Part 1: Introduction to the International Guidelines 2000 for CPR and ECC

International Guidelines This publication presents the conclusions of the International Guidelines 2000 Conference on Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC). We have achieved a long-term goal: to create valid, widely accepted international resuscitation guidelines based on international science and produced by international resuscitation experts. The Guidelines 2000 Conference was more than an update of previous recommendations for CPR and ECC published by the AHA (in 1974,1 1980,2 1986,3 and 19924) and similar recommendations published by the European Resuscitation Council (in 1992,5 1996,6 and 19987). The Guidelines 2000 Conference was the world’s first international conference assembled specifically to produce international resuscitation guidelines. At all stages of planning, coordination, and implementation, conference planners sought and achieved active involvement of individuals and councils outside the United States. Important new recommendations were developed either at the 2000 conference or during the post-conference period of writing, review, and rewriting. Positive new additions had to pass our rigorous evidence-based review. Revisions of or deletions from existing guidelines occurred for any of 3 reasons: (1) lack of evidence to confirm effectiveness, (2) additional evidence to suggest harm or ineffectiveness, or (3) evidence that superior therapies have become available. We have also produced the International Consensus on Science: Proceedings of the 2000 Guidelines Conference on CPR and ECC. The proceedings are detailed articles that recount the discussions and debates at the 2 conferences. The International Guidelines 2000 represent a consensus of experts from a variety of countries, cultures, and disciplines. The conference experts, participants, and resuscitation councils do not dictate or impose these recommendations on any person, Emergency Medical Services (EMS) system, hospital, healthcare facility, community, state, country, or resuscitation council. The majority of the therapeutic interventions in the guidelines are “acts of medical practice.” Most resuscitation personnel in the conference countries can use these interventions on a human being only when authorized by the “proper” local, state, or national agencies. Enforcement, authorization, and certification are medicolegal concepts with no role to play in the science-based International Guidelines 2000. The recommendations of the Guidelines 2000 Conference confirm safety and effectiveness for many approaches, acknowledge ineffectiveness for others, and introduce new treatments that have survived intensive evidence-based evaluation. These new recommendations do not imply that care using past guidelines is either unsafe or ineffective. The conference participants consider these new guidelines to be the most effective and easily teachable guidelines that current knowledge, research, and experience can provide.