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Pre-hospital guidelines for CPR-Induced Consciousness (CPRIC): A scoping review
Jack Howard1,2, Carlos Lipscombe1, Bronwyn Beovich1
1Department of Paramedicine, Monash University, Melbourne, Australia.
Resuscitation Plus
|December 5, 2022
Summary
Prehospital guidelines for CPR-Induced Consciousness are rare and inconsistent, leading to varied treatment approaches. This variability impacts data collection and understanding of CPR-Induced Consciousness
Area of Science:
- Emergency Medicine
- Resuscitation Science
- Clinical Guidelines
Background:
- CPR-Induced Consciousness (CIC) is an emerging phenomenon lacking consensus guidelines from major resuscitation organizations.
- Local prehospital services have independently developed their own CIC management protocols.
- Significant variability exists in current prehospital CIC guidelines, necessitating a comparative review.
Purpose of the Study:
- To identify and compare prehospital CPR-Induced Consciousness guidelines.
- To highlight common management trends and variations in treatment options.
- To discuss factors influencing guideline development and observed management trends.
Main Methods:
- A comprehensive bibliographical search was conducted across five major databases (MEDLINE, EMBASE, Cochrane, Scopus, CINAHL plus).
- A grey literature search included customized Google searches, targeted website reviews, grey literature databases, and expert consultations.
- Extracted guidelines were analyzed to identify management strategies and pharmacological interventions.
Main Results:
- The review identified 23 prehospital CPR-Induced Consciousness guidelines and one good practice statement.
- A significant diversity in management was observed, with 20 different treatment approaches identified among the 23 guidelines.
- Midazolam (61%), Ketamine (48%), and Fentanyl (39%) were the most frequently utilized drugs for CIC management.
Conclusions:
- Prehospital CPR-Induced Consciousness guidelines are notably scarce and exhibit substantial inter-guideline variation.
- This lack of standardization hinders consistent data collection and research into CIC and its treatment effects.
- Further research and consensus development are needed to establish standardized CIC management protocols.
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