EMS encouraged to comment on draft 2015 CPR and ECC guidelines

ILCOR public comment process asks EMS stakeholders for comments on treatment recommendations


DALLAS, Texas — EMS stakeholders are encouraged to comment on questions and evidence being used for development of the 2015 Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC) guidelines by International Liaison Committee on Resuscitation (ILCOR). Organizations or their members can participate in an online public commenting process that has the objective of providing transparent and rigorous treatment recommendations based on high-quality systematic evidence reviews.

Submit public comments now through Feb. 28. 

"This is an unprecedented and inclusive opportunity for EMS to participate in the development of the guidelines," said Kenny Navarro, content consultant to the American Heart Association. "A significant goal of the process is transparency and inclusiveness."

There are a number of questions already open for comment in the topic areas of ALS, BLS, First Aid, and Peds. For example the question, CPR prior to defibrillation asks, "Among adults and children who are in ventricular fibrillation or pulseless ventricular tachycardia in any setting (P), does a prolonged period of chest compressions before defibrillation (I), compared with a short period of chest compressions before defibrillation (C), change Survival with Favorable neurological/functional outcome at discharge, 30 days, 60 days, 180 days AND/OR 1 year, Survival only at discharge, 30 days, 60 days, 180 days AND/OR 1 year, ROSC, rhythm control (O)?"

The question is followed by a draft statement on the consensus of the science related to the question, which is followed by a draft treatment recommendation.

EMS researchers, field professionals, and medical directors will have the most impact by submitting data that is unknown to the AHA or data AHA does not have access to.

"This is an opportunity for people in EMS to ask if specific data has been considered," said Navarro, who is also an EMS1 columnist

The comment process is part of the effort to finalize systematic evidence evaluations for CPR and ECC in preparation for the Consensus on Science Conference in Dallas, Texas from January 31 to February, 5 2015. Interested individuals can register to receive notifications when content is available for public comment. 

"The AHA recognizes with this and other projects the significant impact EMS has on cardiac arrest survival," said Navarro. "The recommendations must be implementable to be worthwhile. To make the biggest difference in cardiac arrest survival it has to be in improving out-of-hospital cardiac arrest survival."

The process to develop the guidelines follows these general steps:

  • Committees, such as ACLS committee, review issues and questions specific to their expertise
  • A thorough review of all relevant literature is conducted
  • Members of the committee use a scoring system to gauge the quality of the evidence
  • A synopsis of the research is written with committee recommendations for guidelines
  • At the Consensus on Science Conference each committee presents its questions, data summary and recommendations
  • After the conference the entire ECC group has an opportunity to comment on all of the recommendations
  • The final step is the writing committee preparing the guidelines for final editing and approval

"This is a thorough process to develop science-based recommendations," said Navarro.

Guidelines are not changed or maintained based on anecdotal experience of an individual provider.

"The committees make recommendations if data supports change," said Navarro.

ILCOR’s Consensus on Science with Treatment Recommendations (CoSTR) document is scheduled for online publication in the medical journals Circulation and Resuscitation on October 15, 2015. The American Heart Association and European Resuscitation Council, along with other ILCOR member councils, will publish CPR and ECC guidelines in parallel, based in part on the CoSTR science review on the same date.

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