Resuscitation Council UK has updated its guidance on life support and anaphylaxis
The Resuscitation Council UK has recently updated its guidance on resuscitation (January 2021) and anaphylaxis (May 2021).
There are no major changes to basic or advanced life support guidelines in adults.
However, additional information has been included about managing patients with conditions that may affect the delivery of life support, such as obesity. It has also incorporated its COVID-19 guidance from April 2020 to minimise the risk of infection from patients suffering with, or suspected of having, COVID-19, which can be found on the Resuscitation Council UK website.
There is also more information on life support in specific situations, such as an update on managing cardiac arrest in sport (the importance of which has recently received worldwide attention with the cardiac arrest of Danish footballer Christian Eriksen) and at mass casualty incidents.
There have been changes to the advance life support for children, and so people working in environments with children should ensure they are aware of the latest changes.
The full guideline can be found on the Resuscitation Council UK website.
There were more changes to the anaphylaxis guideline. The guideline has been broken into two stages: initial treatment of anaphylaxis and treatment of refractory anaphylaxis.
The initial treatment of anaphylaxis now emphasises that intramuscular adrenaline is the main first-line treatment, and should be repeated if required after five minutes (previous versions had stated five to 15 minutes). IV fluid should also be given where available. The guidelines continue to recommend 500 micrograms as the dose for adults and, since auto-injectors are currently unavailable for this dose, that injections should be given using a syringe and needle.
Antihistamines are now only recommended as a third-line treatment, and corticosteroids are no longer recommended in routine treatment of anaphylaxis.
Refractory anaphylaxis is defined as failure to respond to two doses of adrenaline. Treatment would be by adrenaline infusion, although adrenaline IM bolus every five minutes can be used until IV access can be established.