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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. The take home message: “Irrespective of presenting rhythm, in patients with cardiac arrest, there is no conclusive evidence that administration of calcium during cardiopulmonary resuscitation (CPR) improves survival.”

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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. 9] Figure from Clemency et al.

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How to Become a Paramedic in the Army

Paramedic Training Spot

These prerequisites include maintaining a valid EMT-B certificate or higher, successfully completing a CAAHEP-accredited education program within the past 2 years, maintaining valid CPR-BLS credentials or their equivalent, and successfully completing the cognitive and psychomotor examination portions of the NREMT-P curriculum.

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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). 2018;13(9):e0204169. Margey R, Browne L, Murphy E, et al. Cortez E, Krebs W, Davis J, et al. Resuscitation.

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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.