Pre-hospital guidelines for CPR-Induced Consciousness (CPRIC): A scoping review

Howard, Jack B.; Lipscombe, Carlos; Beovich, Bronwyn; Shepherd, Matthew; Grusd, Eystein; Nudell, Nikiah G.; Rice, Don S.; Olaussen, Alexander

doi:10.1016/j.resplu.2022.100335

Cited by 9 publications

(12 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…2,3,12 A large treatment variation exists between published guidelines, making comparisons between outcomes or management difficult, which further exacerbates the ability to gather evidence or data on the subject. 4 One recent observational study suggests that the use of sedatives, like midazolam, is associated with negative outcomes compared to no treatment at all. 1 Some of the variation in treatment lies in the distinct lack of evidence available on the subject.…”

Section: Introductionmentioning

confidence: 99%

“…13 ILCOR highlights the lack of evidence to produce a consensus guideline, stating to use local sedative protocols until further research can be completed. 4,14 Improved prehospital systems and CPR advancements will result in increased rates of CPR-Induced Consciousness presentations. 1,15 In the absence of clinical guidelines, prehospital services with more frequent presentations of CPR-Induced Consciousness will develop different treatment protocols resulting in even more varied methods of treatment, making it even harder to collate outcome data and evaluate evidence-based guidelines.…”

Section: Introductionmentioning

confidence: 99%

“…1,2,3 A recent scoping review of prehospital CPR-Induced Consciousness guidelines found almost 70% of the available guidelines had been published since 2020. 4 From the published data available CPR-Induced Consciousness is associated with younger, healthier, more viable patients who have increased Return of Spontaneous Circulation (ROSC) rates. 5,6,7 CPR-Induced Consciousness occurrence in the prehospital field causes technical and ethical challenges for clinicians both physically and mentally.…”

Section: Introductionmentioning

confidence: 99%

“…International resuscitation bodies are yet to produce guidelines on managing CPR-Induced Consciousness for prehospital clinicians. 4 To date, the only resuscitation body to have recognized CPR-Induced Consciousness within their guidelines is the International Liaison Committee on Resuscitation (ILCOR). 13 ILCOR highlights the lack of evidence to produce a consensus guideline, stating to use local sedative protocols until further research can be completed.…”

Section: Introductionmentioning

confidence: 99%

“…13 ILCOR highlights the lack of evidence to produce a consensus guideline, stating to use local sedative protocols until further research can be completed. 4,14…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Development of an international prehospital CPR-induced consciousness guideline: A Delphi study

Howard,

Grusd,

Rice

et al. 2023

Paramedicine

Self Cite

View full text Add to dashboard Cite

Background Improved prehospital systems are contributing to increased presentations of CPR-Induced Consciousness (CPRIC). Data registries do not report CPRIC presentations and thus continued lack of evidence exists, causing a significant variation of prehospital CPRIC management guidelines. The result is variation in recognizing and managing CPRIC. Steps are needed to improve knowledge of CPRIC and model evidence-based guidelines. Objective An international panel of experts was recruited to create CPRIC definitions, guidelines, and a reporting framework which can be used for reporting purposes. Methods A Delphi methodology was used to gain consensus, defined as ≥70% agreement rate, on three domains or areas of interest: Definition, management guideline and data reporting. Participants were invited from the author's professional organizations, as well as social media outlets to recruit as many international clinicians as possible. The study administered four rounds of online surveys. Each round had multiple consensus statements for participants to respond to. Results Eighty-two percent of panelists reported seeing or managing CPRIC suggesting either improved awareness or increased exposure. Consensus was achieved in all three domains. There was agreement on a clear definition of CPRIC. The panel developed two subgroups of CPRIC; interfering and non-interfering CPRIC. Ketamine was the preferred choice to treat CPRIC. Panelists overwhelmingly felt CPRIC needed to be included into the Utstein guidelines. Conclusions This study successfully created definitions of CPRIC, management guidelines, and a data reporting framework. Using this study as a building block, the study team hopes stronger, evidence-based guidelines can now be researched and published.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…13 ILCOR highlights the lack of evidence to produce a consensus guideline, stating to use local sedative protocols until further research can be completed. 4,14…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations