The “Highlights of the 2015-2020 American Heart Association Guidelines for CPR and ECC “

Highlights of the 2015 American Heart Association 

Guidelines Update for CPR and EEC 2015

Guidelines Highlights

The 2015 Guidelines Highlights provides a summary by topic of the 2015 changes to resuscitation guidelines.

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Classification and staging of diabetic neuropathy

Class I Subclinical Neuropathy*

Abnormal electrodiagnostic tests (EDX)

Decreased nerve conduction velocity

Decreased amplitude of evoked muscle or nerve action potential

Abnormal quantitative sensory testing (QST)

Vibratory/tactile

Thermal warming/cooling

Other

Abnormal autonomic function tests (AFT)

Diminished sinus arrhythmia (beat-to-beat heart rate variation)

Diminished sudomotor function

Increased pupillary latency

Class II Clinical Neuropathy

Diffuse neuropathy

Distal symmetric sensorimotor polyneuropathy

Primarily small fiber neuropathy

Primarily large fiber neuropathy

Mixed

Autonomic neuropathy

Abnormal pupillary function

Sudomotor dysfunction

Genitourinary autonomic neuropathy

Bladder dysfunction

Sexual dysfunction

Gastrointestinal autonomic neuropathy

Gastric atony

Gall bladder atony

Diabetic diarrhea

Hypoglycemic unawareness (adrenal medullary neuropathy)

Cardiovascular autonomic neuropathy

Hypoglycemic unawareness

Focal neuropathy

Mononeuropathy (upper or lower extremity)

Mononeuropathy multiplex

Plexopathy

Polyradiculopathy (can occur with diffuse neuropathy)

Cranial mononeuropathy

* Neurological function tests are abnormal, but no neurological symptoms or clinically detectable neurological deficits indicative of a diffuse or focal neuropathy are present. Class I "Subclinical neuropathy" is further subdivided into Class Ia if an AFT or QST abnormality is present, Class Ib if EDX or AFT and QST abnormalities are present, and Class Ic if an EDX and either AFT or QST abnormalities or both are present.

Adapted from Consensus Panel: Report and Recommendations of the San Antonio Conference on Diabetic Neuropathy. Diabetes 1988; 37:1000.

Management of Rotator Cuff Syndrome in the Workplace

In developed countries, managing rotator cuff syndrome in the workplace presents significant challenges for health care providers and industry employers. Rotator cuff syndrome can substantially affect a person’s health and functioning with pain and/or weakness arising from the injury often restricting a person’s ability to carry out their daily activities and to work. Rotator cuff syndrome frequently results in lost productivity and significant financial costs for industry and employers. It is therefore imperative that appropriate evidence-based management of rotator cuff syndrome is adopted to enhance functioning and minimise negative outcomes for affected individuals, their families and the workplace.

The guidelines have been developed using a rigorous methodology for searching, appraising and grading evidence. Recommendations have been developed using research evidence in conjunction with a multidisciplinary working party. Flowcharts and resources have been developed to support the use of the guidelines. Resources include: assessment and review flowcharts, rotator cuff syndrome information sheet (for injured workers) and return to work (RTW) guides for employers and GPs.

The guidelines are applicable to GPs, medical specialists and other health care providers involved in the treatment of people with rotator cuff syndrome, including physiotherapists, occupational therapists, psychologists, ergonomists, chiropractors and osteopaths. The guidelines can also be used by the injured worker and workplace-based employees involved in coordinating and supporting the RTW for injured workers with rotator cuff syndrome.

The cycle of development, publication, and implementation of clinical practice guidelines

The cycle of development, publication, and implementation of clinical practice guidelines. Implementation or translation into practice should contribute to the development of a subsequent guideline, primarily through health services research. Clinical decision support is shown as the implementation method that bridges the gap between the evidence synthesized by clinical practice guidelines and patient care delivered through the electronic health record. The three major components of information technology in health care are shown: the personal health record, the electronic health record, and the population health record. The arrows represent the flow of information. The arrow between the patient and the personal health record is mostly in the direction of the patient, as patient input into the electronic health record is currently limited.