GETTING TO THE HEART OF THE MATTER. Ritu Sahni, MD, MPH Lake Oswego Fire Department Washington County EMS Clackamas County EMS
|
|
|
- Annabel Mills
- 5 years ago
- Views:
Transcription
1 GETTING TO THE HEART OF THE MATTER Ritu Sahni, MD, MPH Lake Oswego Fire Department Washington County EMS Clackamas County EMS
2
3 TAKE HOME POINTS CPR is the most important thing Train like we fight Measure and Improve Life is about expectation management
4
5 WHAT S THE BIG DEAL? Improving survival from cardiac arrest is happening! Why? A ton of new information over last 8 years.
6 RESUSCITATION OUTCOMES CONSORTIUM (ROC) Large-scale, government-supported, North American effort to conduct prehospital cardiac arrest and severe traumatic injury randomized clinical trials Focus: very early delivery of EMS interventions Optimal potential for benefit for treating cellular injury
7 US AND CANADA FUNDING PARTNERS National Heart, Lung & Blood Institute National Institute for Neurologic Diseases and Stroke American Heart Association Canadian Institutes of Health Research Defense Research and Development Canada Heart and Stroke Foundation of Canada US Department of Defense
8 TOTAL INVESTMENT ( ) US $114 MILLION AHA $5M DOD $13.5M Canada $6.5M NIH-NINDS $5M NIH-NHLBI $84M
9 ROC STUDY SITES MASSIVE INFRASTRUCTURE 10 primary, 8 satellite sites 1 primary DCC, 1 satellite DCC, 1 satellite CCC > 264 EMS and fire agencies 80% Fire Vancouver > 35,000 square miles > 24 million people Seattle-King Co Data Coordinating Center, Seattle Portland Milwaukee Ottawa Toronto Pittsburgh > 3,600 EMS vehicles Orange County San Diego Memphis Alabama > 36,000 EMS personnel Dallas > 100 IRB s > 287 hospitals Davis DP, et al. Prehosp Emerg Care 2007; 11:369-82
10 ROC WHAT DID WE LEARN?
11 SUMMARY OF ROC STUDIES Name Study Type Dates Sample Size Epidemiologic Registry-Cardiac Registry >127,000 Epidemiologic Registry-Trauma Registry ,700 Hypertonic Saline in Traumatic Shock RCT Hypertonic Saline in Traumatic Brain Injury RCT Analyze Early vs Analyze Later in Cardiac Arrest* RCT ,000 Impedance Threshold Device in Cardiac Arrest* RCT ,000 CPR Feedback in Cardiac Arrest RCT Prospective Observational Prehospital and Hospital Registry for Trauma Registry ,319 Resuscitative Endocrinology: Single-dose Clinical Uses for Estrogen in Traumatic Shock Pilot Study Resuscitative Endocrinology: Single-dose Clinical Uses for Estrogen in Traumatic Brain Injury Pilot Study RCT RCT Hypotensive Resuscitation in Traumatic Shock Pilot Study RCT Continuous Cardiac Compressions vs Standard CPR in Cardiac Arrest* RCT ,710 Amiodarone vs Lidocaine vs Placebo Study in Cardiac Arrest* RCT ,025 Pragmatic, Randomized, Optimal Platelet and Plasma Ratios (PROPPR) RCT TXA (Tranexamic Acid in TBI) RCT 2015-present 1002 PROHS (Prehospital Resuscitation on Helicopter Study) Observationa l ROC Pragmatic Airway Resuscitation Trial (PART) RCT 2015-present 3000
12 SCIENTIFIC IMPACT OF ROC STUDIES > 60 peer reviewed publications > 70 abstracts > 1,500 citations Major impact on AHA/ILCOR 2010 and 2015 Resuscitation Guidelines Multiple other publications and grants Training core graduates EMS providers as authors
13 CARDIAC ARREST: ANALYZE EARLY VS. ANALYZE LATER Compressor Other Provider(s) Compressor Other Provider(s) sec 50+ compressions Apply AED and turn on Apply ITD sec Apply AED and turn on Apply ITD Analyze/shock 300 compressions ACLS 3 min Analyze/shock ACLS Analyze Early Analyze Later Prime the Pump Increase Chances of Restarting Heart
14 CARDIAC ARREST: IMPEDANCE THRESHOLD DEVICE (ITD) No flow Recoil Induce Vacuum in Chest Increase Coronary Blood Flow
15 Factorial Design Impedance Threshold Device (ITD vs. Sham) Duration of CPR Before Rhythm Analysis (AE vs. AL) ROC PRIMED Planned 10,000 patient enrollment Interim analysis Futility for both ITD and AE/AL
16 CPR FEEDBACK STUDY Difference = -0.4% (-5.2%, 4.4%) ROSC Difference = -1.9% (-4.3%, 0.4%) Survival
17 ROC - CCC Cluster Randomization 2 CPR strategies before advanced airway placement Early use of epinephrine Continuous Compressions with ventilation every 10 (CCC) vs. 30:2 (ICC) Enrolled 23,711 Survival to discharge 9.0% (CCC) 9.7% (ICC) p value 0.07
18 AMIODARONE-LIDOCAINE-PLACEBO STUDY (ALPS) RCT, adult OHCA Shock refractory initial VF/VT Interventions: Amiodarone (450 mg) Lidocaine (180 mg) Placebo N=3,025 subjects NO DIFFERENCE (p=0.08) Witnessed arrest DIFFERENCE!
19 SO WHAT S THE BIG DEAL? Roc EPISTRY!
20 ROC EPISTRY HIGHLIGHTS Epidemiological Registry = Epistry Data collection began December 1, Collected All cardiac arrests, DOS CPR process data
21 IMPORTANCE OF PUBLIC ACCESS DEFIBRILLATION Higher Survival with Bystander AED Shock % Survival to Hospital Discharge N= 149 N= N= N= N= N= ALL Patients EMS Care Bystander CPR, no Bystander AED Bystander AED Placed Bystander AED Shock Bystander CPR EMS Shocked EMS Witnessed EMS Shocked
22 Secondary ROC Analysis IMPACT OF CHEST COMPRESSION Higher CCF FRACTION Higher Survival ON SURVIVAL? N=506 VF/VT arrests CCF = portion of each minute with active chest compressions Adjusted OR Primary Analysis Adjusted OR of Survival n=97 n=73 n=115 n=132 n=67 95% CI , , Chest Compression Fraction *Adjusted for: age, gender, public location, time from 911 call to arrive at scene, bystander CPR, chest compression rate Christenson, et al., Circulation 2009
23 CHEST COMPRESSION RATE 100- Cubic Spline of Survival vs Chest Compression Rate 95% confidence intervals as dashed lines 120 Probability of Survival to Discharge Average Chest Compression Rate Indris et al. 2015;43:840-8
24 Ian G. Stiell et al. Circulation. 2014;130: CHEST COMPRESSION DEPTH
25 PRE-, POST- AND PERI-SHOCK PAUSE
26 Pre-, Post- and Peri-shock Pause Pre-Shock (secs) Post-Shock (secs) Peri-Shock (secs) Median Pre and Post Shock Pause Unadjusted OR 95% CI Adjusted OR 95% CI >20 Reference -- Reference (1.09, 1.66) 1.25 (0.95, 1.65) < (1.36, 2.19) 1.52 (1.09, 2.11) >10 Reference -- Reference (0.86, 1.37) 1.02 (0.75, 1.38) < (1.58, 2.55) 1.34 (0.94, 1.90) >40 Reference -- Reference (0.88, 1.71) 1.16 (0.76, 1.76) < (1.56, 3.02) 1.82 (1.17, 2.85)
27 COMPRESSIONS MATTER!!! Quality Time to first compression Chest compression fraction Pauses WHAT DOES THIS MEAN?
28 HOW DO WE FIX THAT? Train like we fight Create known expectations (Life is about expectation management) Measure and improve Medications are important just don t know which ones yet and are likely useless in the face of bad CPR
29 Notice all the medica TRAIN LIKE WE FIGHT
Resuscitation Outcomes Consortium: Overview and Update
Resuscitation Outcomes Consortium: Overview and Update RESUSCITATION OUTCOMES CONSORTIUM OPALS PRG Annual Meeting Ottawa 2006 Resuscitation Outcomes Consortium: Overview Mandate and Overview Partners Project
Disclosure. Co-investigators 1/23/2015
The impact of chest compression fraction on clinical outcomes from shockable out-of-hospital cardiac arrest during the ROC PRIMED trial Sheldon Cheskes, MD CCFP(EM) FCFP Medical Director, Sunnybrook Centre
The 2015 BLS & ACLS Guideline Updates What Does the Future Hold?
The 2015 BLS & ACLS Guideline Updates What Does the Future Hold? Greater Kansas City Chapter Of AACN 2016 Visions Critical Care Conference Nicole Kupchik RN, MN, CCNS, CCRN, PCCN, CMC Independent CNS/Staff
Science Behind Resuscitation. Vic Parwani, MD ED Medical Director CarolinaEast Health System August 6 th, 2013
Science Behind Resuscitation Vic Parwani, MD ED Medical Director CarolinaEast Health System August 6 th, 2013 Conflict of Interest No Financial or Industrial Conflicts Slides: Drs. Nelson, Cole and Larabee
University of Washington. From the SelectedWorks of Kent M Koprowicz
University of Washington From the SelectedWorks of Kent M Koprowicz 2007 Site variation in EMS Treatment, Transport and Survival in relation to Restoration of Spontaneous Circulation (ROSC) for Adult Out-of-Hospital
Science Behind CPR Update from Darrell Nelson, MD, FACEP Emergency Medicine Wake Forest University Health Sciences
Science Behind CPR Update from 2010 Darrell Nelson, MD, FACEP Emergency Medicine Wake Forest University Health Sciences FRAMING THE DISCUSSION NO ONE SURVIVES CARDIAC ARREST, EXCEPT ON TV Conflicts of
Manual Defibrillation. CPR AGE: 18 years LOA: Altered HR: N/A RR: N/A SBP: N/A Other: N/A
ROC AMIODARONE, LIDOCAINE OR PLACEBO FOR OUT OF HOSPITAL CARDIAC ARREST DUE TO VENTRICULAR FIBRILLATION OR TACHYCARDIA (ALPS) STUDY: MEDICAL CARDIAC ARREST MEDICAL DIRECTIVE An Advanced Care Paramedic
CARDIAC ARREST RESEARCH STUDIES. Frequently Asked Questions. Why are these studies being conducted in Milwaukee County?
CARDIAC ARREST RESEARCH STUDIES Frequently Asked Questions Why are these studies being conducted in Milwaukee County? For the past 20-30 years, Milwaukee County Emergency Medical Services (EMS) System
in Cardiac Arrest Management Sean Kivlehan, MD, MPH May 2014
in Cardiac Arrest Management Sean Kivlehan, MD, MPH May 2014 1. Capnography 2. Compressions 3. CPR Devices 4. Hypothermia 5. Access 6. Medications Outline Capnography & Termination Significantly Associated
Improving Outcome from In-Hospital Cardiac Arrest
Improving Outcome from In-Hospital Cardiac Arrest National Teaching Institute San Diego, CA Nicole Kupchik RN, MN, CCNS, CCRN, PCCN, CMC Independent CNS/Staff Nurse Objectives 1. Discuss the AHA in-hospital
ROC PRIMED Questions and Answers
ROC PRIMED Questions and Answers 1) What is the ROC PRIMED study? ROC PRIMED stands for the Resuscitation Outcomes Consortium Prehospital Resuscitation using an IMpedance valve and Early versus Delayed
Rowan County EMS. I m p r o v i n g C a r d i a c A r r e s t S u r v i v a l. Christopher Warr NREMT-P Lieutenant.
Rowan County EMS I m p r o v i n g C a r d i a c A r r e s t S u r v i v a l Christopher Warr NREMT-P Lieutenant Rowan County EMS christopher.warr@rowancountync.gov September 9, 2012 2:44 11:44:00 Mr.
Regionalization of Post-Cardiac Arrest Care
Regionalization of Post-Cardiac Arrest Care David A. Pearson, MD, FACEP, FAAEM Department of Emergency Medicine Disclosures I have no financial interest, arrangement, or affiliations and no commercial
Most Important EMS Articles EAGLES 2017
Most Important EMS Articles EAGLES 2017 Corey M. Slovis, M.D. Vanderbilt University Medical Center Metro Nashville Fire Department Nashville International Airport Nashville, TN Overview Best antiarrhythmic
Most Important EMS Articles EAGLES 2017
Most Important EMS Articles EAGLES 2017 Corey M. Slovis, M.D. Vanderbilt University Medical Center Metro Nashville Fire Department Nashville International Airport Nashville, TN Overview Best antiarrhythmic
18% Survival from In-Hospital Cardiac Arrest Ways we can do better! National Teaching Institute Denver, CO Class Code: 149 A
18% Survival from In-Hospital Cardiac Arrest Ways we can do better! National Teaching Institute Denver, CO Class Code: 149 A Nicole Kupchik RN, MN, CCNS, CCRN, PCCN Independent CNS/Staff Nurse Objectives
Cardiac Arrest January 2017 CPR /3/ Day to Survival Propensity Matched
Cardiac Arrest January 217 Corey M. Slovis, M.D. Vanderbilt University Medical Center Metro Nashville Fire Department Nashville International Airport Nashville, TN CPR 217 Used data based on protocol that
The evidence behind ACLS: the importance of good BLS
The evidence behind ACLS: the importance of good BLS Benjamin S. Abella, MD, MPhil, FACEP CRS Center for Resuscitation Science Clinical Research Director Center for Resuscitation Science Vice Chair of
Resuscitation 83 (2012) Contents lists available at SciVerse ScienceDirect. Resuscitation
Resuscitation 83 (2012) 1324 1330 Contents lists available at SciVerse ScienceDirect Resuscitation j ourna l h o me pag e: www. elsevier.com/locate/resuscitation Clinical Paper Wide variability in drug
CPR What Works, What Doesn t
Resuscitation 2017 ECMO and ECLS April 1, 2017 Corey M. Slovis, M.D. Vanderbilt University Medical Center Metro Nashville Fire Department Nashville International Airport Nashville, TN Circulation 2013;128:417-35
Emergency Cardiac Care Guidelines 2015
Emergency Cardiac Care Guidelines 2015 VACEP 2016 William Brady, MD University of Virginia Guidelines 2015 Basic Life Support & Advanced Cardiac Life Support Acute Coronary Syndrome Pediatric Advanced
Lesson learnt from big trials. Sung Phil Chung, MD Gangnam Severance Hospital, Yonsei Univ.
Lesson learnt from big trials Sung Phil Chung, MD Gangnam Severance Hospital, Yonsei Univ. Trend of cardiac arrest research 1400 1200 1000 800 600 400 200 0 2008 2009 2010 2011 2012 2013 2014 2015 2016
PROBLEM: Shock refractory VF/pVT BACKGROUND: Both in 2015 CoSTR. Amiodarone favoured.
Question Should AMIODARONE vs LIDOCAINE be used for adults with shock refractory VF/pVT PROBLEM: Shock refractory VF/pVT BACKGROUND: Both in 2015 CoSTR. Amiodarone favoured. OPTION: AMIODARONE plus standard
2015 AHA Guidelines: Pediatric Updates
2015 AHA Guidelines: Pediatric Updates Advances in Pediatric Emergency Medicine December 9, 2016 Karen O Connell, MD, MEd Associate Professor of Pediatrics and Emergency Medicine Emergency Medicine and
What works? What doesn t? What s new? Terry M. Foster, RN
What works? What doesn t? What s new? Terry M. Foster, RN 2016 Changes Updated every 5 years Last update was 2010 All recommendations have been heavily researched with studies involving large number of
Management of Cardiac Arrest Based on : 2010 American Heart Association Guidelines
Management of Cardiac Arrest Based on : 2010 American Heart Association Guidelines www.circ.ahajournals.org Elham Pishbin. M.D Assistant Professor of Emergency Medicine MUMS C H E S Advanced Life Support
Development of an Out-of-Hospital Cardiac Arrest Surveillance Registry
Development of an Out-of-Hospital Cardiac Arrest Surveillance Registry Bryan McNally, MD, MPH Executive Director CARES Associate Professor of Emergency Medicine Emory University School of Medicine Rollins
The Pragmatic Airway Resuscitation Trial
The Pragmatic Airway Resuscitation Trial Henry E. Wang, MD, MS Professor and Vice Chair for Research Department of Emergency Medicine The University of Texas Health Science Center at Houston McGovern Medical
JUST SAY NO TO DRUGS?
JUST SAY NO TO DRUGS? THE EVIDENCE BEHIND MEDICATIONS USED IN CARDIAC RESUSCITATION NTI 2014 CLASS CODE 148 Nicole Kupchik RN, MN, CCNS, CCRN, PCCN Objectives 1. Discuss the historical evidence supporting
Prof Gavin Perkins Co-Chair ILCOR
Epidemiology of out of hospital cardiac arrest how to improve survival Prof Gavin Perkins Co-Chair ILCOR Chair, Community Resuscitation Committee, Resuscitation Council (UK) Conflict of interest Commercial
Beth Cetanyan, RN AHA RF Aka The GURU
* Beth Cetanyan, RN AHA RF Aka The GURU *Discuss common causes of Pediatric CA *Review current PALS Guidelines *Through case presentations and discussion, become more comfortable and confident in providing
New ACLS/Post Arrest Guidelines: For Everyone? Laurie Morrison, Li Ka Shing, Knowledge Institute, St Michael s Hospital, University of Toronto
New ACLS/Post Arrest Guidelines: For Everyone? Laurie Morrison, Li Ka Shing, Knowledge Institute, St Michael s Hospital, University of Toronto COI Declaration Industry and ROC ALS Taskforce ILCOR Author
Advanced Cardiac Life Support (ACLS) Science Update 2015
1 2 3 4 5 6 7 8 9 Advanced Cardiac Life Support (ACLS) Science Update 2015 What s New in ACLS for 2015? Adult CPR CPR remains (Compressions, Airway, Breathing Chest compressions has priority over all other
All under the division of cardiovascular medicine University of Minnesota
The Team 1) Demetris Yannopoulos M.D. Medical Director, 2) Kim Harkins, Program Manager 3) Lucinda Klann, CARES Data Manager 4) Esther Almeida, Administrative Assistant All under the division of cardiovascular
Strengthening the Chain of Survival in Sudden Cardiac Arrest
Strengthening the Chain of Survival in Sudden Cardiac Arrest Katie Talk CCEMTP AHA Faculty/ Instructor for ACLS, BLS & PALS Clinical Educator for ACSI Employed by Advanced Circulatory Systems, Inc. (manufacture
Sooner to the Ballooner: Going Straight to the Cath Lab with Refractory VF/VT
Sooner to the Ballooner: Going Straight to the Cath Lab with Refractory VF/VT Marc Conterato, MD, FACEP Office of the Medical Director NMAS and the HC EMS Council/Minnesota Resuscitation Consortium DISCLOSURE
Epinephrine Cardiovascular Emergencies Symposium 2018
Epinephrine Cardiovascular Emergencies Symposium 218 Corey M. Slovis, M.D. Vanderbilt University Medical Center Metro Nashville Fire Department Nashville International Airport Nashville, TN High Quality
Advanced Resuscitation - Adult
C02A Resuscitation 2017-03-23 17 years & older Office of the Medical Director Advanced Resuscitation - Adult Intermediate Advanced Critical From PRIMARY ASSESSMENT Known or suspected hypothermia Algorithm
Answer: It s ALL Hot!
Answer: It s ALL Hot! What s Hot in Resuscitation? Ben Bobrow, MD FACEP Chair BLS Subcommittee Associate Professor Maricopa Medical Center Emergency Medicine Department System measurement Bystander Dispatch-assisted
Pediatric Cardiac Arrest General
Date: November 15, 2012 Page 1 of 5 Pediatric Cardiac Arrest General This protocol should be followed for all pediatric cardiac arrests. If an arrest is of a known traumatic origin refer to the Dead on
Australian Resuscitation Outcomes Consortium (Aus-ROC)
Australian Resuscitation Outcomes Consortium (Aus-ROC) A NHMRC Centre of Research Excellence (CRE) in Clinical Research, #1029983 Out-of-hospital cardiac arrest registry ( Epistry ) Presented by Prof Judith
Strengthening the Chain of Survival
Impedance Threshold Device Strengthening the Chain of Survival 2007 Advanced Circulatory Systems, Inc. 1 49-0363-000, 01 Katie Talk NREMT-P AHA Faculty (NC) Clinical Educator for Advanced Circulatory Systems,
POTENTIAL UTILITY OF NEAR-INFRARED SPECTROSCOPY IN OUT-OF-HOSPITAL CARDIAC ARREST: AN ILLUSTRATIVE CASE SERIES
POTENTIAL UTILITY OF NEAR-INFRARED SPECTROSCOPY IN OUT-OF-HOSPITAL CARDIAC ARREST: AN ILLUSTRATIVE CASE SERIES Adam Frisch, MD, Brian P. Suffoletto, MD, MS, Rachel Frank, EMT, Christian Martin-Gill, MD,
Supplementary Online Content
Supplementary Online Content Hasegawa K, Hiraide A, Chang Y, Brown DFM. Association of prehospital advancied airway management with neurologic outcome and survival in patients with out-of-hospital cardiac
Regional Approach to Cardiovascular Emergencies Cardiac Arrest Resuscitation System A Regional Approach: Developing Continuity From Scene to CCU
Regional Approach to Cardiovascular Emergencies Cardiac Arrest Resuscitation System A Regional Approach: Developing Continuity From Scene to CCU R. Darrell Nelson, MD, FACEP Emergency Medicine Wake Forest
HIGH QUALITY CPR: IS IT TIME FOR MECHANICAL ASSISTANCE?
HIGH QUALITY CPR: IS IT TIME FOR MECHANICAL ASSISTANCE? EMERGENCY NURSES ASSOCIATION - 2018 Nicole Kupchik MN, RN, CCNS, CCRN-K, PCCN-CMC Objectives Discuss issues with CPR performance in hospitals Describe
Victorian Ambulance Cardiac Arrest Registry (VACAR)
Victorian Ambulance Cardiac Arrest Registry (VACAR) Dr Karen Smith (PhD) VACAR Chair Manager Research and Evaluation Ambulance Victoria Smith K, Bray J, Barnes V, Lodder M, Cameron P, Bernard S and Currell
Bone Voyage Administrating ALS Medications via the Intra- Osseous Route. Jon Jui MD, MPH
Bone Voyage Administrating ALS Medications via the Intra- Osseous Route Jon Jui MD, MPH Do ALS Medications lead to Improved Survival in Out of Hospital Cardiac Arrest? Intravenous drug administration during
VanderbiltEM.com. Prehospital STEMIs. EMS Today 2018 Research That Should Be On Your Radar Screen 3/1/2018
EMS Today 2018 Research That Should Be On Your Radar Screen Corey M. Slovis, M.D. Vanderbilt University Medical Center Metro Nashville Fire Department Nashville International Airport Nashville, TN VanderbiltEM.com
ROC ALPS. Amiodarone, Lidocaine, or Placebo Study
ROC ALPS Amiodarone, Lidocaine, or Placebo Study Learning Objectives Understand the rationale for antiarrhythmic use in out-of-hospital cardiac arrest Understand how to carry out the ROC ALPS study protocol
Emergency Medicine Research: Creating Evidence to Improve Safety and Effectiveness of ED Patient Care
Emergency Medicine Research: Creating Evidence to Improve Safety and Effectiveness of ED Patient Care Dr Eric Clark MD, FRCPC Department of Emergency Medicine University of Ottawa Canada No Conflicts of
SYSTEMS BASED APPROACH TO OUT-OF-HOSPITAL CARDIAC ARREST
SYSTEMS BASED APPROACH TO OUT-OF-HOSPITAL CARDIAC ARREST Kenneth A Scheppke, MD Chief Medical Officer Palm Beach County Fire Rescue State EMS Medical Director Florida Department of Health CASE REPORT 42
Lessons Learned From Cardiac Resuscitation Research: What Matters at the Bedside?
Lessons Learned From Cardiac Resuscitation Research: What Matters at the Bedside? JILL LEY, MS, RN, CNS, FAAN CLINICAL NURSE SPECIALIST SURGICAL SERVICES CALIFORNIA PACIFIC MEDICAL CENTER CLINICAL PROFESSOR,
DSED: Is It Real? Brent Myers, MD MPH FACEP CMO and EVP of Medical Operations, Evolution Health Associate CMO, American Medical Response
DSED: Is It Real? Brent Myers, MD MPH FACEP CMO and EVP of Medical Operations, Evolution Health Associate CMO, American Medical Response However beautiful the strategy, you should occasionally look at
System Utilization 2013
System Utilization 2013 8000 7000 Contra Costa County 911 Ambulance Response and Transport By Month 2012 Through 2013 (2013 Data excludes SRVFD) Response 6000 5000 Transport 4000 3000 2000 1000 0 1/1/2012
The ARREST Trial: Amiodarone for Resuscitation After Out-of-Hospital Cardiac Arrest Due to Ventricular Fibrillation
The ARREST Trial: Amiodarone for Resuscitation After Out-of-Hospital Cardiac Arrest Due to Ventricular Fibrillation Introduction The ARREST (Amiodarone in out-of-hospital Resuscitation of REfractory Sustained
Supplemental Digital Content 1. Simulation scenarios and critical action checklist for debriefing
Supplemental Digital Content 1. Simulation scenarios and critical action checklist for debriefing Simulation Scenario #1 I. Title (ACS)-VF-Asystole-ROSC II. Target learner 6-7 medical students per team
Update on Sudden Cardiac Death and Resuscitation
Update on Sudden Cardiac Death and Resuscitation Ashish R. Panchal, MD, PhD Medical Director Center for Emergency Medical Services Assistant Professor Clinical Department of Emergency Medicine The Ohio
Evidence Based EMS: The Science Behind Your Care
Evidence Based EMS: The Science Behind Your Care Sean Kivlehan, MD, MPH, NREMT-P September 2016 RESPONSE AIRWAY BREATHING CIRCULATION DISABILITY RESPONSE AIRWAY BREATHING CIRCULATION DISABILITY Eisenberg,
Aiming for high quality CPR: why it matters and how we can get there. Benjamin S. Abella, MD, MPhil, FACEP
Aiming for high quality CPR: why it matters and how we can get there Benjamin S. Abella, MD, MPhil, FACEP Clinical Research Director Center for Resuscitation Science Department of Emergency Medicine University
Key Performance Indicators (KPIs) and Checklist Training
Key Performance Indicators (KPIs) and Checklist Training Raynor Baker Raynor has been an EMT for 13 years. He is currently a volunteer Lieutenant with CCFD5 and works full-time for Lake Chelan Community
ACLS. Advanced Cardiac Life Support Practice Test Questions. 1. The following is included in the ACLS Survey?
1. The following is included in the ACLS Survey? a. Airway, Breathing, Circulation, Differential Diagnosis b. Airway, Breathing, Circulation, Defibrillation c. Assessment, Breathing, Circulation, Defibrillation
Johnson County Emergency Medical Services Page 23
Non-resuscitation Situations: Resuscitation should not be initiated in the following situations: Prolonged arrest as evidenced by lividity in dependent parts, rigor mortis, tissue decomposition, or generalized
Advanced Resuscitation - Child
C02C Resuscitation 2017-03-23 1 up to 10 years Office of the Medical Director Advanced Resuscitation - Child Intermediate Advanced Critical From PRIMARY ASSESSMENT Known or suspected hypothermia Algorithm
Resuscitation 82 (2011) Contents lists available at ScienceDirect. Resuscitation. journal homepage:
Resuscitation 82 (2011) 277 284 Contents lists available at ScienceDirect Resuscitation journal homepage: www.elsevier.com/locate/resuscitation Clinical paper Variation in out-of-hospital cardiac arrest
Cardiac Arrest Registry Database Office of the Medical Director
Cardiac Arrest Registry Database 2010 Office of the Medical Director 1 Monthly Statistical Summary Cardiac Arrest, September 2010 Western Western Description Division Division % Totals Eastern Division
Cardiac Arrest Registry Database Office of the Medical Director
Cardiac Arrest Registry Database 2010 Office of the Medical Director 1 Monthly Statistical Summary Cardiac Arrest, December 2010 Western Western Description Division Division % Totals Eastern Division
2015 Interim Training Materials
2015 Interim Training Materials ACLS Manual and ACLS EP Manual Comparison Chart Assessment sequence Manual, Part 2: The Systematic Approach, and Part BLS Changes The HCP should check for response while
Guideline of Singapore CPR
KACPR Symposium Guideline of Singapore CPR Lim Swee Han MBBS (NUS), FRCS Ed (A&E), FRCP (Edin), FAMS Senior Consultant, Department of Emergency Medicine, Singapore General Hospital Adjunct Associate Professor,
Any man s death diminishes me, because I am involved in mankind. - John Donne
Any man s death diminishes me, because I am involved in mankind - John Donne Cardiac Arrest in 2011 Where are we? Or where should we be? Michael W. Dailey, MD FACEP Associate Professor of Emergency Medicine
Michigan Pediatric Cardiac Protocols. Date: November 15, 2012 Page 1 of 1 TABLE OF CONTENTS
Date: November 15, 2012 Page 1 of 1 TABLE OF CONTENTS Pediatric Asystole Section 4-1 Pediatric Bradycardia Section 4-2 Pediatric Cardiac Arrest General Section 4-3 Pediatric Narrow Complex Tachycardia
Code Talkers NONE. Disclosures Brady & Slovis. Lay Provider Care. Cardiac Arrest 2017 Resuscitation & Post-arrest Management
X 10/27/2017 Code Talkers 2017 Cardiac Arrest 2017 Resuscitation & Post-arrest Management What makes sense - & doesn t - in cardiac arrest management William Brady, MD University of Virginia Corey Slovis,
Four Important Factors
It s Simple but It s not Easy! Death circa the 14 th century Implementing Change to Improve Survival from Cardiac Arrest Credit to the Baltimore Sun for this image Kevin G. Seaman, M. D., FACEP Medical
Out-of-hospital cardiac arrest is a leading cause of premature. Resuscitation Science
Resuscitation Science Chest Compression Fraction Determines Survival in Patients With Out-of-Hospital Ventricular Fibrillation Jim Christenson, MD; Douglas Andrusiek, MSc; Siobhan Everson-Stewart, MS;
HigHligHts of the 2018 Focused In 2015 Updates to the American Heart Association Guidelines for CPR and ECC: Advanced Cardiovascular Life
Highlights of the 2018 Focused Updates to the American Heart Association Guidelines for CPR and ECC: Advanced Cardiovascular Life Support and Pediatric Advanced Life Support - Heart and Stroke Foundation
Controversies in ACLS Drugs: What, When, Why
Controversies in ACLS Drugs: What, When, Why Michael W. Donnino, MD Emergency Medicine and Critical Care Director of the Center for Resuscitation Science Beth Israel Deaconess Medical Center mdonnino@bidmc.harvard.edu
Michigan Pediatric Cardiac Protocols. Date: November 15, 2012 Page 1 of 1 TABLE OF CONTENTS
Date: November 15, 2012 Page 1 of 1 TABLE OF CONTENTS Pediatric Asystole Section 4-1 Pediatric Bradycardia Section 4-2 Pediatric Cardiac Arrest General Section 4-3 Pediatric Narrow Complex Tachycardia
ACLS/ACS Updates 2015
ACLS/ACS Updates 2015 Advanced Cardiovascular Life Support by: Fareed Al Nozha, JBIM, ABIM, FKFSH&RC(Cardiology) Consultant Cardiologist Faculty, National CPR Committee, ACLS Program Head, SHA Dr Abdulhalim
Controversies in Chest Compressions & Airway Management During CPR. Bob Berg
Controversies in Chest Compressions & Airway Management During CPR Bob Berg No Financial Conflicts of Interest Employment: University of Pennsylvania AHA Volunteer AHA GWTG-R & Systems of Care committees
Advanced Resuscitation - Adolescent
C02B Resuscitation 2017-03-23 10 up to 17 years Office of the Medical Director Advanced Resuscitation - Adolescent Intermediate Advanced Critical From PRIMARY ASSESSMENT Known or suspected hypothermia
CARDIOPULMONARY RESUSCITATION QUALITY: WIDESPREAD VARIATION IN DATA INTERVALS USED FOR ANALYSIS
Accepted manuscript of: Talikowska, M. and Tohira, H. and Bailey, P. and Finn, J. 2016. Cardiopulmonary resuscitation quality: Widespread variation in data intervals used for analysis. Resuscitation. 102:
New and Future Trends in EMS. Ron Brown, MD, FACEP Paramedic Lecture Series 2018
New and Future Trends in EMS Ron Brown, MD, FACEP Paramedic Lecture Series 2018 New technologies and protocols DSD Mechanical Compression ITD BiPAP Ultrasound Double Sequential Defibrillation Two defibrillators
Update on Sudden Cardiac Death and Resuscitation
Update on Sudden Cardiac Death and Resuscitation Ashish R. Panchal, MD, PhD Medical Director Center for Emergency Medical Services Assistant Professor Clinical Department of Emergency Medicine The Ohio
Future of Cardiac Arrest Management for Paramedics
Future of Cardiac Arrest Management for Paramedics EMS TODAY 2013 Mark Whitbread Consultant Paramedic London Ambulance Service London Ambulance Service NHS Trust 620 sq miles 8.2 million population 2011/12
Cardiocerebral Resuscitation and the community
Cardiocerebral Resuscitation and the community Why and How to implement in your community! 1 2 Hey guys I have an idea! I propose that if patients become unresponsive and stop breathing that we not breath
Advanced Life Support
Standard Operating Procedure 2.1 Advanced Life Support Position Responsible: Head of Operations CGC Approved: October 2017 Related Documents Further Information 1.0 Background Magpas Resuscitation Policy
WORKSHEET for Evidence-Based Review of Science for Veterinary CPCR
RECOVER 2011 1 of 6 WORKSHEET for Evidence-Based Review of Science for Veterinary CPCR 1. Basic Demographics Worksheet author(s) James Barr Mailing address: 4474 TAMU Texas A&M University College Station,
THE FOLLOWING QUESTIONS RELATE TO THE RESUSCITATION COUNCIL (UK) RESUSCITATION GUIDELINES 2005
THE FOLLOWING QUESTIONS RELATE TO THE RESUSCITATION COUNCIL (UK) RESUSCITATION GUIDELINES 2005 1. The guidelines suggest that in out-of-hospital cardiac arrests, attended but unwitnessed by health care
Trial of Continuous or Interrupted Chest Compressions during CPR
Original Article Trial of Continuous or Interrupted Chest Compressions during CPR Graham Nichol, M.D., M.P.H., Brian Leroux, Ph.D., Henry Wang, M.D., Clifton W. Callaway, M.D., Ph.D., George Sopko, M.D.,
A BS TR AC T. n engl j med 365;9 nejm.org september 1,
The new england journal of medicine established in 1812 september 1, 2011 vol. 365 no. 9 Early versus Later Rhythm Analysis in Patients with Out-of-Hospital Cardiac Arrest Ian G. Stiell, M.D., Graham Nichol,
SUMMARY OF MAJOR CHANGES 2010 AHA GUIDELINES FOR CPR & ECC
SUMMARY OF MAJOR CHANGES 2010 AHA GUIDELINES FOR CPR & ECC The following is a summary of the key issues and changes in the AHA 2010 Guidelines for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiac
ILCOR Evidence Review
ILCOR Evidence Review Task Force BLS 19-Apr-13 Question Status Pending Evidence Collection Short Title Dispatch CPR instructions PICO Question Evidence Reviewers ;#34;#Christian Vaillancourt;#177;#Manya
Sudden Cardiac Arrest
Sudden Cardiac Arrest Amit Sharma, MD, FACP, FACC Interventional Cardiologist Rockledge Regional Medical Center Assistant Professor of Medicine University of Central Florida Disclosures No relevant financial
RACE CARS: Hospital Response. David A. Pearson, MD Department of Emergency Medicine Carolinas Medical Center February 23, 2012
L MODULE 9 RACE CARS: Hospital Response David A. Pearson, MD Department of Emergency Medicine Carolinas Medical Center February 23, 2012 2 Objectives: Post-cardiac arrest syndrome Therapeutic hypothermia
Classification of Cardiopulmonary Resuscitation Chest Compression Patterns: Manual Versus Automated Approaches
ORIGINAL CONTRIBUTION Classification of Cardiopulmonary Resuscitation Chest Compression Patterns: Manual Versus Automated Approaches Henry E. Wang, MD, MS, Robert H. Schmicker, MS, Heather Herren, RN,
Ventricular Tachyarrhythmias after Cardiac Arrest in Public versus at Home
original article Ventricular Tachyarrhythmias after Cardiac Arrest in Public versus at Myron L. Weisfeldt, M.D., Siobhan Everson-Stewart, Ph.D., Colleen Sitlani, M.S., Thomas Rea, M.D., Tom P. Aufderheide,
Learning Station Competency Checklists
Learning Station Competency Checklists Cardiac Arrest: Shockable Rhythm Team Dynamics Practice Demonstrates effective team dynamics (see, below) Performs manual maneuvers to open airway* Initiates assisted
The Future of EMS as Revealed through Research. A Window into the Near Future
The Future of EMS as Revealed through Research A Window into the Near Future Raymond L. Fowler, M.D., FACEP Co-Principal Investigator National Institutes of Health Resuscitation Outcomes Consortium --------------------
Vasopressori ed Antiaritmici
Vasopressori ed Antiaritmici cosa e quando? Claudio Sandroni Istituto Anestesiologia e Rianimazione UCSC ILCOR ALS Task Force - ERC ALS Working Group Deputy Chair, ESICM TEM Section COI Co-author, ERC
Controversies in EMS
Controversies in EMS Mike McEvoy, PhD, NRP, RN, CCRN EMS Coordinator Saratoga County, NY Staff RN Cardiovascular Surgical ICU and Chair Resuscitation Committee Albany Medical Center www.mikemcevoy.com