Pre-hospital guidelines for CPR-Induced Consciousness (CPRIC): A scoping review

Jack Howard; Carlos Lipscombe; Bronwyn Beovich; Matthew Shepherd; Eystein Grusd; Nikiah G. Nudell; Don Rice; Alexander Olaussen

Resuscitation Plus (Dec 2022)

Pre-hospital guidelines for CPR-Induced Consciousness (CPRIC): A scoping review

Jack Howard,
Carlos Lipscombe,
Bronwyn Beovich,
Matthew Shepherd,
Eystein Grusd,
Nikiah G. Nudell,
Don Rice,
Alexander Olaussen

Affiliations

Jack Howard: Department of Paramedicine, Monash University, Melbourne, Australia; Ambulance Victoria, Melbourne, Victoria, Australia
Carlos Lipscombe: Department of Paramedicine, Monash University, Melbourne, Australia
Bronwyn Beovich: Department of Paramedicine, Monash University, Melbourne, Australia
Matthew Shepherd: Department of Paramedicine, Monash University, Melbourne, Australia; Ambulance Victoria, Melbourne, Victoria, Australia
Eystein Grusd: Department of Health Sciences Gjøvik, Faculty of Medicine and Health Sciences, NTNU – Norwegian University of Science and Technology, Gjøvik, Norway
Nikiah G. Nudell: Trauma Research Department, Medical Center of the Rockies, UCHealth, Loveland, CO, USA; The Paramedic Foundation, Duluth, MN, USA
Don Rice: University of Nebraska Medical Center, Omaha, NE, USA
Alexander Olaussen: Department of Paramedicine, Monash University, Melbourne, Australia; National Trauma Research Institute, The Alfred Hospital, Melbourne, Australia; Centre for Research and Evaluation, Ambulance Victoria, Blackburn North, Victoria, Australia; Corresponding author at: Department of Paramedicine School of Primary and Allied Health Care Faculty of Medicine, Nursing and Health Sciences Monash University Level 2, Building H, Peninsula Campus 47–49 Moorooduc Highway, Frankston, VIC 3199, Australia.

Journal volume & issue: Vol. 12
p. 100335

Abstract

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Background: CPR-Induced Consciousness is an emerging phenomenon with a paucity of consensus guidelines from peak resuscitative bodies. Local prehospital services have had to implement their own CPR-Induced Consciousness guidelines. This scoping review aims to identify prehospital CPR-Induced Consciousness guidelines and compare or contrast their management options. Objective: The purpose of this scoping review is to identify and compare as many prehospital CPR-Induced Consciousness guidelines as feasible, highlight common management trends, and discuss the factors that might impact CPR-Induced Consciousness guidelines and the management trends identified. Design: To search for prehospital CPR-Induced Consciousness guidelines, a bibliographical search of five databases was undertaken (MEDLINE, EMBASE, Cochrane, Scopus, and CINAHL plus). Also included was a grey literature search arm, comprised of four search strategies: 1. Customised Google search, 2. Hand searching of targeted websites, 3. Grey literature databases, 4. Consultation with subject experts. Results: Our search extracted 23 prehospital CPR-Induced Consciousness guidelines and one good practise statement from the International Liaison Committee on Resuscitation. Of the 23 prehospital guidelines available, we identified 20 different ways of treating CPR-Induced Consciousness. Midazolam was the most frequently used drug to treat CPR-Induced Consciousness (14/23, 61%), followed by Ketamine (11/23, 48%) and Fentanyl (9/23, 39%). Conclusion: Prehospital CPR-Induced Consciousness guidelines are both exceptionally uncommon and vary substantially from each other. This has a flow-on effect towards data collection and only serves to continue CPR-Induced Consciousness’s relatively unknown status surrounding both knowledge of, and the effect CPR-Induced Consciousness treatment has on cardiac arrest outcomes.

Published in Resuscitation Plus

ISSN: 2666-5204 (Online)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine
Website: https://www.journals.elsevier.com/resuscitation-plus

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