#RESUS2020: the perfect demonstration

Rules

Registration

Registration for the ERC Congress is mandatory for the Resuscitation competition participants. In this context participants are considered to be the Team Leader and Team Members. Registration of any live actors or technical crew is not required. There are no additional costs for entry to the competition.

Scope

The competition is restricted to Adult, Paediatric and Newborn Advanced Life Support according to the ERC Guidelines 2015, with a special attention to the ERC COVID-19 Guidelines, available at: https://erc.edu/covid

The aim for each team is to provide a video in which the team performs the perfect advanced life support demonstration.

The video demonstration(s) adjudged to be the best, will considered for use on the ERC Virtual Learning Environment.

Competition rules

There will be three simultaneous competitions run in parallel: Adult, Paediatric and Newborn teams can enter one, two or all three competitions.

A separate video must be submitted for each competition entered. Fully animated / Computer-generated imagery videos will not be accepted.(see appendix A for more information)

The Judges' decision is final, no appeal is possible.

Composition of teams

Teams must be composed of a team leader plus a maximum of four team members (smaller numbers allowed). All team members must be registered doctors, nurses or allied health professionals (e.g. Physiotherapists, Paramedics). Students of Medicine or Nursing may participate if they are regularly participating in resuscitation as part of their clinical practice.

Number of teams / selection

The National Resuscitation Councils will be the first point of contact to select a video from a team to represent them for each of the three scenarios.

Teams must contact a National Resuscitation Council, as only an NRC can submit a video.

How to contact an NRC: https://erc.edu/about/national-resuscitation-councils.

Demonstration scenario

For each category a demonstration scenario manuscript will be available at the RESUSCITATION2020 landing page: https://www.resuscitation2020.eu

Each scenario will use the following format:

  • Scene setting and role allocation (no more than 2 minutes long)
  • Demonstration (no more than 16 minutes long)
    • Clinical assessment of the sick patient using the ABCDE approach
    • Assessment of the collapsed patient and confirmation of cardiac arrest
    • High quality CPR (use of real time feedback device is encouraged); minimising no-flow (hands off) time
    • Early, safe defibrillation (use of start/stop tool is encouraged)
    • Treatment according to ALS/EPALS/NLS algorithm
    • Identification and treatment of reversible cause(s)
    • Confirmation of ROSC and Post Resuscitation Care
  • Post event debriefing, lead by a local Instructor, using “Debrief as a learning conversation” based on Rudolph, J. W et al (2007) Anesthesiology clinics, 25 (2): 361-376. (no more than 7 minutes long)

The entire demonstration should be no longer than 16 minutes, next to 2 minutes for scene setting and an additional 7 minutes for debrief. The total video-time must be no longer than 25 minutes. No marks will be allocated after the allotted time has elapsed.

Scenarios must be run in English.

The level of fidelity for simulations must be equivalent to the ERC ALS / EPALS / NLS courses.

Videos must be submitted by the NRC’s in fully edited form, ready for public viewing by September 30 2020 – 23:59:59.

Equipment

Standard ALS / EPALS / NLS clinical equipment must be used.

No mechanical CPR devices are allowed. The use of real time CPR feedback devices is encouraged.

Competitors are encouraged to contact NRC or local course organisers in order to access Manikins and defibrillators from ERC partners.

Scoring

ERC Science and Education Committees (SEC) will choose the top 5 videos submitted from each of ALS, EPALS and NLS scenarios based on the combination of two elements:

  • The four point system as described by Napier et al., (Resuscitation. 2009 Sep;80(9):1034-8.)
  • Team Emergency Assessment Measurement as described by Cooper et al., (Resuscitation. 2010 Apr;81(4):446-52).

The SEC judges will be independent from the teams to avoid a COI.

The top 5 videos, with the highest scores will be published on the RESUSCITATION2020 virtual platform. NRC Chairs and congress visitors will have an opportunity to watch the videos from the moment the platform will go live.

NRC chairs will be invited to give a score (1 to 5) in each category. Votes can only be made for teams that they are not nationals of e.g. Austrians cannot vote for Austria.

The votes from each section will be weighted accordingly:

  • SEC reviewers (counts for 60%)
  • NRC’s (assigned to the chair) (counts for 40%)

The voting will be closed on 21.10.2020 23:59:59. The 2 videos with the highest scores for each scenario, will be announced and discussed during the corresponding live sessions with SEC co-chairs and with ERC Resuscitation competition coordinators as moderators. All participants from each of the finalists are kindly asked to attend these sessions.

Outfit

Teams are encouraged to participate in their usual work uniform.

Award

  • A trophy
  • Title of "ERC Resuscitation Champions 2020"
  • Free access to the next ERC conference for every team member of the winning team
  • Invitation to defend the title at the next meeting
  • 1 year of full ERC Membership for all team members of the winning team.
  • Mindray BeneHeart AED

Appendix A - Recording of your video

Following video formats are supported:

  • .MOV
  • .MPEG4
  • .MP4
  • .AVI
  • .WMV
  • .MPEGPS
  • .FLV
  • 3GPP
  • WebM
  • DNxHR
  • ProRes
  • CineForm
  • HEVC (h365)

Resolution of the video: 16:9 and at least 720p.
Also following options are suitable for submitting of your video:

  • 2160p: 3840x2160
  • 1440p: 2560x1440
  • 1080p: 1920x1080
  • 720p: 1280x720

The maximum file size can be up to 128GB, but as this will be difficult to forward to your NRC’s, it is recommended to use video compression that limits the file size. A Full HD video (1080p) that is optimally compressed without significant results (for streaming) is usually between 20MB and 30MB per minute, for a 4k video (2160p) you should count about 80-90MB per minute.

The length of your video is outlined in the section ‘Demonstration Scenario’.

On the RESUSCITATION2020 virtual platform, videos will be streamed from YouTube. All videos must therefore also comply with the YouTube community guidelines: https://www.youtube.com/intl/en_be/howyoutubeworks/policies/community-guidelines

Scenarios

Case 1: European paediatric advanced life support

Scene setting and role allocation (no more than 2 minutes long)

Patiënt: Chandler

Age: 5 years

Scenario:
Chandler goes to his room after breakfast. He did not appear for lunch at noon, despite being yelled for. His mum thought he was sleeping a bit extra in the morning but then she went for a look. She finds the boy in bed but unresponsive. Living very close to the hospital, they come running in with the boy in your ED. They alerted via mobile phone so you have a few minutes to prepare.

Demonstration (no longer than 16 minutes)

  • Initial state
    A at risk, no secretions
    B normal auscultation, superficial, slow, no WOB
    C CR 4", pulse a bit weak & slow, pale
    D GCS 4
  • Once monitor attached: RR 6/min, SpO2 in air 89% - HR 68/min narrow, SBP 88 mean 47 mmHg
  • You start proper resuscitation
  • However, despite your actions, five minutes after start the child condition suddenly worsens: SpO2 drops + rhythm becomes slow (<60 BPM) & irregular
  • As a result of your resuscitation 4 minutes later: cappilairy refull (CR) 4"; pulse better; GCS = E2 M4 V2 or intubated; Sp02 95%; HR 96, BPs 95/64
  • Additional information: Chandler suffers from food poisoning after eating contaminated food during breakfast
  • What will be your further actions?
  • How will you organise post resuscitation care?

Post-event debriefing (no longer than 7 minutes)

Case 2: Newborn life support

Scene setting and role allocation (no more than 2 minutes long)

Patiënt: Baby boy Chandler

Age: 41 week term

Scenario:
Home delivery at term, no anticipated problems, thick fresh and old particulate meconium noted at rupture of membranes. There is no time for transfer. You arrive with an ambulance crew, a few minutes before the baby is delivered - covered in thick green meconium. Cord cut and clamped.

Demonstration (no longer than 16 minutes)

  • Initial state
    Tone: floppy baby
    Colour: green/blue
    Breathing: not breathing
    Heart rate: HR very slow
  • You start proper resuscitation
    The chest moves after the 4th inflation breath
    The heart rate (HR) remains very slow despite adequate ventilations
  • After 3 minutes of resuscitation HR increases, there is a first gaps and the chest is hyperexpanded with crepitations
  • What will be your further actions?
  • How will you organise post resuscitation care?

Post-event debriefing (no longer than 7 minutes)

Case 3: Advanced life support

Scene setting and role allocation (no more than 2 minutes long)

Patiënt: Chandler

Age: 35 years

Scenario:
Chandler’s sister is calling an ambulance because he appears to be deteriorating rapidly. She is very concerned. Chandler has no significant medical history. 3 days ago he was diagnosed with community acquired pneumonia by his GP. Managed with oral antibiotics. Team arrives on scene after a four minute drive.

Demonstration (no longer than 16 minutes)

  • Initial state
    A compromised (gurgling / snoring)
    B RR 40 min-1, SpO2 unrecordable, chest – coarse crackles
    C P 140 min-1, BP unrecordable, CRT > 5 sec
    D responsive only to pain
  • However, despite your actions, five minutes after start Chandler's condition suddenly worsens: unconscious – gasping – no output – non-shockable rhythm on monitor
  • When re-evaluating the rhythm during cardio-pulmonary resuscitation, the second rhythm is ventrical fibrillation
  • When re-evaluating the rhythm during cardio-pulmonary resuscitation, the third rhythm is small complex. Tachycardia 120/' sinus. FiO2 92%, BP 74/38, glasgow coma scale remains 3.
  • Additional information: Chandler suffers from a tension pneumothorax
  • What will be your further actions?
  • How will you organise post resuscitation care?

Post-event debriefing (no longer than 7 minutes)

Time Frame

  • 01.09.2020
    Publication of the 3 Resuscitation Competition Scenarios.
    Publication of the Competition Rules for participating team
  • 15.09.2020
    Opening the Resuscitation Competition Submission page for NRC’s.
  • 30.09.2020 - 23:59:59 PM
    Deadline submission videos by the NRC’s for the Resuscitation Competition.
  • 01.10.2020
    All submitted videos will be reviewed by the competition jury.
  • 15.10.2020
    Top 5 videos for each scenario, with the highest quotation will be published on the RESUSCITATION2020 virtual platform for consultation by the registrants and the NRC’s.
    NRC's will be invited to review and give their quotations for each of the videos.
  • 21.10.2020 - 23:59:59 PM
    NRC voting will be closed.
  • RESUSCITATION2020, the Virtual Congress
    The top 2 videos with the highest scores for each scenario, will be discussed during the 60-minute live session with SEC co-chairs and with ERC Resus coordinators as moderators + in the panel at least 1 participant from each of the teams from the corresponding top 2 videos.
  • Winners will be announced during the Closing Ceremony on day 3.