Nihon rinsho. Japanese journal of clinical medicine
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New guidelines for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC) were released in October 2010. The 2010 Guidelines changed a core concept of basic life support from traditional A-B-C (Airway, Breathing, Chest compressions) procedure to C-A-B (Chest compressions, Airway, Breathing) procedure. ⋯ Japanese researchers contributed to the revision of the guidelines from a stage of establishment of a CoSTR(2005 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations) which gives the guidelines theoretical evidences. It is expected for us to promote resuscitation science even in traditional theoretical field but also in the field of education, implementation, and team approach.
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The percutaneous cardiopulmonary support (PCPS) allows maintaining the patient's cardiac and pulmonary status with low cardiac or pulmonary performance due to acute myocardial infarction, pulmonary thromboembolism, postoperative phase of great blood vessels/open heart surgery or percutaneous coronary intervention, and so on. This system consists of a centrifugal pump with its control system, membrane oxygenator, measure devices for blood flow and pressure and a heating system for temperature conditioning of blood. ⋯ However, multicenter study about the utility of ECPR used PCPS for the out-of-hospital cardiac arrest(Study of Advanced life support for Ventricular fibrillation with Extracorporeal circulation in Japan: SAVE-J) is started in April 2007, and it is said that ECPR may improve neurological outcome comparing with that of the conventional CPR by the interim report. Further studies will determine its efficacy and adequate criteria.
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[Immediate Cardiac Life Support (ICLS) course developed by Japanese Association for Acute Medicine].
The Immediate Cardiac Life Support (ICLS) course was developed and launched by Japanese Association for Acute Medicine (JAAM) for resident training, in April 2002. The ICLS course is designed as multi-professional one-day (8 hours) resuscitation course and teaches the essential skills and team dynamics required to manage a patient in cardiac arrest for 10 minutes before the arrival of a cardiovascular specialist. The course consists of skill stations and scenario stations. ⋯ In total, 117,246 candidates attended 6,971 ICLS courses until the end of December 2010. Furthermore, we developed additional course of ICLS to manage stroke, Immediate Stroke Life Support (ISLS). We also describe the development and structure of, and rationale for the ICLS course.
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the last 7 years, more than 300,000 automated external defibrillators(AEDs) installed nationwide in Japan, and at least one AED has placed in 38,634 schools. Therefore, only 0.7% of bystanders used the AEDs(By-AED) in all OHCA cases with th 48 % of ROSC. In recent years, elementary and junior high school student has interested in AED results in each school has at least one AED. ⋯ CPR +AED education should be started in lower grade of elementary school with AED trainer. In conclusion, school CPR programs are extremely important for awareness both in skill and knowledge of CPR among the entire school. Future research is warranted to improve the resuscitation rate by school CPR program.
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Historical Article
[Historical review from beginning of CPR to CPCR (cardiopulmonary resuscitation to cardiopulmonary-cerebral resuscitation)].
This 2010 is a memorial year for CPR, as in 1960 closed chest cardiac massage was first introduced in clinical setting. Jude, Kouwenhoven are the pioneer of this method. However, Prof. ⋯ Brain oriented resuscitation is the target for CPR. Chain of survival is still very useful to treat cardiac arrest. Post cardiac arrest syndrome should be well recognized and hypothermia therapy is introduced as one of the best treatment.