All in Cardiac Arrest

Episode 110: EMS WEEK with Dr. Zaffer Qasim

Episode 110: EMS WEEK with Dr. Zaffer Qasim

Ed Bauter
Cardiac Arrest, FOAMed, Interview, Trauma

Summary

In this episode, Dr. Zaf Qasim discusses advances in medical resuscitation and the future of cardiac arrest care. The conversation covers topics such as compression-only CPR, the controversy surrounding head-up CPR, the use of band and piston-driven devices, and the potential of extracorporeal cardiopulmonary resuscitation (eCPR). The importance of good dispatch and patient selection is emphasized as key factors in improving outcomes. The episode concludes with a discussion on the need for a paradigm shift in how we approach cardiac arrest care. Then, Dr. Zaf Qasim discusses updates in trauma resuscitation. The focus is on the use of whole blood in trauma resuscitation, the importance of meaningful intervention in the pre-hospital setting, the role of ultrasound in trauma resuscitation, and the use of ketamine and fentanyl in RSI and trauma scenarios. Dr. Qasim emphasizes the need for resuscitation before intubation and the importance of controlling bleeding and restoring volume. He also highlights the potential of technology, such as ultrasound and sending real-time information to the trauma team. The conversation ends with a call for hope in the future of pre-hospital medicine.

Takeaways

Advances in medical resuscitation have focused on basic life support (BLS) interventions, such as compression-only CPR and early defibrillation.
The effectiveness of head-up CPR in improving outcomes is still under debate, and more research is needed to determine its role in human resuscitation.
While band and piston-driven devices have shown variable results in improving outcomes, they can be useful logistically in certain situations.
Extracorporeal cardiopulmonary resuscitation (eCPR) shows promise for refractory ventricular fibrillation patients, but its implementation requires system-wide changes and good patient selection.
Good dispatch and patient selection are crucial in improving cardiac arrest care and should be prioritized in system design and protocols.
A paradigm shift is needed to move from a one-size-fits-all approach to cardiac arrest care to a more individualized approach based on patient outcomes and preferences.

The use of whole blood in trauma resuscitation is gaining traction and has shown to improve outcomes.
Meaningful intervention in the pre-hospital setting, such as giving blood and controlling bleeding, is crucial for improving trauma outcomes.
Ultrasound can provide valuable information in trauma resuscitation, including assessing the heart and identifying pericardial effusion.
Ketamine is still a great drug for RSI in trauma, but dosage and patient physiology should be considered.
Technology, such as ultrasound and real-time information sharing, has the potential to enhance trauma resuscitation.
There is hope for the future of pre-hospital medicine, with a focus on improving pre-hospital interventions and outcomes.

Episode 101: Death Notifications with Steph Leather

Episode 101: Death Notifications with Steph Leather

Ed Bauter
Cardiac Arrest, FOAMed, Interview

We're bad at notifying families what's happening during a cardiac arrest event. We're even worse on ourselves. The average person may see 3 or 4 dead people in their lives and EMS workers often see that many in a shift. The Overrun's new team member Steph Leather, a national speaker on death notifications and a director of a clinical psychology practice takes us through the steps to make death notifications easier on ourselves and on families of our patients.

Episode 97: 2023 Resuscitation Update

Episode 97: 2023 Resuscitation Update

Ed Bauter
Cardiac Arrest, FOAMed

The gang gets back together and discusses new resuscitation data from 2022.

Blood-Pressure Targets in Comatose Survivors of Cardiac Arrest

Question and Methods: double-blind RCT out of Denmark whether high or low arterial blood-pressure targets would be superior in preventing death or severe anoxic brain injury in comatose survivors of OHCA. Enrolled 789 patients

RePHILL Study

Question and Methods: Multicenter RCT out of the UK that investigated prehospital resuscitation using PRBCs and plasma versus normal saline to improve tissue perfusion or mortality in adult trauma patients with hemorrhagic shock.

Mike's favorite study about Refractory VFib

Question and Methods: Shock-refractory VFib remains a common occurrence during OHCA → does dual sequential defib and vector-changing defib improve outcomes in patients with refractory VF? Primary outcome measure was survival to hospital discharge; secondary outcomes termination of VF, ROSC, good neurologic outcome at hospital discharge

Head and thorax elevation during cardiopulmonary resuscitation using circulatory adjuncts is associated with improved survival

Question and Methods: Does the use of a head up device as part of a CPR bundle improve survival from OHCA?

Episode 95: Haney Mallemat and Medicine in Social Media

Episode 95: Haney Mallemat and Medicine in Social Media

Ed Bauter
Cardiac Arrest, Controversy, Interview

Dr. Haney Mallemat (@criticalcarenow) joins Dan to discuss how social media can influence medicine and how recent medical events have shined a light on CPR and bleeding control.

In a matter of a few days, the world was shocked to hear that actor Jeremy Renner had been traumatically injured while on vacation in Nevada and Buffalo Bills player Damar Hamlin experienced a cardiac arrest on the field. These two tragic events have shown the world, albeit briefly, how important early CPR and bleeding control are to survival.

Episode 94: Better CPR at the end of the year with Josh Lupton and Ken Milne

Episode 94: Better CPR at the end of the year with Josh Lupton and Ken Milne

Ed Bauter
Cardiac Arrest

We end the year with 2 great interviews about cardiac arrest. Josh Lupton is a physician in Oregon who found in 2021 that there might be an ideal number of rescuers for OHCA. Hint: It's more than you think.

Then Ken Milne joins us from the Skeptics Guide to Emergency Medicine to discuss whether heads-up CPR with a commercial device is ready for prime time.

This is our last episode of the year and we wanted to thank everyone for listening. Check out the website, subscribe to the podcast, and keep an eye out during 2023. Lots of more exciting stuff coming!