The ERC Guidelines 2021 (Part 1/7)

The European Resuscitation Council has published the new ERC Guidelines 2021 for cardiopulmonary resuscitation. Here is an overview of key changes and the main aspects that have remained the same.

New European guidelines for cardiopulmonary resuscitation

The European Resuscitation Council (ERC) has recently published the new ERC Guidelines 2021 for cardiopulmonary resuscitation. Here is an overview of the most important changes (and the main aspects that have remained unchanged).

Made in cooperation with our partners from

Every year in Europe, it is estimated that more than 400,000 people suffer a cardiac arrest. It is estimated that a return of spontaneous circulation (ROSC) is possible in 33% of cases, but people who survive after hospitalisation account for 8% of all cases. The percentage of people who witness a cardiac arrest and intervene with life-saving manoeuvres (cardiac massage, artificial ventilations) is on average 58% (range 13-83%). Automated External Defibrillators (AEDs) are used in only 28% of cases (range 4-59%).

The goal of the European Resuscitation Council (ERC) is to increase the survival of people in cardiac arrest by ensuring high quality cardiopulmonary resuscitation for all. ERC activities include the production of up-to-date, evidence-based European guidelines for the prevention and treatment of cardiac arrest and life-threatening emergencies. The first ERC guidelines were presented in Brighton (England) in 1992 and covered basic and advanced life support. Since 2000, ERC guidelines have been produced every 5 years. The guidelines present in detail the scientific basis and the resulting treatment recommendations, which are based on the International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science.

In the last five years, some scientific aspects of resuscitation have gained further importance. This is also, and in a special way, reflected in the distribution of chapters in the new guidelines. For example, knowledge on epidemiology and concepts of prevention (life-saving system) of cardiac arrest has increased a lot. As a result, topics are no longer treated within other chapters, but are now presented separately and prominently. 

The evidence, which has been evaluated over a period of several years by numerous international experts in a highly standardised process, has been summarised in the following ERC Guidelines topics for the 2021 revision:

The ERC 2021 Guidelines present a major update on cardiopulmonary resuscitation and provide the most up-to-date evidence-based procedures for citizens (lay professionals), healthcare professionals and health policy makers across Europe. The ERC Guidelines 2021 can be downloaded here: New ERC Guidelines.

An overview of the most important ECR Guidelines 2021 changes is available in this esanum article series:

1. Dirks B, Böttiger BW. Die neuen internationalen Leitlinien zur Reanimation 2021 - sie sind da! The new 2021 international guidelines on resuscitation - here they are! Notf Rett Med. 2021 Mar 30:1-2. German. doi: 10.1007/s10049-021-00866-0. Epub ahead of print. PMID: 33814972; PMCID: PMC8009072.
2. Perkins GD, Graesner JT, Semeraro F, Olasveengen T, Soar J, Lott C, Van de Voorde P, Madar J, Zideman D, Mentzelopoulos S, Bossaert L, Greif R, Monsieurs K, Svavarsdóttir H, Nolan JP; European Resuscitation Council Guideline Collaborators. European Resuscitation Council Guidelines 2021: Executive summary. Resuscitation. 2021 Apr;161:1-60. doi: 10.1016/j.resuscitation.2021.02.003. Epub 2021 Mar 24. PMID: 33773824.