[Again new resuscitation guidelines (2006): justification, costs and potential confusion].
The last revision of the Dutch resuscitation guidelines, a translation of the European Resuscitation Council Guidelines 2005, is based on the recommendations of the International Liaison Committee on Resuscitation (ILCOR). The previous Dutch guidelines were issued in 2002. Most changes are based on laboratory studies and retrospective analyses. The most important changes are: recognizing circulatory arrest on unresponsiveness and abnormal breathing; a new ratio of chest compressions to ventilations i.e. 30:2 instead of 15:2; and following the procedure of checking the airway (A), taking over the circulation (C) and breathing (B). Furthermore in the event of ventricular fibrillation or ventricular tachycardia with no pulsations then one defibrillator shock only is to be given; this is in contrast with the previous application of cycles of 3 shocks. The work and costs of implementation involved in the revision of resuscitation guidelines are tremendous, especially in view of the huge number of laypersons who need to be retrained. Also, frequent changes of guidelines may cause confusion and have a negative effect on the quality of resuscitation. Therefore, it is not evident that the benefits of this revision justify its costs. It would be good to prospectively evaluate the effectiveness and costs of this revision. In the future, these data might help to decide when altered international recommendations should be translated into new Dutch resuscitation guidelines. Alternative strategies should be considered, for example only changing the guidelines for advanced life support.
Meertens
J H J M
JH
Universitair Medisch Centrum Groningen, afd. Intensive Care en Beademing, Postbus 30.001, 9700 RB Groningen. j.h.j.m.meertens@anest.umcg.nl
Monteban-Kooistra
W E
WE
Tulleken
J E
JE
Ligtenberg
J J M
JJ
Zijlstra
J G
JG
D016887:Cardiopulmonary Resuscitation / Q000191:economics* / Q000592:standards*; D003362:Cost-Benefit Analysis; D004632:Emergency Medical Services / Q000379:methods / Q000592:standards*; D005392:First Aid / Q000379:methods / Q000592:standards; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D017410:Practice Guidelines as Topic