Modern BLS, dispatch and AED concepts.
Basic Life Support has changed significantly over the last 15 years. Evidence-based changes in recommendations involved compression rate, compression depth and the ratio between compressions and ventilations. There is much evidence that early basic life support increases the probability of survival two- to three-fold. Recognition of a cardiac arrest remains challenging for witness and dispatcher. Educating the public in basic life support and recognition of cardiac arrest are key factors in improving survival of cardiac arrest. The large differences in survival between countries and regions clearly indicate that education and implementation must be high on the agenda in each community. Dispatchers play an increasingly important role in the process, both in rapid recognition of the cardiac arrest as well as giving telephone guidance to those bystanders that had not followed a training in basic life support. Those instructions should only instruct to deliver chest compressions. For those who have been trained in BLS and who are willing to give full CPR, should administer ventilations and chest compressions according to the guidelines. The AED plays a key role in early management of cardiac arrest and can substantially contribute to better survival. Logistics of placement of AEDs and the optimal way to bring AEDs to a victim require much more efforts, especially for victims in residential area's, where the great majority of cases of cardiac arrest occur.
Academic Medical Center, Department of Cardiology, Room F4-228, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. Electronic address: r.w.koster@amc.nl.
Rudolph W
RW
Koster
D000818:Animals; D016887:Cardiopulmonary Resuscitation / Q000193:education / Q000379:methods*; D047548:Defibrillators; D004631:Emergency Medical Service Communication Systems; D019317:Evidence-Based Medicine / Q000379:methods; D006801:Humans; D008020:Life Support Care / Q000379:methods* / Q000639:trends; D058687:Out-of-Hospital Cardiac Arrest / Q000401:mortality / Q000628:therapy*; D017410:Practice Guidelines as Topic; D015996:Survival Rate; D013997:Time Factors
automated external defibrillation; basic life support; cardiac arrest; chest compressions; defibrillation; dispatch; ventilations