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SGEM#238: The Epi Don’t Work for OHCA

The Skeptics' Guide to EM

A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest. A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest. An oral airway is placed, peripheral intravenous (IV) line started successfully and the paramedic asks her partner if you want to administer IV epinephrine? JAMA 2009, Hagihara et al.

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Recerts and New Protocols

Peter Canning

I recerted CPR, ACLS (Advanced Cardiac Life Support) and PALS (Pediatric Advanced Life Support) late in December. The pediatric epinephrine and norepinephrine infusion rates have been lowered to 0.1-0.5 AEMTs may administer epinephrine IV in cardiac arrest.* The certs are good for two years.

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SGEM#189: Bring Me To Life in OHCA

The Skeptics' Guide to EM

The classic paper on ACLS drugs is called OPALS (Ontario Pre-hospital Advanced Life Support) study and was done by Dr. Ian Stiell and team. There have been a number of papers published since OPALS that support the findings of not using ACLS drugs like epinephrine for OHCA: * Olavseengen et al. vs. 66.8%, p=0.73).

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IV versus IO: Does your Site of Access Matter in Cardiac Arrest?

NAEMSP

Background Despite conflicting literature to support some pharmacological therapies in out of hospital cardiac arrest, the American Heart Association (AHA) currently recommends obtaining vascular access intravenously or intraosseously in cardiac arrest. [1] minutes versus 5.4 minutes). [5] Circulation. 2020 Oct 20;142(16_suppl_2):S366-S468.

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Three Pillars for Pediatric Resuscitation Success

Handtevy

Data from the AHA and the Pediatric Advanced Life Support (PALS) guidelines consistently report neurologic intact survival from pediatric cardiac arrest to be 3% for infants and 10% for children. By Peter Antevy, MD.

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Resident Journal Review: Available Evidence Regarding Targeted Temperature Management (TTM)

AAEM RSA

For both groups, mean time to basic life support was determined to be one-minute, advanced life support started at 10 minutes, and time to ROSC at 25 minutes. Rates of cardiovascular disease were high and approximately 40% of patients in both groups had an ST-segment elevation myocardial infarction.

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Calcium in Out-of-Hospital Cardiac Arrest

NAEMSP

After several cycles of defibrillation, epinephrine, and amiodarone, the patient remains in cardiac arrest. Part 3: Adult Basic and Advanced Life Support: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. He is found to be in ventricular fibrillation (VF).

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