JRC
Newsletter

ISSN 2433-3123

Volume 2 No 1. (English ed.) February 21, 2018

Japan Resuscitation Council
www.japanresuscitationcouncil.org/jrc-newsletter/

Contents
A digest of ALS in the JRC 2015 guidelines . .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  . 1Mayuki Aibiki, Auditor of the Japan Resuscitation Council（Ehime University ）Issue：Critical care of mothers . .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  . 2Gen Ishikawa (Nippon Medical School Chiba Hokusoh Hosp）

Maternal Death in Japan . .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  . 3Junichi Hasegawa (St. Marianna University School of Medicine）

Cardiac arrest during pregnancy from the viewpoint of critical care medicine. .  .  .  . 4Atsushi Sakurai (Nihon University School of Medicine), et al.

Management of maternal cardiac arrest including perimortem cesarean section. .  . 5Katsuo Terui (Saitama Medical Center)

The difference of Japanese consensus and the world consensuses about maternal
cardiac arrest. .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  . 7Tomoyuki Yamashita (Japanese Red Cross Medical Center）

The current situation of perimortem cesarean delivery in Japan. .  .  .  .  .  .  .  .  .  .  .  .  .  . 8Jun Murotsuki (Miyagi Children’s Hospital)

J-CIMELS：background of establishment and current activity status. .  .  .  .  .  .  .  .  .  .  . 9Akihiko Sekizawa (Showa University School of Medicine)

Nepal inspection. .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  . 10
Kazuo Okada, Emeritus President of the Japan Resuscitation Council

Editorial Note . .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  . 12
Masao Nagayama, Secretary-General of the Japan Resuscitation Council(International University of Health and Welfare School of Medicine)the Editorial Board＜ Editor in chief ＞
Hiroshi Nonogi     （Shizuoka General Hospital ）＜ Members of editorial board ＞
Migaku Kikuchi （Dokkyo Medical University Hospital）
Toshiki Sera         （Hiroshima Prefectural Hospital）
Satoshi Takeda     （Jikei University School of Medicine）
Masao Nagayama  (International University of Health and Welfare School of Medicine）
Eisei Hoshiyama （Dokkyo Medical University Hospital）

JRC Newsletter

Volume 2. No 1. (English ed.). p1, 2018

A digest of ALS in the JRC 2015 guidelines
Mayuki Aibiki MD, PhD.
Auditor of the Japan Resuscitation Council (JRC),
Chair of the Department of Emergency and Critical Care Medicine,
Ehime University Graduate School of Medicine.
Vice-President of Ehime University Hospital.

Revised ALS recommendations from 2010 GLs

Perspectives for 2020 GLs

guideline (GLs) :ILCOR has introduced the continuous evidence

1) subsequently increase cardioversion energy if
ineffective for VF/pVTs;

evaluation in the CoSTR development, which provides
the newest information. Thus, JRC has reformed the2) supply high possible oxygen concentration during

GLs generating system. The PICO question will be

CPR, but need adjusted normal PaO2 after

modified to PICOST (PICO + Study design and Time

ROSC; a capnography, a monitor for ROSC andframe); also, the number of PICOs has been reduced forendotracheal tube (ET) placement, should not be

concentrating on progressive issues.

applied on prognositication during CPR;
3) any chest compression devices should not
be employed routinely, but is indicated formaintaining the compression quality or avoiding
harm to CPR providers; ECPR could be a choicefor persistent CPAs if regulated by criteria;

Reference:

1) Aibiki M. Editorial for the paper of Dr. Hans Kirkegaard etal. JAMA 2017; 318: 341-50. J Emerg Crit Care Med 2017. doi:
10.21037/jeccm.2017.11.02.
2) Kaneko T, Kasaoka S, Nakahara T, et al. Effectiveness of lower
target temperature therapeutic hypothermia in post-cardiac
arrest syndrome patients with a resuscitation interval of ≤ 30
min. J Intensive Care. 2015; 3(1): 28. doi:10.1186/s40560-015-0095-2.

4) echocardiography could detect causes of CA, also
reveal ET positioning;5) Adrenalin should be given soon, especially for the
non-shockables; Amiodarone might be effective for
persistent VF/pVTs, but if not work nifekalant or
lidocaine could be an alternative, but which might
be changed in 2020.
6) TM should be lasted for at least 24 hours at alevel between 32 and 36 centigrade; A 2017 study
testing effects of 24 vs 48 hours at 33 centigrade
showed no neurological benefits, but includes
intriguing results that have been described inan editorial (1). Kaneko et al. reported merits
from hypothermia in OHCAs <30 minutes (2), so
further studies are needed.

Japan Resuscitation Council

1

Issue：Critical care of mothers
From the 10th J-ReSS Symposium 1“Critical care of mothers”（17 July, 2017 in Yokohama）
The symposium session entitled the Critical Care of Mothers was held in the 10th Japan Resuscitation
Science Symposium on 17 July, 2017 in Yokohama.
In this session, six experts presented and reviewed topics. JH showed the achievement of the nationwide
registration system of maternal deaths, underlined the reality that one-fourth of maternal deaths were due
to postpartum hemorrhage (PPH) and also showed the reality that the most frequent period of onset of CPA
were 1 to 3 hours after initial symptoms of PPH. JH highlighted the importance of immediate hemostasis, bloodtransfusion and maternal transport. KT showed the topic of the AHA Scientific Statement: Cardiac Arrest in
Pregnancy (Circulation. 2015;132:1747-1773). In this topic the importance of manual left uterine displacement(LUD) and consideration of perimortem cesarean delivery (PMCD) while resuscitation were discussed. AtS
showed the reality that poor prognosis after ROSC was often seen in case of maternal cardiac arrest of noncardiac origin because of antecedent cerebral ischemia. In addition, AtS cast the idea of developing maternal
RSS for in-hospital and “obstetric bypass” for primary healthcare level especially for maternal emergency. TY
reviewed the JRC Guidelines 2015 comparing to AHA, ERC, ANZCOR Guidelines and CoSTR 2015. Other thanguidelines, TY also reviewed the Consensus Statement of Society for Obstetric Anesthesia Perinatology in 2014
and the AHA Scientific Statement: Cardiac Arrest in Pregnancy. TY highlighted importance of accumulating
evidence of maternal emergency cases and establishing clinical strategy for beneficial outcome. JM showed
the results of survey work by the Liaison Council of MFICU in Japan. In this survey, the fact that 18 PMCD
cases existed was revealed. Among them, twelve cases obtained ROSC after PMCD and three were survived
in intact. In this topic, JM speculated efficacy of Extra-corporeal Life Support on this field. AkS showed thedissemination project of maternal emergency life support course program (J-MELS) by Japan Council for
Implementation of Maternal Emergency Life Support System (J-CIMELS). It is expected that prognosis ofmaternal emergency could be improved by spreading those courses; J-MELS basic and advanced.
Although problem that remains to be solved has been still in Japan, maternal mortality ratio is in the lowest
group in the world. In Japan more than half of all deliveries are managed not in tertiary care center, but
in private clinics operated by one or two obstetricians. The secret and endeavor of low mortality in Japan
should be analyzed and proved to the world. So that, it could lead to contribution of improvement of maternalmortality in the world.
Gen Ishikawa, MD, PhD.
Senior Assistant Professor, Nippon Medical School Chiba Hokusoh Hosp.

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Japan Resuscitation Council

JRC Newsletter
From the 10th J-ReSS Symposium 1

Volume 2. No1. (English ed.). p 3, 2018

“Critical care of mothers”（17 July, 2017 in Yokohama）

Maternal death in Japan
Junichi Hasegawa, MD, PhD.
Associate Professor, St. Marianna University School of Medicine

The current maternal mortality rate in Japan, which is estimated to be around 4 in 100,000 deliveries, is similar
to that in other developed countries. In 2010, the Japan Association of Obstetricians and Gynecologists (JAOG)
established a registration system and the Maternal Death Exploratory Committee to further reduce the numberof maternal deaths. In order to provide information that could help in the prevention of maternal deaths, and to
improve the quality of obstetric health care, the Committee conducted a causal analysis of each maternal death andreported its recommendations for general obstetrical practice by which the number maternal deaths due to similarcauses could be reduced. Maternal deaths were frequently caused by obstetric hemorrhage (23%), stroke (16%),amniotic fluid embolism (12%), cardiovascular disease (8%) and pulmonary disease (8%). The committee consideredthat it was impossible to prevent death in 51% of the cases, whereas they considered prevention in 26%, 15% and
7% of the cases to be slightly, moderately and highly possible, respectively. It was difficult to prevent maternal
deaths due to amniotic fluid embolism and stroke. In contrast, half of the deaths due to obstetric hemorrhage wereconsidered preventable, because the peak duration between the initial symptoms and initial cardiopulmonary arrest
was 1-3 hours. A range of measures, including individual education and the construction of good relationships
among regional hospitals, should be established in the near future to improve primary care for patients withmaternal hemorrhage and to save the lives of mothers in Japan.

Japan Resuscitation Council

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JRC Newsletter
From the 10th J-ReSS Symposium 1

Volume 2. No1. (English ed.). p4-5, 2018

“Critical care of mothers”（17 July, 2017 in Yokohama）

Cardiac arrest during pregnancy from the viewpoint of criticalcare medicine
A t s u s h i S a k u r a i 1 , 8 ） , Y a s u f u m i M i y a k e 2 , 8 ） , T o m o a k i I k e d a 3 , 8 ） , A t s u n o r i Y a m a h a t a 4 , 8 ） ,.
Akihiko Sekizawa5,8）, Junichi Hasegawa6,8）, Takashi Okai7,8）
1. Division of Emergency and Critical Care Medicine Department of Acute Medicine, Nihon University School of Medicine
2. Department of Emergency Medicine, Teikyo University Hospital
3. Department of Obstetrics and Gynecology Mie University Faculty of Medicine
4. Department of Emergency Medicine, Kyoto Prefectural University of Medicine
5. Department of Obstetrics and Gynecology Showa University School of Medicine
6. Department of Obstetrics and Gynecology St. Marianna University School of Medicine
7. Aiiku Hospital
8. Japan Council for Implementation of Maternal Emergency Life-Saving System (J-CIMELS)

BackgroundIn general, good neurological outcome is predicted for most cardiac arrest (CA) patients with cardiac etiology(ischemic heart disease, arrhythmia, etc.). On the other hand, poor neurological outcome is often predicted formany patients with non-cardiac etiology caused by hypoxia and hypo-perfusion. Hasegawa et al. reported thatthe cause of maternal deaths is frequently related to non-cardiac etiology (Hasegawa, BMJ, 2016).   Subsequently,
many pregnant women who succumb to maternal death may have already suffered from brain ischemia causedby hypoxia and hypo-perfusion prior to CA. In such cases, poor outcome can be predicted. Treatment prior to CA
occurrence should be actively pursued.
Rapid Response System (RRS)
To prevent CA at a medical institute, RRS has recently emerged worldwide and become the first link in the
chain of survival according to the 2015 American Heart Association Guideline. More than half of all deliveries arehandled at private clinics operated by one, sometimes two, obstetricians. Depending on the RRS policy, a criticalpregnant patient should be transferred from a clinic to an advanced medical institute prior to CA occurrence.
Therefore establishing clear criteria for emergency transfer of critical pregnant patients from a clinic to anadvanced medical institute prior to CA occurrence and a safe transport system, such as an ambulance with adoctor onboard, is considered important.
Transport to an advanced medical institute
Treatment for CA, difficult airway, respiratory failure, massive hemorrhage with coagulopathy, etc. involving a
critical pregnant patient should be handled at an advanced medical institute. Consequently collaboration between
the obstetrician and the medical staff, including the emergency physician, anesthesiologist, other surgeons and theintensivist. Equipment such as a rapid infusion fluid warming device, massive transfusion system, ventilator, blood
purification device and ECMO should be on hand. Discussion on obstetric bypass, similar to trauma bypass, where
the most critically ill trauma patients bypass closer hospitals and are transported directly to a trauma centerand are treated by an advanced medical staff and equipment is needed. When establishing an obstetric bypass
system, simultaneous consideration of the criteria for emergency transport from a clinic in order to prevent CA
during transport to a distant advanced medical institute. Hence, over-triage should be allowed and critical pregnant
patients with stable vital signs should be transported at an earlier point. Further study regarding the acceptable

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Japan Resuscitation Council

Volume 2. No 1. (English ed.). 2018
patient ratio of over-triage for each region.
Establishment of a system for each region
In the establishment of an obstetric transport system to prevent maternal death, conditions may vary by individual
region in Japan. Consequently collaboration between the medical management council and the perinatal medical
council in each region in order to appropriately assign advanced medical institutes, establish the transport criteria
and maintain the obstetric transport system.

Japan Resuscitation Council

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JRC Newsletter
From the 10th J-ReSS Symposium 1

Volume 2. No 1. (English ed.). p 6, 2018

“Critical care of mothers”（17 July, 2017 in Yokohama）

Management of maternal cardiac arrest including perimortem
cesarean section
Katsuo Terui, MD, PhD.
Professor, Saitama Medical Center, Saitama Medical University
The most important point in managing maternal cardiac arrest is high quality CPR with effective chest
compressions and immediate AED. AED can be safely applied during pregnancy with standard energy. JRC
resuscitation guideline 2015 basically followed ILCOR consensus statement, and suggested perimortem cesarean
section with weak recommendation and very weak evidence. The guideline did not make any recommendation onleft pelvic tilt or left uterine displacement because of inadequate evidence.
AHA guideline on maternal cardiac arrest in 2015 is one of the most detailed guidelines for pregnant women. It
takes into consideration physiological changes during pregnancy and findings from obstetric  anesthesia literature.
BLS for in-hospital maternal cardiac arrest begins with emergency call by witnessing unresponsive, apneic or
abnormal breathing pattern patient with fundal height above umbilicus. First responder must call for at least 3
persons and emergency cart. Maternal ACLS team needs to be called for at the same time. High quality chest
compression is the first step, with the patient in supine position. Once extra hands are available, US guideline
recommends manual left uterine displacement by one or two hands, but not tilting the patient table. Left uterine
displacement is expected to relieve aortocaval compression by gravid uterus. It recommends CPR sequence as
C-A-B-U(uterine displacement). Perimortem cesarean section is the extreme way of increasing venous return
during CPR. PMCD should be strongly considered for every mother in whom ROCS has not been achieved after
about 4 minutes of resuscitative efforts (Class IIa, LOE C).

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Japan Resuscitation Council

JRC Newsletter
From the 10th J-ReSS Symposium 1

Volume 2. No 1. (English ed.). p 7, 2018

“Critical care of mothers”（17 July, 2017 in Yokohama）

The difference of Japanese consensus and the world consensuses
about maternal cardiac arrest
Tomoyuki Yamashita, MD.
Dept. of Emergency and Critical Care Medicine, Japanese Red Cross Medical Center
Japan Resuscitation Council Resuscitation Guidelines 2015 (JRC 2015) suggest cesarean delivery of the fetus
for women of late pregnancy in the situation of cardiac arrest. However, there is no suggestion for left uterine
displacement (LUD) nor timing of fetus delivery.
In the American Heart Association (AHA) Guidelines 2015, LUD and preparation of Cesarean section rightafter cardiac arrest is recommended. Cesarean delivery should be considered at 4 minutes after onset of maternal
cardiac arrest or resuscitative efforts if ROSC is not seen. The cesarean delivery should not be delayed even ifmaternal resuscitation is futile. Systematic preparation and training is crucial to meet these recommendations.
Heart & Stroke Foundation of Canada (HSFC) Guideline is roughly similar to AHA 2015.
In comparison to AHA, European Resuscitation Council (ERC) guidelines 2015 allows left lateral tilt instead of
LUD, if high-quality chest compression can be continued. It also recommends the position of chest compression tobe slightly higher on the sternum in third trimester of pregnancy. ERC 2015 recommends emergency hysterotomy
or Caesarean section for delivery of fetus within 5 minutes, and also emphasizes the importance of difficult airway
management, intravascular access above the diaphragm and regular training to prepare for obstetric emergencies.
Australian and New Zeeland Council of Resuscitation (ANZCOR) guideline 2011 has similar recommendations.
In addition to guidelines, Society for Obstetric Anesthesia Perinatology Consensus Statement 2014 and AHA
Scientific Statement 2015, have detailed recommendations that answer clinically significant questions.
Next guidelines of JRC, we need to consider including details and how to educate new consensuses.

Japan Resuscitation Council

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JRC Newsletter
From the 10th J-ReSS Symposium 1

Volume 2. No 1. (English ed.). p 8, 2018

“Critical care of mothers”（17 July, 2017 in Yokohama）

The current situation of perimortem cesarean delivery in Japan
Jun Murotsuki
Department of Maternal and Fetal Medicine, Tohoku University Graduate School of Medicine, Miyagi
Children’s Hospital[Objective]
Perimortem cesarean delivery (PCD) is a cesarean section preformed during maternal cardiac arrest is toincrease the chance of successfully resuscitating the mother.  The aim of this study was to investigate the actual
conditions, results, and problems of PCD conducted in Japan.
[Study design]
We sent a primary survey form to 187 secondary and tertiary perinatal centers and examined the number of
PCD. Then, we sent a secondary survey form to the facility that responded to the primary survey, and investigatedthe details of PCD.
[Results]
There were 18 cases in 14 facilities of PCD identified; 10 in-hospital cases and 8 out-of-hospital cases.   Of 18
PCD with potentially resuscitatable cases, 8 cases of mothers were resuscitated and survived, but only 5 cases
discharged from the hospital in good condition.  Four other mothers were successfully resuscitated after PCD, butdied from complications of atonic bleeding and multiple organ failure.  The major causes of maternal cardiac arrest
are peripartum cardiomyopathy, lung edema, aortic dissection.   Fifteen infants survived (3 sets of twin); 2 otherinfants survived initially, but died several days after the deliveries.
[Conclusion]
PCD within 5 minutes of maternal cardiac arrest improves maternal and neonatal outcomes.  For any indicationof maternal cardiac arrest, the cesarean delivery should be performed.

8Japan Resuscitation Council

JRC Newsletter
From the 10th J-ReSS Symposium 1

Volume 2. No 1. (English ed.). p 9, 2018

“Critical care of mothers”（17 July, 2017 in Yokohama）

J-CIMELS：background of establishment and current activity
statusAkihiko Sekizawa, MD, PhD

Department of Obstetrics and Gynecology, Showa University School of Medicine

The Japan Association of Obstetricians and Gynecologists (JAOG) established a registration system and theMaternal Death Exploratory Committee in 2010 to reduce the number of maternal deaths. The Committee
continues conducting causal analysis for each maternal death. The most frequent cause of maternal deaths
between 1992 and 2017 was postpartum hemorrhage (PPH) although the maternal mortality rate associated with
PPH reduced from 38% to 22%. Of all maternal deaths, half occurred after delivery or cesarean section. In the PPH
cases, interval between initial symptoms and cardiopulmonary arrest is not too short, and its peak duration was
1–3 h. No cases of PPH were recorded wherein cardiopulmonary arrest occurred within 30 min. Therefore, thecommittee considers that improvement of the management of PPH can reduce the maternal mortality rate. Vitalsigns and the amount of bleeding should be immediately determined; efficient primary care, including hemostasis,
vital care, and primary resuscitation are required. The committee announced to remind the importance of vital
signs as one of the recommendations. Thus, the committee made recommendations for saving mothers’ lives ineach year through the analyses of maternal deaths. However, the number of maternal death was 40-50 cases ineach year and did not decrease despite of these efforts. Because it is important to consider changes in vital signs at
the early stage and subsequent initial treatment, the committee thought that daily training and simulation enable
us to take prompt action during real emergencies. Therefore, the Japan Council for Implementation of Maternal
Emergency Life-Saving System (J-CIMELS) has established in 2015 to reduce maternal mortality rate. The aimof the simulation course organized by J-CIMELS is for all caregivers in delivery service to understand maternal
conditions and develop skills regarding primary care for maternal emergency with the help of doctors well trainedin emergency medicine. We recommended that all caregivers in delivery service should participate in this course
and improve their skills for safe management of women during pregnancy and labor. We believe that maternal
death rate in Japan will gradually decrease through the activity of J-CIMELS.

Japan Resuscitation Council

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JRC Newsletter

Volume 2. No 1. (English ed.). pp 10-11, 2018

Nepal inspection

Kazuo Okada
Emeritus Chair, Japan Resuscitation Council

I could have the chance to visit Nepal in October ofThis is the first time to meet him andhe expressedto join to RCA. He is eagerly explained that RCA

2017.
This country is geographically situated in west

membership is important to advance Nepal CPR withpart of Asia. As I have worked for ILCOR since 2000,

the international collaboration of RCA. He explained

new Co-chairs, Prof. Neumar and Gavin strongly

that the Government could more easily understand theinsisted that next coming 2015 to 2020, ILCOR should

importance of resuscitation and will be more expand

cover globally. Not only several countries but also all

the activity to CPR in Nepal.

territory should be covered by ILCOR system in theworld.
However, RCA could not include all Asian countries,
Taiwan, Korea, Japan and Singapore were the founding
countries in 2005 RCA establishment. Since thenPhilippine, Thailand, and Hong Kong joined to thisOrganization.  
While urgent request for assembling all countries interritory of RCA, still it could not be accomplished until
now.
Chair of Nepal Resuscitation Council Dr. Maharjan
visited me at RCA General Assembly held in Singapore
on February 2016.  

Picture 1

10

At RCA2016 with Dr. Maharjan

Figure 1

Importance of CPR in Asia and Nepal

Figure 2

From Dr. Maharjan's lecture

Japan Resuscitation Council

Volume 2. No 1. (English ed.). 2018
I could decide to visit Nepal and survey how is theorganization of CPR training system. Following thisyears.  7 years has passed NCEM (Nepal Colleague ofEmergency Medicine) since its establishment.

survey I could recommend if Nepal has been well

Training was almost the same as JRC, RCA

educated and trained CPR.I have arrived at Katmandu

Guidelines, but airway management seemed a little bit

airport on 18th, October, 2017. Next day Prof. Maharjan

different from RCA Guidelines

organized Symposium ‘Importance of CPR in Asia andmight be caused from Nepal instructor’s deficit. As

Nepal’, where I have presented ‘the step to establish

the summary of this course、it was almost the same

RCA’ and Prof. Maharjan ‘Preventive Emergency

to RCA, JRC Guidelines, but numbers of instructors

Medicine in Nepal’ and Dr. Shrestha ‘Updates on

are not enough. Urgent increase of instructors is

CPR Guidelines learning from the World’ These

mandatory in Nepal. AED has not been permitted topresentations were followed ‘AED demonstration anduse for citizens by government, this could  not enhancepractice of AED usage’ by a member of Nihon Kohden

the increase of  survival rate from arrested victims..

Co. Japan

This may be financial problem which should be

After having passed the checking CPR knowledge andand CoSTR.

This

supported from the world, specially from Japan.

practice, BLS course started to candidates with several

Nepal is situated in west part of Asia, however,Instructors in the afternoon. This was organized byas RCA and JRC we should encourage Nepal to join

‘NADEM’ (Nepal Disaster and Emergency Medicine

RCA. Prof. Maharjan would sincerely like to become

Center), and 2017 is anniversary of NADEM 10tha member of RCA, which contributes the advance of
CPR in Nepal. Saving lives should be expanded in all
RCA territory.

Picture 2

Training at NADEM

Picture 4

NADEM Token of Appreciation 2017
Presented

Picture 3

Training at NADEM

Picture 5

Cremation ceremony at Katmandu

Japan Resuscitation Council

11

Editorial Note
It was a great pleasure for those of us with the Japan Resuscitation Council (JRC) tohave launched the JRC Newsletter: English Edition last year at the 15th anniversary of
our founding. The first issue was welcomed by many colleagues in the world. Here, thesecond issue of this newsletter is briefly introduced.    
First, Professor Mayuki Aibiki briefly summarized the Advanced Life Support (ALS)
chapter of the JRC Resuscitation Guidelines 2015 ; other chapters will be summarized
briefly in subsequent issues. Next, we published the abstracts from the extremely popular
symposium “Maternal Resuscitation” from the tenth J-ReSS (Japan-Resuscitation Science
Symposium) held at Yokohama last July. Third, Professor Kazuo Okada, the founding
Chair and now the Emeritus Chair of the JRC, contributed an article, an observational
report on the Kingdom of Nepal, where he was invited last Autumn to discuss education
regarding resuscitation in this great Asian country.
JRC is an interdisciplinary academic society of high public interest dedicated tothe improvement of clinical and scientific affairs on cardiopulmonary and cerebral
resuscitation. Together with the International Liaison Committee on Resuscitation (ILCOR)
and the Resuscitation Council of Asia (RCA) and others, JRC is creating JRC Resuscitation
Guidelines 2020 . In the next issue, we will introduce a brief sketch of progress.
We ask your feedback on the JRC Newsletter: English Edition, as we intend for it to bea valuable resource for the global and domestic progress of resuscitation and resuscitation
science.  

Masao Nagayama, MD, PhD, FAAN, FJSIMSecretary-General, Japan Resuscitation Council (JRC)
Professor, Department of Neurology,
International University of Health and Welfare School of Medicine

12Japan Resuscitation Council

Members of the Japan Resuscitation Council<Member Societies of the Board of Directors>
Japanese Association for Acute Medicine
Japanese Circulation Society
Japanese Society of Anesthesiologists
Japanese Society of Intensive Care Medicine
Japan Society of Perinatal and Neonatal Medicine<Member Societies and Organizations>Japan First aid and Emergency care Foundation
Japan Foundation for Emergency Medicine
Japan Pediatric Society
Japan Society of Neurological Emergencies and Critical Care
Japanese Dental Society of Anesthesiology
Japanese Paramedics Association
Japanese Red Cross Society
Japanese Society for Emergency Medicine
Japanese Society of Emergency Pediatrics
Japanese Society of Internal Medicine<Nonprofit Societies and Organizations>Japan Society for Instruction Systems in Healthcare
Japan Society for Prehospital Medicine
Japan Society of Neurosurgical Emergency
Japanese Association of Brain Hypothermia and Temperature Management
Japanese Society of Pediatric Anesthesiology
Japanese Society of Reanimatology
Japan ACLS Association
Osaka Life Support Association

Supporting members of the Japan Resuscitation Council<Supporting Organization>
Japan Medical Association<Supporting Companies>
IMI. Co., Ltd
Asahi Kasei ZOLL Medical Corporation
Athena Kogyo Co., Ltd.
Kawasumi Laboratories
Daiken Medical Co., Ltd.
Nihon Kohden Corporation
Physio-Control Japan, Inc.
Philips Electronics Japan, Ltd.
Laerdal® and Resusci® are registered trademarks of Laerdal Medical Corporation.

JRC Newsletter Volume 2. No 1. (English ed.). 2018
http://www.japanresuscitationcouncil.org/jrc-newsletter/
Published on 21th February, 2018
Publisher

Japan Resucitation Council (JRC)
Former Sakakibara Heart Institute, Japan Research Promotion Society for Cardiovascular  Diseases, 2-5-4, Yoyogi, 2-5-4, Sibuya-ku, Tokyo,  151-0053，Japan

Editorial office© Printed in Japan

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