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From Science to Guidelines: The Future for Resuscitation
Robert W. Neumar
; Department of Emergency Medicine, Hospital of the University of Pennsylvania, Ground Floor, Ravdin Building, 3400 Spruce Street, Philadelphia, PA 19104, USA
Sažetak
The periodic development and publication of treatment guidelines is integral to the field of cardiopulmonary resuscitation
and emergency cardiovascular care. The methods for guideline development have evolved over the past few decades, and
the process itself has become the subject of increasing scientific investigation. An internationally validated tool for assessing
the quality of clinical practice guidelines is The Appraisal of Guidelines for Research and Evaluation (AGREE) instrument.
Applying this tool to the ILCOR 2010 International Consensus on CPR (cardiopulmonary resuscitation) and ECC (emergency
cardiac care) Science with Treatment Recommendations (CoSTR) and the resulting member council guidelines will be a
valuable initial step in evaluating both the process and the product. By doing so, important strengths can be recognized
as well as opportunities for improvement moving forward. Beyond validated tools to assess and improve the quality of the
traditional guidelines process, a critical reassessment of the overall strategy for improving cardiac arrest outcomes is indicated.
From the lay-provider perspective, innovative approaches to facilitate performance of bystander CPR are needed.
This is likely to entail more individualized instructional methods that are titrated to the provider’s capabilities for learning
and performance. What the future might hold for professional providers is a more individualized treatment strategy titrated
to real-time physiologic monitoring with mechanized delivery of therapies guided by real-time computer-aided medical
decision-making. These individualized instructional and treatment strategies could revolutionize our approach to cardiac
arrest resuscitation, and dramatically change how guidelines are developed, implemented and evaluated.
Ključne riječi
cardiac arrest; cardiopulmonary resuscitation; CPR; guidelines
Hrčak ID:
59427
URI
Datum izdavanja:
1.9.2010.
Posjeta: 1.261 *