Advisory statements of the International Liaison Committee on Resuscitation.
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Biomedical subjects
Publications and source records attributed to R O Cummins.
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These recommendations are presented to enhance the safety and efficacy of AEDs intended for public access. The task force recommends that manufacturers present developmental and validation data on their own devices, emphasizing high sensitivity for shockable rhythms and high specificity for nonshockable rhythms. Alternative defibrillation waveforms may reduce energy requirements, reducing the size and weight of the device. The highest levels of safety for public access defibrillation are needed. Safe and effective use of AEDs that are widely available and easily handled by nonmedical personnel has the potential to dramatically increase survival from cardiac arrest.
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Researchers face a number of constraints to human resuscitation research. To overcome these constraints we must first recognize them and then work to develop solutions. The constraints include history, which tends to create a standard-of-care aura around practices that have not been confirmed by valid research. Until recently, we have lacked uniform models, nomenclature, and definitions for resuscitation research, though the "Utstein style" movement is doing much to overcome this particular constraint. We have to face several barriers that emerge from the very nature of human cardiopulmonary emergencies, such as its relative rarity, the multifactorial causes and outcomes, and its sudden, unpredictable nature. Good research requires appropriate levels of funding. Currently, human resuscitation research does not rank high on the funding priority list of our major funding agencies. This requires an organized approach to generate funding support and requires strong, coherent research proposals. Despite these constraints, we face many opportunities to improve survival from cardiopulmonary emergencies.
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The present trend in managed care has meant downsizing expectations concerning the availability of support for resuscitation research. This trend applies to funding possibilities from industry, governmental agencies, and nongovernmental agencies (Table 1). There will be increasing barriers to making innovations. Truth, science, and good patient care alone will not make potential donors give grants. Investigators must also understand the potential donors' expectations and be persuasive. "Delight your donor". Industries' concerns include intellectual property rights and publications. The National Institutes of Health, recently favoring molecular biology over lifesaving therapies or integrated physiologic research, is an anomaly. The current peer review system propagates itself without having advocates for resuscitation research. This system has become a self-fulfilling prophecy. The American Heart Association is only recently, after 30 yrs of educational activities concerning cardiopulmonary resuscitation, considering putting some basic research money into resuscitation research. In university hospitals, where clinical departments have made significant contributions to innovative, clinically relevant life-support research, funded with incomes from patient care, the sky is beginning to fall. Resuscitation researchers need persuasive advocates with clout and hard data to convince funding agencies to give support to multilevel research and development in areas of pathophysiology and reversibility of terminal states and clinical death--to give these topics a higher priority than is currently available.