Leo Bossaert

A serious threat to Evidence Based Resuscitation within the European Union

Fritz Sterz *, Ernst A. Singer , Bernd Bottiger , Douglas Chamberlain , Peter Baskett , Leo Bossaert , Petter Steen g a Department of Emergency Medicine, University of Vienna Medical School, Austria b Institute of Pharmacology, University of Vienna Medical School, Austria c Department of Anaesthesiology, University of Heidelberg, 110 D-69120, Heidelberg, Germany d 25 Woodland Drive Hove, BN3 6DH, United Kingdom e Stanton Court, Stanton St Quintin, Chippenham, Wiltshire, SN14 6DQ, United Kingdom f European Resuscitation Council, Universiteitsplein 1, PO Box 113, B-2610 Antwerpen, Belgium g Institute for Experimental Medical Research, Ulleval University Hospital, Kirevn 166, N-0407, Oslo, Norway

EuReCa ONE-27 Nations, ONE Europe, ONE Registry: a prospective observational analysis over one month in 27 resuscitation registries in Europe - the EuReCa ONE study protocol

BackgroundThere is substantial variation in the incidence, likelihood of attempted resuscitation and outcomes from out-of-hospital cardiac arrest (OHCA) across Europe. A European, multi-centre study provides the opportunity to uncover differences throughout Europe and may help find explanations for these differences. Results may also have potential to support the development of quality benchmarking between European Emergency Medical Services (EMS).Methods/DesignThis prospective European study involves 27 different countries. It provides a common Utstein-based dataset, data collection tool and a common data collection period for all participants.Study research questions will address the following: OHCA incidence in different European regions; incidence of cardiopulmonary resuscitation (CPR); initial presenting rhythm in patients where bystanders or EMS start CPR or any other resuscitation intervention; proportion of patients with any return of spontaneous circulation (ROSC); patient status at the end of pre-hospital treatment i.e. ROSC at handover to hospital, ongoing CPR, dead; proportion of patients still alive 30 days after OHCA; proportion of patients discharged alive from hospital.All patients who suffered an OHCA during October 2014 and were attended and/or treated by an EMS and documented in one of the participating registries will be included in the study. Each National Coordinator is responsible for data collection and quality control in his/her country and will transfer unprocessed anonymised data via secure electronic transfer.Descriptive analysis will be performed at European, national and registry level. For endpoints like ROSC, admission or survival, multivariate logistic regression analysis will be performed.DiscussionDocumenting differences in epidemiology, treatment and outcome in out-of-hospital cardiac arrest throughout Europe is a first step in finding explanations for these differences. Study results might also support the development of quality benchmarking between Emergency Medical Services (EMS) which in turn will facilitate initiatives to improve OHCA outcome in Europe.Trial registrationThe EuReCa ONE Study is registered by ClinicalTrials.gov National CoordinatorT02236819).

AED in Europe : report on a survey

INTRODUCTION Based on the strategies for community defibrillation defined by a joint policy conference of ESC and ERC, we have conducted a survey to identify the current status of AED programmes in Europe. METHODS All registered visitors to the website of the ERC were contacted by e-mail and invited to participate in a web-based survey. RESULTS Of the 983 usable responses, 899 came from 36 European countries, representing a total of 748 million inhabitants. In 11 countries AED use by non-physicians has been implemented partially. All but 3 countries reported that first-tier ambulances are equipped with defibrillators. In 13 countries everybody is allowed to use an AED and in 11 countries anybody who has been trained. In 14 countries there are a few community responder programmes, in 14 countries there are hardly any, and in 7 countries there are none. Thirteen countries have implemented a few on-site responder programmes; in 16 countries there are hardly any such programmes, and in 7 countries none. Programmes for home responders can hardly be found in 19 countries; in-hospital programmes exist in 7 countries nearly everywhere. Only 1 country reported that epidemiologic and/or economic evaluations are carried out nearly everywhere when planning AED programmes. Nationwide registries to collect data from resuscitation attempts have been set up in 4 countries. In 27 countries inventories for AEDs can be found here and there. CONCLUSION Much has been achieved concerning the provision and use of AEDs in Europe, but there is still a long way to go.

Perspectiva sobre las guías de reanimación de 2010 del European Resuscitation Council: la necesidad de hacerlo mejor

Although several investigators have observed that the incidence of cardiac arrest is diminishing, the overall survival remains disappointingly low at 10% or less. Cardiovascular disease remains responsible for 41% of all deaths in Europe. Cardiac arrest is usually the catastrophic first symptom of a heart attack. Recently, several organizations have managed to improve their chain of survival so that up to 61% of cardiac arrest victims presenting with ventricular fibrillation (VF) or ventricular tachycardia (VT) can be resuscitated successfully, but systematic reviews have demonstrated that outcome differs dramatically between regions: published survival figures range between 6% and 31% for all cardiac arrests and between 8% and 43% for VF/VT arrests. This massive difference in survival reflects the so-called formula of survival, ‘‘science + education + implementation = survival’’: survival from cardiac arrest will only increase by improving our scientific understanding of the cardiac arrestresuscitation complex, by improving development and training of evidence based guidelines, and by improving implementation of these guidelines in all steps of the clinical practice of emergency cardiovascular care (ECC).

Kids Save Lives – ERC‑Positionspapier zur Schülerausbildung in Wiederbelebung

Der plotzliche prahospitale Herzkreislaufstillstand mit erfolgloser kardiopulmonaler Reanimation (CPR) ist die dritthaufigste Todesursache in zivilisierten Landern. Die Uberlebensraten der Betroffenen liegen zwischen 2 % und 10 %. In Europa und in den USA sterben mehr als 700.000 Menschen pro Jahr an den Folgen des plotzlichen Herzkreislaufstillstands. Das Gleiche gilt auch fur andere Industrienationen weltweit. Viele dieser Leben konnten gerettet werden, wenn mehr Laien umgehend mit Wiederbelebungsmasnahmen beginnen wurden. Die Zeit bis zum Eintreffen des Rettungsdienstes kann einige (6–12) Minuten und auch langer dauern. Bedauerlicherweise beginnt das Gehirn nach einem Herzkreislaufstillstand bereits nach nur 3–5 min ohne Blutfluss unwiederbringlich zu sterben. Bis zu 70 % der plotzlichen Herzkreislaufstillstande sind von Familienmitgliedern, Freunden und umstehenden Laien bezeugt. So kann das potenziell todliche Intervall bis zum Eintreffen des...