Healthcare experts from around the globe are in Dallas for a once-every-five-years gathering to evaluate the latest questions and scientific research about CPR and emergency cardiovascular care, or ECC. The results will lead to recommendations that form how much of the world trains its medical workers and treats its patients.
The International Consensus on CPR and ECC Science Conference that begins Saturday and runs through Thursday will host nearly 250 medical professionals, resuscitation researchers and educators and deal with over 150 different topics — everything from chest compression rates during CPR and the timing of drug delivery to aspirin for chest pain and treatment for babies.
“What is most impressive about it is the process,” said Robert Neumar, M.D., Ph.D., chair of the American Heart Association’s Emergency Cardiovascular Care Committee. He is also professor and chair of the University of Michigan Health System’s Department of Emergency Medicine.
“We are able to have this format where we can bring experts around the world to come to consensus on the globe’s literature,” Neumar said. “Cardiac arrest is a global disease, and there’s tremendous value to have people from different countries and cultures come together. It’s not just the science but how it impacts how you treat patients in places like Japan, South America and the United States. Even if evidence is the same … how you treat patients might be different based on the resources available.”
The last major conference, in 2010, caused a shift in how CPR was taught or performed. It went from a focus on ABC — airway, breathing and chest compressions — to CAB — chest compressions, airway and breathing. There is no clear indication of what will emerge this time around, Neumar said.
“There has been a lot of new science in the past five years and a lot of that science refines our recommendations more than changes them,” he said. The consensus process is part of the work of the International Liaison Committee on Resuscitation, formed in 1992 to provide a forum for major resuscitation organizations worldwide.
Jose Maria Ferrer, M.D., AHA’s science and medicine advisor for Emergency Cardiovascular Care, said it was the result of doctors and scientists concluding that “you shouldn’t need a passport to do CPR,” that there should be basic universal guidelines.
Currently, ILCOR comprises the American Heart Association, the European Resuscitation Council, the Heart and Stroke Foundation of Canada, the Australian and New Zealand Committee on Resuscitation, the Resuscitation Council of Southern Africa, the InterAmerican Heart Foundation and the Resuscitation Council of Asia. ILCOR has seven task forces, dealing with various disciplines: basic and advanced life support, resuscitation in children and newborns, first aid, acute coronary syndrome and resuscitation education.
These review the most recent peer-reviewed studies and investigations on resuscitation and emergency medicine from around the world. The recommendations hashed out this week, and from public comment open throughout February, are scheduled for online publication in the medical journals Circulation and Resuscitation on Oct. 15. ILCOR’s member councils will also create their own guidelines based on this, including the AHA 2015 Guidelines for CPR and ECC, which will also be released on Oct. 15.
The public comment is being hosted through a system called SEERS, Scientific Evidence Evaluation and Review System, that allows anyone to see draft recommendations, source materials and give feedback in an enhanced, forum-style format. Anyone giving feedback, from the public to representatives from the drug and device industry, is required to identify themselves and give their background and affiliations, so everyone can see potential conflicts.
The idea, Ferrer said, is not only to make the entire process more transparent, but also to allow more continuous conversation that deals more proactively with ongoing research during the five years between conferences.
“At the end of the day, both AHA and ILCOR are about moving the needle,” he said, “about improving survival from cardiac arrest and other emergency cardiovascular conditions.”