European resuscitation council should have gone further to promote cardiopulmonary resuscitation awareness
During the second-half of 2009, we collected data on a small series of six out-of-hospital witnessed cardiac arrest patients who were successfully revived in the field and, subsequently, were admitted to the intensive care unit of a district general hospital. Our analysis revealed some very important practical findings.1 We noted that five out of the six patients had suffered from massive pulmonary aspiration of gastric contents during the procedure of cardiopulmonary resuscitation. That complication compounded the morbidity of the sufferers. As a result, we advocated the idea of ‘airway protection’ during cardiopulmonary resuscitation at that time.1 We are aware that the active management of the airway is now duly emphasised in the current advanced cardiac life support guidelines, although such an emphasis was completely missing from such guidelines in 2009. Furthermore, we highlighted that cardiopulmonary resuscitation outcomes were poor in the individuals who suffered from cardiac arrest in their homes compared with the ones who faced that calamity in public places. One obvious reason for this difference was that the individuals who suffered from cardiac arrest in their homes did not receive immediate cardiopulmonary resuscitation in the form of basic life support because their family members were unaware of the procedure,2 whereas in public places, at least one or more passersby were aware of how to perform cardiopulmonary resuscitation.2 Similarly, it was evident from the data that all patients in this series had a history of cardiac disease and were under the care of medical professionals.2 In that situation, we proposed that healthcare providers caring for cardiac patients should undertake the responsibility of enhancing awareness and knowledge of basic life support techniques among the family members of patients suffering from cardiac disease.2 In its 2015 resuscitation guidelines,3 although the European Resuscitation Council emphasised the education of school children in cardiopulmonary resuscitation to produce a future generation of effective resuscitators, the European Resuscitation Council has, unfortunately, not gone far enough in this direction by advocating that healthcare providers support this project by educating families about basic life support in a focused and precise manner.