The annual update that builds on the success of the past courses
4th CPR - Thinking Beyond The Manual!
A unique one day course on the complexities of the cardiac arrest and post resuscitation
decision-making process faced by the “hands on clinician”,
organised by Infomed Research and Training, on Thursday 8 October 2009
at the Russell Square Conference Centre, 10-12 Russell Square, London

Are you…

• A doctor working in Emergency, Acute, General, Intensive Care or Cardiovascular Medicine?

• A ‘hands on clinician’ involved in the practice of ALS?

• A Resuscitation Trainer?

• Sometimes hesitant about whom should go to ITU?

• Wondering about what futility really is?

• In need of objective guidance on treatment withdrawal?

• Asking about induced hypothermia?

…if so, this Course is for you!

About the Course…

• Lectures from a multi-speciality Faculty concentrating on those multidisciplinary issues that reflect the patient pathway

• Lectures are didactic, focus on the ‘how to do it’ through problems and solutions, comments and interaction

• A serious attempt to strike the right balance between personal justice towards the individual patient and distributive justice towards the community at large

• A look in depth at the same clinical questions asked daily in our hospitals but answered differently from one institution to the next – why is this so?

• Focuses on the essential adjunctive knowledge for Resuscitation Training Officers

Programme:

08.40 – 09.20 Registration
09.20 – 09.30 Introduction and welcome

09.30 – 10.15

Practical ALS Overview: What’s New and Why?

Dr Andy Lockey, Clinical Director in Emergency Medicine, Calderdale and Huddersfield NHS Foundation Trust, and Executive Member and Chair of ALS Course Sub-Committee, Resuscitation Council (UK)

• Any changes in the guidelines?

• What is wrong with vasopressin?

• Why and when massage before shock?

• Should we compress whilst charging?

• Impedance valve
• ETCO2
• ACD’s
• Pneumatic compression device
• Costs and benefits

11.00 – 11.30 Tea and coffee

11.30 – 12.15
Basic Life Support – Does Quality Matter?
Dr Tony Handley, Consultant Physician and Cardiologist, and Executive Member
and Chair of BLS/AED Sub-Committee, Resuscitation Council (UK)

• Why do so few people survive cardiac arrest?
• Does the quality of BLS affect outcome?
• Compression only CPR?
• Can we make BLS more effective?

12.15 – 12.45
Resuscitation Officer’s Pearls
Resuscitation Officer, Name TBC

• What are the common things that go wrong?
• The fifth T and fifth H!
• What we should audit and what can we learn?
• The Utstein template – uses and problems

12.45 – 13.45 Lunch

13.45 – 14.30
Prognostication after Cardiac Arrest in the Wards and the ED
Dr Gavin Perkins, Associate Clinical Professor Critical Care and Resuscitation, Warwick Medical School
and Heart of England NHS Trust, and Executive Member, Resuscitation Council (UK)

• Prediction of outcome in comatose survivors post successful ALS –– circumstances surrounding CPR; cardiovascular criteria for withdrawing; neurological examination; how much adrenaline per minute is futile?; biochemical markers; radiological studies; what level of metabolic acidosis is futile?
• Knowing when to stop
• Ethics, family, colleagues
• Decision to go upstairs

14.30 – 15.15 VISITING LECTURER
Induced Hypothermia – How, When and Why
Dr Kees H Polderman, Associate Professor in Intensive Care Medicine,
University Medical Center Utrecht, The Netherlands

• To cool or not to cool and how long to cool down?
• Evidence for in hospital arrests: is there any?
• Evidence for out of hospital arrests
• VF/VT yes PEA/ASYSTOLE no: is it really that simple?
• Cooling and re-warming: side-effects, problems and solutions

15.15 – 15.30 Tea and Coffee

15.30 – 16.15
Resuscitation where the Guidelines Don’t Apply
Dr Tim Harris, Consultant in Emergency Medicine, Royal London Hospital

• When to consider blind thrombolysis?
• Toxicology
• Electrocution
• Drowning
• Traumatic cardiac arrest

16.15 – 17.15 VISITING LECTURER
Difficult Decisions in the Post-Primary CPR Patient in ICU
Dr Kees H Polderman, Associate Professor in Intensive Care Medicine,
University Medical Center Utrecht, The Netherlands

• Who should not be admitted to ITU? What criteria to use?
• Neurological and cardiovascular criteria to withdraw/withhold treatment in ITU?
• Early biochemical and neurological prognostic markers
• Neurological assessment: is it possible?
• Use of early ECHO/CT: who and when?
• Should age be a criterion for (withholding) ICU treatment?