Full Erc 2010 Guidelines

Electrical therapies: automated external defibrillators,
defibrillation, cardioversion and pacing5,14
The most important changes in the 2010 ERC Guidelines for
electrical therapies include:
• Theimportance of early, uninterrupted chest compressions is
emphasised throughout these guidelines.
• Much greater emphasis on minimising the duration of the preshock
and post-shock pauses; thecontinuation of compressions
during charging of the defibrillator is recommended.
• Emphasis on resumption of chest compressions following defibrillation;
in combination with continuation ofcompressions
during defibrillator charging, the delivery of defibrillation should
be achievable with an interruption in chest compressions of no
more than 5 s.
• The safety of the rescuer remains paramount,but there is recognition
in these guidelines that the risk of harm to a rescuer from
a defibrillator is very small, particularly if the rescuer is wearing
gloves. The focus is now on a rapid safetycheck to minimise the
pre-shock pause.
• When treating out-of-hospital cardiac arrest, emergency medical
services (EMS) personnel should provide good-quality CPR while
a defibrillator isretrieved, applied and charged, but routine delivery
of a specified period of CPR (e.g., 2 or 3 min) before rhythm
analysis and a shock is delivered is no longer recommended.
For some emergency medicalservices that have already fully
implemented a specified period of chest compressions before
defibrillation, given the lack of convincing data either supporting
or refuting this strategy, it isreasonable for them to continue
this practice.
• The use of up to three-stacked shocks may be considered if
VF/VT occurs during cardiac catheterisation or in the early postoperative
period followingcardiac surgery. This three-shock
strategy may also be considered for an initial, witnessed VF/VT
cardiac arrest when the patient is already connected to a manual
defibrillator.
• Encouragement of...