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A 40-something presented after attempted prehospital resuscitation with persistent Ventricular Fibrillation

Dr. Smith's ECG Blog

Two recent interventions have proven in randomized trials to improve neurologic survival in cardiac arrest: 1) the combination of the ResQPod and the ResQPump (suction device for compression-decompression CPR -- Lancet 2011 ) and 2) Dual Sequential defibrillation. Figure-1: The initial ECG in today's case — obtained after ROSC.

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The ‘Hidden C’

Don't Forget the Bubbles

A third RCT demonstrated that even brief low-level incivility could increase the risk of major error during CPR by up to 66%. Here are ten things to think about: 1. Churruca K, Pavithra A, McMullan R, Urwin R, Tippett S, Cunningham N, Loh E, Westbrook J. 2014 Jun 26;23(12):653-9. 2020 Jan 1;35(1):70-6. 2020 Aug 20.

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Calcium in Out-of-Hospital Cardiac Arrest

NAEMSP

CPR is taken over by responding crews, and he is placed on a cardiac monitor/defibrillator. Current AHA guidelines do not recommend routine use of calcium in cardiac arrest (Panchal, et al., Calcium acts as a vasopressor and inotropic agent (Lindqwister, et al., He is found to be in ventricular fibrillation (VF).

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

NAEMSP

Meyer MD Clinical Scenario You are dispatched to a 57-year-old male with a witnessed cardiac arrest and bystander CPR being performed. Your partner deploys the cardiac monitor and while CPR is continued you turn your attention to establishing vascular access. 1] Table from Hamam et al. minutes versus 5.4 minutes). [5]

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What Is the Best Defibrillation Strategy for Refractory Ventricular Fibrillation?

ACEP Now

1 Overall, survival is poor following cardiac arrest, and is affected by factors including age, comorbidities, witnessed arrest, early CPR, early defibrillation, and return of spontaneous circulation (ROSC). References Go AS, Mozaffarian D, Roger VL, et al. Larribau R, Deham H, Niquille M, et al. 2018;13(9):e0204169.

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AHA/NCS Statement on Critical Care Management of Post ROSC Patients

EMDocs

The neurologic section was divided into (1) brain oxygenation, perfusion, edema, and intracranial pressure (ICP); (2) seizures and the ictal-interictal continuum (IIC); and (3) sedation and analgesia. Reference: Hirsch KG, Abella BS, Amorim E, et al; American Heart Association, Neurocritical Care Society. 2023 Dec 1.

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Cardiac Care Show – Episode 1: Mechanical CPR

ECG Medical Training

Cardiac Care Show – Episode #1: Mechanical CPR Hello, and welcome to the Cardiac Care Show. In today’s episode I’d like to talk about mechanical CPR, which is a frequent topic of conversation in the Resuscitation group on Facebook and the #FOAMed community on Twitter. So, mechanical CPR is a no-brainer, right?

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