Termination of Cardiopulmonary Resuscitation in Mountain Rescue: A Scoping Review and ICAR MedCom 2023 Recommendations.

Viktor Lugnet, Miles McDonough, Les Gordon, Mercedes Galindez, Nicolas Mena Reyes, Alison Sheets, Ken Zafren, Peter Paal

Journal: High altitude medicine & biology 2023;24(4):274-286

PMID: 37733297

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Abstract

Lugnet, Viktor, Miles McDonough, Les Gordon, Mercedes Galindez, Nicolas Mena Reyes, Alison Sheets, Ken Zafren, and Peter Paal. Termination of cardiopulmonary resuscitation in mountain rescue: a scoping review and ICAR MedCom 2023 recommendations. . 24:274-286, 2023. In 2012, the International Commission for Mountain Emergency Medicine (ICAR MedCom) published recommendations for termination of cardiopulmonary resuscitation (CPR) in mountain rescue. New developments have necessitated an update. This is the 2023 update for termination of CPR in mountain rescue. For this scoping review, we searched the PubMed and Cochrane libraries, updated the recommendations, and obtained consensus approval within the writing group and the ICAR MedCom. We screened a total of 9,102 articles, of which 120 articles met the inclusion criteria. We developed 17 recommendations graded according to the strength of recommendation and level of evidence. Most of the recommendations from 2012 are still valid. We made minor changes regarding the safety of rescuers and responses to primary or traumatic cardiac arrest. The criteria for termination of CPR remain unchanged. The principal changes include updated recommendations for mechanical chest compression, point of care ultrasound (POCUS), extracorporeal life support (ECLS) for hypothermia, the effects of water temperature in drowning, and the use of burial times in avalanche rescue.

Address: International Commission for Mountain Emergency Medicine (ICAR MedCom), Kloten, Switzerland.; Department of Anesthesiology and Intensive Care, Östersund Hospital, Östersund, Sweden.; Swedish Mountain Guides Association (SBO), Gällivare, Sweden.; Department of Emergency Medicine, UCSF Fresno, Fresno, California, USA.; Langdale Ambleside Mountain Rescue Team, Ambleside, United Kingdom.; Department of Anaesthesia, University Hospitals of Morecambe Bay Trust, Lancaster, United Kingdom.; Department of Internal Medicine, Hospital Zonal Ramón Carrillo, San Carlos de Bariloche, Argentina.; Comisión de Auxilio Club Andino Bariloche, San Carlos de Bariloche, Argentina.; Department of Emergency Medicine, Sótero del Río Hospital, Santiago de Chile, Chile.; Grupo de Rescate Médico en Montaña (GREMM), Santiago, Chile.; Emegency Medicine Section, Pontificia Universidad Católica de Chile, Santiago, Chile.; Emergency Medicine, Boulder Community Health, Boulder, Colorado, USA.; Wilderness Medicine Section, University of Colorado Health Sciences Center, Aurora, Colorado, USA.; Himalayan Rescue Association, Kathmandu, Nepal.; Department of Emergency Medicine, Stanford University Medical Center, Stanford, California, USA.; Alaska Native Medical Center, Anchorage, Alaska, USA.; Department of Anaesthesiology and Intensive Care Medicine, St. John of God Hospital, Paracelsus Medical University, Salzburg, Austria.

DOI: 10.1089/ham.2023.0068