University of Oklahoma Health Sciences Center

A GUIDE to help patients and families better understand serious illnesses: Mnemonic device provides way to teach learners about advance care planning

Author/s:

Helen James, Warren Harris Lewin

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Advance care planning (ACP) was identified as a priority in the 2006 final report of the Public Information and Awareness Working Group of the Canadian Strategy on Palliative and End-of-Life Care.1 An important component of ACP is patients’ understanding of their prognoses, which might include expectations related to future function, symptoms, and life expectancy.2-4 Without realistic prognostic information, patients are at risk of not engaging in ACP that would otherwise help them gain control over their illnesses, reduce anxiety, and avoid unwanted treatments.2,3,5 Moreover, lack of that information might lead to challenging downstream goals-of-care conversations. In guidance published in 2023 regarding a physician’s duty to discuss a patient’s medical condition and prognosis during a goals-of-care discussion when the physician deems cardiopulmonary resuscitation not to be indicated, the College of Physicians and Surgeons of Ontario highlighted the importance of physicians being able to communicate prognoses skillfully.6

Keywords

advance care planning terminal care end of life care Life expectancy anxiety

2023 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, I

Author/s:

Janet E. Bray, Kee-Chong Ng, Helen G. Liley, Robert Greif, Jestin N. Carlson, Peter T. Morley, an R. Drennan, Michael Smyth, Barnaby R. Scholefield, Gary M. Weiner, Adam Cheng, Therese Djärv, Cristian Abelairas-Gómez, Jason Acworth, Lars W. Andersen, Dianne L. Atkins, David C. Berry, Farhan Bhanji, Joost Bierens, Thomaz Bittencourt Couto, Vere Borra, Bernd W. Böttiger, Richard N. Bradley, Jan Breckwoldt, Pascal Cassan, Wei-Tien Chang, Nathan P. Charlton, Sung Phil Chung, Julie Considine, Daniela T. Costa-Nobre, Keith Couper, Katie N. Dainty, Vihara Dassanayake, Peter G. Davis, Jennifer A. Dawson, Maria Fernanda de Almeida, Allan R. De Caen, Charles D. Deakin, Bridget Dicker, Matthew J. Douma, Kathryn Eastwood, Walid El-Naggar, Jorge G. Fabres, Joe Fawke, ino Fijacko, Judith C. Finn, Gustavo E. Flores, Elizabeth E. Foglia, Fredrik Folke, Elaine Gilfoyle, Craig A. Goolsby, Asger Granfeldt, Anne-Marie Guerguerian, Ruth Guinsburg, Tetsuo Hatanaka, Karen G. Hirsch, Mathias J. Holmberg, et al.

The International Liaison Committee on Resuscitation engages in a continuous review of new, peer-reviewed, published cardiopulmonary resuscitation and first aid science. Draft Consensus on Science With Treatment Recommendations are posted online throughout the year, and this annual summary provides more concise versions of the final Consensus on Science With Treatment Recommendations from all task forces for the year. Topics addressed by systematic reviews this year include resuscitation of cardiac arrest from drowning, extracorporeal cardiopulmonary resuscitation for adults and children, calcium during cardiac arrest, double sequential defibrillation, neuroprognostication after cardiac arrest for adults and children, maintaining normal temperature after preterm birth, heart rate monitoring methods for diagnostics in neonates, detection of exhaled carbon dioxide in neonates, family presence during resuscitation of adults, and a stepwise approach to resuscitation skills training. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the quality of the evidence, using Grading of Recommendations Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence-to-Decision Framework Highlights sections. In addition, the task forces list priority knowledge gaps for further research. Additional topics are addressed with scoping reviews and evidence updates.

Keywords

first aid heart failure neonates

2022 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations

Author/s:

Wyckoff, M. H., Greif, R., Morely, P. T., Ng, K., Olasveengen, T. M., Singletary, E. M., Soar, J., Cheng, A., Drennan, I. R., Liley, H. G., Scholefield, B. R., Smyth, M. A., Welsford, M., Zideman, D. A., Acworth, J., Aickin, R., Andersen, L. W., Atkins, D., Berry, D. C., Bhanji, F., Bierens, J., Borra, V., Böttiger, B. W., Bradley, R. N., Bray, J. E., Breckwoldt, J., Callaway, C. W., Carlson, J. N., Cassan, P., Castrén, M., Chang, W., Charlton, N. P., Chung, S. P., Considine, J., Costa-Nobre, D. T., Couper, K., Couto, T. B., Dainty, K. N., Davis, P. G., Fernanda de Almeida, M., R. de Caen, A., Deakin, C. D., Djärv, T., Donnino, M. W., Douma, M. J., Duff, J. P., Dunne, C. L., Eastwood, K., El-Naggar, W., Fabres, J. G., Fawke, J., Finn, J., Fogila, E. E., Folke, F., Gilfoyle, E., Goolsby, C. A., Granfeldt, A., Guerguerian, A., Guinsburg, R., Hirsch, K. G., Holmberg, M. J., Hosono, S., Hsieh, M., Hsu, C. H., Ikeyama, T., Isayama, T., Johnson, N. J., Kapadia, V. S., Kawakami, M. D., Kim, H., Kleinman, M., Kloeck, D. A., Kudenchuk, P. J., Lagina, A. T., Lauridsen, K. G., Lavonas, E. J., Lee, H. C., Lin, Y. J., Lockey, A. S., Maconochie, I. K., Madar, R. J., Hansen, C. M., Masterson, S., Matsuyama, T., McKinlay, C. J. D., Meyran, D., Morgan, P., Morrison, L. J., Nadkarni, V., Nakwa, F. L., Nation, K. J., Nehme, Z., Nemeth, M., Neumar, R. W., Nicholson, T., Nikolaou, N., Nishiyama, C., Norii, T., Nuthall, G. A., O'Neill, B. J., Ong, Y. G., Orkin, A. M., Paiva, E. F., Parr, M. J., Patocka, C., Pellegrino, J. F., Perkins, G. D., Perlman, J. M., Rabi, Y., Reis, A. G., Reynolds, J. C., Ristagno, G., Rodriguez-Nunez, A., Roehr, C. C., Rüdiger, M., Sakamota, T., Sandroni, C., Sawyer, T. L., Schexnayder, S. M., Schmölzer, G. M., Schnaubelt, S., Semeraro, F., Skrifvars, M. B., Smith, C. M., Sugiura, T., Tijssen, J. A., Trevisanuto, D., Van de Voorde, P., Wang, T., Weiner, G. M., Wyllie, J. P., Yang, C., Yeung, J., Nolan, J. P., Berg, K. M.

This is the sixth annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. This summary addresses the most recently published resuscitation evidence reviewed by International Liaison Committee on Resuscitation Task Force science experts. Topics covered by systematic reviews include cardiopulmonary resuscitation during transport; approach to resuscitation after drowning; passive ventilation; minimizing pauses during cardiopulmonary resuscitation; temperature management after cardiac arrest; use of diagnostic point-of-care ultrasound during cardiac arrest; use of vasopressin and corticosteroids during cardiac arrest; coronary angiography after cardiac arrest; public-access defibrillation devices for children; pediatric early warning systems; maintaining normal temperature immediately after birth; suctioning of amniotic fluid at birth; tactile stimulation for resuscitation immediately after birth; use of continuous positive airway pressure for respiratory distress at term birth; respiratory and heart rate monitoring in the delivery room; supraglottic airway use in neonates; prearrest prediction of in-hospital cardiac arrest mortality; basic life support training for likely rescuers of high-risk populations; effect of resuscitation team training; blended learning for life support training; training and recertification for resuscitation instructors; and recovery position for maintenance of breathing and prevention of cardiac arrest. Members from 6 task forces have assessed, discussed, and debated the quality of the evidence using Grading of Recommendations Assessment, Development, and Evaluation criteria and generated consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence-to-Decision Framework Highlights sections, and priority knowledge gaps for future research are listed.

Keywords

AHA Scientific Statements Advanced life support basic life support cardiac arrest first aid resuscitation

Cardiopulmonary Resuscitation

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