Through a set of systematic reviews and updates of the scientific evidence issued by the International Liaison Committee on Resuscitation (ILCOR), the 2021 Guidelines of the European Resuscitation Council present the most up-to-date recommendations for the practice of resuscitation in Europe.
These Guidelines cover the epidemiology of cardiac arrest, the role of systems in saving lives, basic and advanced life support, resuscitation in special circumstances, post-resuscitation care, first aid, neonatal and pediatric life support, ethics and health issues. training. From the Lifeguard Project we will briefly comment on the new SVB 2021 algorithm
Important points to keep in mind in Basic Life Support
- Early recognition of cardiac arrest.
- Alert the emergency services.
- Immediately begin CPR.
- Get an automated external defibrillator (AED).
- Learn cardiopulmonary resuscitation.
Few changes are found in Basic Life Support, they simply make the set of these maneuvers easier, as a point to note is that the cycle of compressions plus insufflations follow within the protocol according to the ERC
Updated algorithm 2021 recommendations
How to recognize a cardiac arrest
We will recognize CRP in an unconscious person who is not breathing normally, noisy breaths are not effective breaths. Hence the importance of emphasizing that agonizing or difficult breathing is a symptom of a possible cardiac arrest.
Make the call or alert the emergency services, if we are alone and do not have a telephone, we must leave the victim alone and call and then begin cardiopulmonary resuscitation.
No change at this point, since the easier it is for the lay staff, the better the performance will be, we remind you of the most important points:
Begin as soon as possible with compressions in the center of the victim's chest, compressing it about 5-6 cm and at a rate of between 100 and 120 compressions per minute, if possible reducing the number of interruptions and always on a hard surface.
It is as important that the chest is compressed by those centimeters as it is allowed to rise to allow the massage to be as effective as possible.
A terrain that always raises doubts, but rescue breaths (mouth-to-mouth) follow within the protocols, 2 inflations are given every 30 compressions.
In case of not wanting or not knowing how to do the ventilations, we will perform chest compressions all the time and without stopping until the arrival of the emergency services.
Automated External Defibrillation
The location of an AED (Automated External Defibrillator) must be indicated with clear and visible signage.
Nothing new about the use of the defibrillator in the current recommendations, we leave you the most noteworthy points:
Turn on the AED and listen to the indications of the device, in case the AED is ready to deliver the shock, do not delay it by continuing to perform cardiac massage, if we are more than one rescuer when placing the electrodes we will try not to stop doing the massage while stick to the victim's naked body. If shock occurs, look for signs of life, quickly initiate chest compressions.
Especially delicate point for non-health personnel who, not being used to these situations, could put us at risk. We give you some recommendations:
Activate the PAS protocol (protect, warn and help) protecting ourselves first and ensuring that the situation is safe for everyone. If when evaluating, we suspect that he may be in a standstill, we will initiate CPR without fear of causing injury to the victim. Do not be afraid of discharge as serious damage from accidental discharge is very low. Even as we have already indicated above, if we pay attention to the indications of the defibrillator, we should not have any surprise.
We cannot forget that in times of pandemic the risks of contagion from Covid-19 are the order of the day. Current recommendations tell us that in the event of a cardiac arrest if you do not have a mask, we will put a surgical mask or cloth over your mouth to perform chest compressions.
Management of Foreign Body Airway Obstruction (OVACE)
We can find ourselves in two situations:
- Patient with incomplete obstruction: can speak and / or cough. The indication is to encourage coughing.
- Patient with complete obstruction: cannot speak, cough, or make sounds.
In case of complete obstruction, we will start with 5 interscapular blows alternating with 5 abdominal compressions or the so-called Heimlich maneuver.
Continue alternating these maneuvers until the obstruction is resolved or the patient is unconscious and falls to the ground, that will be the moment to quickly initiate CPR.
With regard to anti-choking devices (Lifevac and Dechoker) there are no recommendations either for or against.