--- Rowley Cottingham
<[log in to unmask]> wrote:
> > Life support courses have been a very powerful
> force
> > in driving up standards of resus in the UK IMHO.
>
>
> That may be so in terms of trauma resuscitation
> (forcing those who weren't interested to follow a
> recipe book) but one of
> the most interesting papers on cardiac resuscitation
> showed that there had been no overall improvement in
> outcome in 30
> years.
Interesting! The introduction of resus training in our
hospital improved the survival to discharge from
cardiac arrest (all causes) from 17% to 28%. Somebody
somewhere must be getting worse. The audit figures
show a clear difference in survival to discharge
between arrests where ALS protocols were followed and
those where they weren't. Most of the problems with
the non ALS arrests were people giving things
(calcium, bicarb) when not indicated. The core message
of ALS is right. Good BLS, good oxygenation, early
defib, look for causes. The problem is some of the
extra nonsense that has been put in. I can see some
point in a basic guide to management of brady and
tachy arrythmias while you are waiting for the cavalry
to arrive (give oxygen is the main message), but the
AF algorithm is a complete waste of space IMHO. As I
have said before, the key to improved
>
> Of course this makes for a major problem for the
> Resus council who need it all to be complicated to
> have something to
> debate, but we need to stay on message with
> resuscitation - most nursing and other paramedical
> staff are absolutely
> terrified of ALS courses, and we need to get away
> from this negativity.
>
I don't see why this is a problem. Nothing wrong with
a simple message.
Fred.
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