adults, children and newborns, the new guidelines also address ethical questions of resuscitation," the Berlin Charité continued. (fp).

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