Introduce compulsory first aid training at school, adopt mobile technologies and applications that allow the geo-localization of the defibrillators closest to the place of the emergency, ensure that the 112 operators (118) give the person who called them instructions on how to carry out cardiopulmonary resuscitation right away: these are some of the recommendations addressed to European states and health systems contained in the new European guidelines on first aid presented by the Italian resuscitation council (Irc), a scientific society accredited by the Ministry of Health, whose partners contributed to the definition of the new document. The new guidelines, which are updated every 5 years on the basis of scientific evidence relating to epidemiological data and the most effective measures of intervention, were published by the European resuscitation council (ERC), of which IRC is a part, based on the recommendations of the International liaison committee on resuscitation (Ilcor), a worldwide consensus on the treatment of arrest cardiac.
The role of Covid-19
During the pandemic lafraid of getting infected in some way helping those who are victims of a heart attack, by the so-called “lay rescuers”, prompted Ilcor himself to publish in May 2020 new “rules of behavior” to be followed in the event of cardiac arrest in light of the Covid-19 risk to change standard practices with the aim of reducing the risk of the rescuer. The European and Italian councils did the same. “It is therefore clear that in these new 2020 guidelines a reference to the situation introduced by the pandemic should be made – he explains Giuseppe Ristagno, resuscitator and president of Irc who, together with Federico Semeraro e Andrea Scapigliati of the scientific committee, collaborated in the drafting of the European Guidelines -. By now we have to live with Sars-Covid 2 and therefore we also had to give indications for this type of patients “(here the article explaining how).
For every minute that passes, 10% less survival
Every year in Europe it is estimated that over 400,000 people are affected by cardiac arrest. It is estimated that in 33% of cases it is possible to restore the circulation (ROSC, return of spontaneous circulation), but people who survive after hospitalization are 8% of total cases. The percentage of people who witness cardiac arrest and who intervene with life-saving maneuvers (heart massage, ventilations) is on average 58% but it varies a lot in different countries. L’use of defibrillators semiautomatic (AED) takes place only in 28% of cases. «The chance of survival from cardiac arrest decreases by 10% for every minute that passesHe observes Giuseppe Ristagno, president of the Italian Resuscitation Council (IRC). «For this reason, the new guidelines want to lay the foundations for a“ chain of survival ”that includes, also through the direct involvement of citizens, the rapid recognition of cardiac arrest, the call to 112 (118), the initiation of life-saving maneuvers and the use of the defibrillator. Is important that these points, which are based on strong scientific evidence and which have as a fundamental premise the need to train as many people as possible on first aid, have been established within the European guidelines because henceforth they will represent a model for states and health systems to adapt to and on which to build more effective intervention procedures “.
School training and mobile applications
“I’m more than 65,000 cases of cardiac arrest that happen every year in Italy and only a small part takes place in departments equipped to deal with the problem promptly. It is therefore essential that they come involved in the rescue all those in the “chain of survival” ranging from the occasional witness of an illness to the most experienced resuscitator in the treatment of post-cardiac arrest syndrome “he adds Niccolò B.Grieco member of IRC and director of advanced courses at the Critical Care Niguarda training center, which for years has been involved in training and updating medical and nursing staff of the Cardiothoracovascular Department of the Niguarda Hospital in Milan, supported by the De Gasperis Foundation. One of the central points of the European document, published in full in the scientific journal “Resuscitation” and on the website of the European resuscitation council, is precisely the training of citizens, whose involvement is essential to make rescue faster and more effective. Experts ask European states to introduce compulsory first aid training at school and to promote initiatives to train as many citizens as possible. In fact, trained people are able to carry out the necessary operations in case of emergency, waiting for the arrival of help: recognize cardiac arrest, call 112 immediately (118), immediately start life-saving maneuvers (cardiac massage, ventilations), use the semi-automatic defibrillator (AED), when available. Training that can be supported by the use of smartphones, tablets, etc. using apps and social media, as well as feedback devices. As well as tools such as gamification (e.g. virtual and augmented reality, tablet apps that simulate monitors, etc.). If people witnessing cardiac arrest are not trained, it is essential that the 112 (118) operators give them instructions over the phone on what to do.
Geolocation app and awareness campaigns
According to the guidelines the operators they must adopt uniform and effective criteria to quickly understand if the report received concerns a cardiac arrest. In this case the operators must give indications on how to carry out cardiopulmonary resuscitation (if the victim does not respond and in case of absent or irregular breathing). In addition, experts ask European states to adopt technologies and applications for mobile phones that make it possible to alert 112 more quickly (118) and to geo-locate defibrillators available in the area to understand where the one closest to the place of the emergency is. The same technology would allow you to also geo-locate potential rescuers (doctors or people trained in first aid) who are in the area and who, having downloaded the application, have given their willingness to intervene in case of need. “In the new guidelines there is a new chapter called System saving lives, the system to save lives, in which the focus is mainly on the need to have the community intervene as first aid while waiting for the advanced means of aid to arrive ». Through what tools? “For example, the use of apps to locate not only the defibrillators but also the lay rescuers registered in the rescue system, close to the victim, and therefore being able to alert them and send them on the spot in the shortest possible time. It’s still, the creation of records of the Dae (automatic external defibrillators, ed) in order to locate them as easily as possible. Then use artificial intelligence for recognition also through the call. Without forgetting the awareness campaigns such as Kids Save Livesto be encouraged even more “. In this regard, the new Guidelines
The first aid bill (blocked for two years)
These innovations envisaged by the new guidelines have already been included, also on the initiative of the IRC, in the first aid bill which today is awaiting final approval by the Senate Hygiene and Health Commission, having already obtained the yes of the House in 2019 (here the article). Irc will also provide for the translation and adaptation of the Italian version of the guidelines that will be available for free on the association’s website. The IRC experts who collaborated in the definition of the European document are Giuseppe Ristagno (president of IRC), Andrea Scapigliati (past president di IRC), Federico Semeraro (former president and member of the scientific committee of IRC, current president-elect of the European Resuscitation Council), Claudio Sandroni (former member of the scientific committee of IRC), Tommaso Pellis (coordinator of the scientific committee of IRC) e Daniele Trevisanuto (associate professor of pediatrics and IRC member). He also collaborated Tommaso Scquizzato, medical student.
April 27, 2021 (change April 27, 2021 | 19:59)
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