RCoA ARIES Talk: Resuscitation Medicine by Jerry Nolan

The RCoA Anaesthesia, Research, Innovation, Education, and Scientific (ARIES) Talks are a series of short, informative and entertaining talks from high profile speakers on areas of relevance to anaesthesia, critical care and pain medicine. Please see our website (https://www.rcoa.ac.uk/rcoa25/ariestalks) for more information.

In the UK, the current rate of survival to hospital discharge after an out-of-hospital cardiac arrest is just 8%. The chain of survival summarises the steps that need to be optimised if this survival rate is to be increased. Bystander CPR increases survival rate by 2–3 times and yet only 55% of cardiac arrest victims in the UK receive bystander CPR. Strategies to improve bystander CPR rates include: use of compression-only CPR, especially if this guided by ambulance dispatchers; mandatory CPR education in schools and before passing a driving test; and use of text messaging to direct volunteer responders to the scene of a cardiac arrest. Wider implementation of public access defibrillation (PAD) using automated external defibrillators (AEDs) will also improve survival rates. It remains unclear which, if any, of the advanced life support interventions improve survival. Two ongoing randomised controlled trials involving most of the ambulances services in the UK are evaluating the optimal advanced airway strategy (igel versus tracheal intubation) and the role of adrenaline during CPR. The treatment a patient receives after return of spontaneous circulation has been achieved will influence the final outcome. Such treatment includes temperature control to prevent fever and careful prognostication to pevent premature withdrawal of life-sustaining therapy.

© Royal College of Anaesthetists 2016

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