The role of the ARC in the development of resuscitation guidelines

The Australian Resuscitation Council (ARC) is a member organization of ILCOR – the International Liaison Committee on Resuscitation. ILCOR has eight international resuscitation organization members:

ILCOR was established in 1993 with the aim of developing evidence based, scientific resuscitation guidelines for adults, paediatrics and infants.

The objectives of ILCOR are:

  • To provide a forum for discussion and for coordination of all aspects of adult, paediatric and infant cardiopulmonary and cerebral resuscitation worldwide
  • To foster scientific research in areas of resuscitation where there is a lack of data or where there is controversy
  • To disseminate information on training and education in resuscitation
  • To provide a mechanism for collecting, reviewing, updating and sharing international scientific data on
    resuscitation

Every five years, ILCOR host the International Consensus on CPR and ECC Science with Treatment Recommendations (CoSTR) conference. In preparation for this meeting, more than 250 CPR and ECC scientific topics undergo evidence-based, systematic review. At the CoSTR conference, members evaluate and interpret peer reviewed, published scientific evidence for each specific topic. The results of the CoSTR conference provide the scientific basis from which individual resuscitation councils (such as the ARC) develop and revise resuscitation guidelines.

The most recent CoSTR conference was held 2-5 February 2015. ILCOR published an updated CoSTR statement in October 2015. The revised Australian Resuscitation Council guidelines were then published in January 2016

In 2015, the literature was searched and consensus reached on following aspects of newborn resuscitation by members of ILCOR Neonatal Task Force:

  • Optimal assessment of heart rate
  • Delayed cord clamping in preterm infants requiring resuscitation
  • Umbilical cord milking
  • Temperature maintenance in the delivery room and maintaining infant temperature during resuscitation
  • Continuous positive pressure ventilation (CPAP) and intermittent positive pressure ventilation (IPPV)
  • PEEP versus no PEEP
  • Intubation and suctioning in non-vigorous infants born through meconium stained amniotic fluid
  • Oxygen concentration for resuscitating premature newborns
  • Two-thumb versus 2-finger technique for chest compressions
  • Chest compression ratio
  • Oxygen delivery during neonatal CPR
  • Laryngeal mask airway
  • IPPV and use of a device to assess respiratory function
  • Apgar score of 0 at ten minutes or greater
  • Predicting death or disability for newborns >34 weeks’ gestation based on Apgar score and/or absence of breathing
  • Neonatal resuscitation training frequency

Following publication of each updated CoSTR document, it is anticipated that changes will be made to current neonatal resuscitation guidelines. It is noteworthy that the Australian Resuscitation Council state:

“While many countries update their resuscitation guidelines at set times (e.g. every 5 years) the ARC has always adopted a process of ongoing evaluation of the science with updates whenever necessary. Where there is sufficient evidence to warrant an immediate change in a particular resuscitation guideline, the ARC will make the change and not wait for any specific time to occur.”
( Australian Resuscitation Council Newsletter, February, 2009, p.2) .

 

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