The evidence behind ACLS: the importance of good BLS

Size: px
Start display at page:

Download "The evidence behind ACLS: the importance of good BLS"

Transcription

1 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 Research Department of Emergency Medicine University of Pennsylvania Laerdal Workshop December 2014

2 Cardiac arrest is the ultimate EMS disease! arrest % Surviving CPR defibrillation ROSC Time hospital discharge

3 50 years of modern CPR A B A. Peter Safar, 1950s B. Early symposium on CPR 1961

4 Cardiac arrest: fundamentals of therapy Chain of Survival Prompt Access Early ACLS Early Provider ACLS Manual CPR (American Defib Heart Care Association)

5 Chest compression alone CPR Bystander contacted standard CPR (n=960) chest compression alone (n=981) 11.5% 14.4% (OR 2.9) Survival to DC

6 Standard CPR vs CC alone Blood pressure Time = chest compression Berg et al, 2001

7 Standard CPR vs CC alone Blood pressure Time = chest compression Berg et al, 2001

8 No flow / compression fraction Survival to discharge, % comp fraction, % Christenson J et al, Circ 2009 poor survival with lowest compression fraction in OHCA

9 Chest compression depth CPP, mm Hg inches vs 1.5 inches Survival: 100% 15% CPR duration, min ICCM, 2005

10 CPR first may improve survival Influence of cardiopulmonary resuscitation prior to defibrillation in patients with out-of-hospital ventricular fibrillation 24% (155/639) 30% (142/478) p=0.04 Defib first - AHA 42 months 36 months CPR (90 sec) first, then defib Cobb et al, 1999

11 CPR first may improve survival: RCT probability of survival time from collapse, min CPR first Standard care p=0.006 Wik et al, 2003

12 CPR sensing and recording defibrillator Similar defibrillators now made by both Philips and Zoll

13 Using CPR feedback to improve quality Kramer Johansen, 2006 Abella, 2007

14 Actual arrest transcript: U of C, 2004 Arrest transcript ventilations rhythm check ECG ECG: v tach ECG: v fib shock given compressions

15 Chest compression rates Number of 30 sec segments n=1626 segments R>120 Chest compression rate (min-1) Abella et al, 2005

16 Chest compression rates by survival Number of 30 sec segments p=0.003 No ROSC ROSC Mean rate, no ROSC group 79 ± 18 * Mean rate, ROSC group 90 ± 17 * >120 Chest compression rate (min -1 ) Abella et al, 2005

17 CPR renaissance: measuring CPR Valenzuela et al, Circ 2005 Wik et al, JAMA 2005 Abella et al, JAMA 2005 Aufderheide et al,circ 2004

18 Hyperventilation during EMS resuscitation 16 seconds v v v v v v v v v v mean ventilation rate: 30 ± 3.2 first group: 37 ± 4 after retraining: 22 ± 3 Aufderheide et al, 2004

19 Chest compression pauses before shocks 4:55 5:00 5:05 5:10 Compressions ECG Pause before shock

20 Dose-effect of pre-shock pauses VF removed, percent % 10.3 (n=10) 64% (n=11) p= % (n=11) 10% 33.2 (n=10) Pre-shock pause, seconds Edelson et al, 2006

21 Shock success by compression depth Shock success, percent 120% 100% 80% 60% 40% 20% 0% p= % 62% 93% ACLS Range 100% n=10 n=13 n=14 n=5 < >2 Compression depth, inches Edelson et al, 2006

22 Improving EMS care with CC only Bobrow et al, 2008 Interventions: 1. Significantly delay intubation compressions before first shock 3. Minimize pre and post shock pauses Tripled survival to hospital discharge (3.8% à 9.1%)

23 Improving EMS care with CC only Confirmation of this finding: 2009

24 How to train for quality

25 Debriefing intervention l Code review investigation: All residents and students rotating through resuscitation team roles Debrief teams on their events Weekly min resuscitation debriefing/ teaching sessions

26 Impact of CPR feedback and debriefing Edelson et al, 2008

27 Impact of CPR feedback and debriefing Edelson et al, 2008

28 Impact of CPR feedback and debriefing EMS version of the Edelson 2008 study Performed using Zoll feedback defibrillators in Arizona

29 Impact of CPR feedback and debriefing

30 The key importance of CPR Reflected in the poor impact of ACLS meds: 2009 Randomized trial of epinephrine versus no epinephrine For EMS treated cardiac arrest à NO SURVIVAL BENEFIT!

31 Key take home points 1.Cardiac arrest is not hopeless! 2.CPR quality has big impact 3.Minimize ventilations 4.Maximize chest compression rate and depth 5.Consider CPR feedback tools and code debriefing 6.Use hypothermia after cardiac arrest

32 Questions??

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 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

More information

Answer: It s ALL Hot!

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

More information

Improving Outcome from In-Hospital Cardiac Arrest

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

More information

HIGH QUALITY CPR: IS IT TIME FOR MECHANICAL ASSISTANCE?

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

More information

But unfortunately, the first sign of cardiovascular disease is often the last. Chest-Compression-Only Resuscitation Gordon A.

But unfortunately, the first sign of cardiovascular disease is often the last. Chest-Compression-Only Resuscitation Gordon A. THE UNIVERSITY OF ARIZONA Sarver Heart Center 1 THE UNIVERSITY OF ARIZONA Sarver Heart Center 2 But unfortunately, the first sign of cardiovascular disease is often the last 3 4 1 5 6 7 8 2 Risk of Cardiac

More information

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 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

More information

Helping you save more lives. Philips HeartStart Resuscitation Solutions Leading the way in quality resuscitation

Helping you save more lives. Philips HeartStart Resuscitation Solutions Leading the way in quality resuscitation Helping you save more lives Philips HeartStart Resuscitation Solutions Leading the way in quality resuscitation The link between early defibrillation and quality As a worldwide leader in defibrillation

More information

The 2015 BLS & ACLS Guideline Updates What Does the Future Hold?

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

More information

2015 AHA Guidelines: Pediatric Updates

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

More information

CARDIOPULMONARY RESUSCITATION QUALITY: WIDESPREAD VARIATION IN DATA INTERVALS USED FOR ANALYSIS

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:

More information

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 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.

More information

Therapeutic hypothermia Transcutaneous pacing Sodium bicarbonate Rx Calcium, Magnesium Fluids and Pressors Antiarrhythmic Rx Epi/Vasopressin O 2

Therapeutic hypothermia Transcutaneous pacing Sodium bicarbonate Rx Calcium, Magnesium Fluids and Pressors Antiarrhythmic Rx Epi/Vasopressin O 2 Resuscitation Arsenal Therapeutic hypothermia Transcutaneous pacing Sodium bicarbonate Rx Calcium, Magnesium Fluids and Pressors Antiarrhythmic Rx Epi/Vasopressin O 2 /intubation Shock CPR ` 1994-96 Standing

More information

AutoPulse Plus. Maximizes the likelihood of. Shock Success

AutoPulse Plus. Maximizes the likelihood of. Shock Success AutoPulse Plus Maximizes the likelihood of Shock Success Shock Sync For decades, the standard treatment for a fibrillating heart has been to deliver a shock. To do this, we stop chest compressions, analyze

More information

Science Behind CPR Update from Darrell Nelson, MD, FACEP Emergency Medicine Wake Forest University Health Sciences

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

More information

Controversies in Chest Compressions & Airway Management During CPR. Bob Berg

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

More information

Developments in Cardiopulmonary Resuscitation Guidelines

Developments in Cardiopulmonary Resuscitation Guidelines Developments in Cardiopulmonary Resuscitation Guidelines Bernd W. Böttiger Seite 1 To preserve human life by making high quality resuscitation available to all Outcome after CPR in Germany ROSC ( Return

More information

Four Important Factors

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

More information

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 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

More information

OTHER FEATURES SMART CPR

OTHER FEATURES SMART CPR SMART CPR Philips has augmented the HeartStart AED s well proven patient analysis logic with SMART CPR, a feature that provides a tool for Medical Directors and Administrators to implement existing or

More information

SUMMARY OF MAJOR CHANGES 2010 AHA GUIDELINES FOR CPR & ECC

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

More information

Regionalization of Post-Cardiac Arrest Care

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

More information

Epinephrine Cardiovascular Emergencies Symposium 2018

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

More information

Maximises the likelihood of. Shock Success

Maximises the likelihood of. Shock Success Maximises the likelihood of Shock Success Shock Sync For decades, the standard treatment for a fibrillating heart has been to deliver a shock. To do this, we stop chest compressions, analyse the heart

More information

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 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

More information

Sudden Cardiac Arrest

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

More information

Supplemental Digital Content 1. Simulation scenarios and critical action checklist for debriefing

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

More information

What works? What doesn t? What s new? Terry M. Foster, RN

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

More information

JUST SAY NO TO DRUGS?

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

More information

The Need for Basic & Translational Research in Cardiac Arrest Customized Treatment. Robert A. Berg IOM August 2014

The Need for Basic & Translational Research in Cardiac Arrest Customized Treatment. Robert A. Berg IOM August 2014 The Need for Basic & Translational Research in Cardiac Arrest Customized Treatment Robert A. Berg IOM August 2014 Present State of Translational Large Animal CPR Research in the USA Dismal Few labs (~10)

More information

New Life for the Treatment of Sudden Death: Translating New Guidelines to our Patients

New Life for the Treatment of Sudden Death: Translating New Guidelines to our Patients New Life for the Treatment of Sudden Death: Translating New Guidelines to our Patients Terry Vanden Hoek, M.D. Associate Professor Medicine Emergency Resuscitation Center University of Chicago and Argonne

More information

Supplementary Online Content

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

More information

Management of Cardiac Arrest Based on : 2010 American Heart Association Guidelines

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

More information

GETTING TO THE HEART OF THE MATTER. Ritu Sahni, MD, MPH Lake Oswego Fire Department Washington County EMS Clackamas County EMS

GETTING TO THE HEART OF THE MATTER. Ritu Sahni, MD, MPH Lake Oswego Fire Department Washington County EMS Clackamas County EMS GETTING TO THE HEART OF THE MATTER Ritu Sahni, MD, MPH Lake Oswego Fire Department Washington County EMS Clackamas County EMS TAKE HOME POINTS CPR is the most important thing Train like we fight Measure

More information

Disclosure. Co-investigators 1/23/2015

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

More information

Update on Sudden Cardiac Death and Resuscitation

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

More information

Manual Defibrillation. CPR AGE: 18 years LOA: Altered HR: N/A RR: N/A SBP: N/A Other: N/A

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

More information

An Analysis of Continuous Chest Compression CPR for EMS Providers During Out of Hospital Cardiac Arrest

An Analysis of Continuous Chest Compression CPR for EMS Providers During Out of Hospital Cardiac Arrest Illinois Wesleyan University Digital Commons @ IWU Honors Projects Psychology 2010 An Analysis of Continuous Chest Compression CPR for EMS Providers During Out of Hospital Cardiac Arrest Megan L. Gleason

More information

2015 Interim Training Materials

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

More information

Emergency Cardiac Care Guidelines 2015

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

More information

WORKSHEET for Evidence-Based Review of Science for Veterinary CPCR

WORKSHEET for Evidence-Based Review of Science for Veterinary CPCR RECOVER 2011 1 of 7 WORKSHEET for Evidence-Based Review of Science for Veterinary CPCR 1. Basic Demographics Worksheet author(s) Kate Hopper Mailing address: Dept Vet Surgical & Radiological Sciences Room

More information

Hanna K. Al-Makhamreh, M.D., FACC Interventional Cardiologist

Hanna K. Al-Makhamreh, M.D., FACC Interventional Cardiologist Hanna K. Al-Makhamreh, M.D., FACC Interventional Cardiologist Introduction. Basic Life Support (BLS). Advanced Cardiac Life Support (ACLS). Cardiovascular diseases (CVDs) are the number one cause of death

More information

IMPACT OF THE 2005 AHA GUIDELINES ON RESUSCITATION OUTCOMES Ronna Zaremski, RN, MSN, CCRN

IMPACT OF THE 2005 AHA GUIDELINES ON RESUSCITATION OUTCOMES Ronna Zaremski, RN, MSN, CCRN Page 1 of 9 IMPACT OF THE 2005 AHA GUIDELINES ON RESUSCITATION OUTCOMES Ronna Zaremski, RN, MSN, CCRN Introduction Recommendations for the management of cardiac arrest have been developed, refined, and

More information

Overview and Latest Research on Out of Hospital Cardiac Arrest

Overview and Latest Research on Out of Hospital Cardiac Arrest L MODULE 1 Overview and Latest Research on Out of Hospital Cardiac Arrest Jamie Jollis, MD Co PI RACE CARS 2 Out of Hospital Cardiac Arrest in U.S. 236 000 to 325 000 people in the United States each year

More information

Guideline of Singapore CPR

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,

More information

Update on Sudden Cardiac Death and Resuscitation

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

More information

Out-Of-Hospital Management and Outcomes of Sudden Cardiac Death Abdelouahab BELLOU, MD, PhD

Out-Of-Hospital Management and Outcomes of Sudden Cardiac Death Abdelouahab BELLOU, MD, PhD Out-Of-Hospital Management and Outcomes of Sudden Cardiac Death Abdelouahab BELLOU, MD, PhD Professor of Internal Medicine, Emergency Medicine, Therapeutics. Past President of the European Society for

More information

Resuscitation Guidelines update. Dr. Luis García-Castrillo Riesgo EuSEM Vice president

Resuscitation Guidelines update. Dr. Luis García-Castrillo Riesgo EuSEM Vice president Resuscitation Guidelines update Dr. Luis García-Castrillo Riesgo EuSEM Vice president There are no COIs to disclose in this presentation. CPR Mile Stones 1958 -William Kouwenhoven, cardiac massage. 1967

More information

Disclosures. Overview. Cardiopulmonary Arrest: Quality Measures 5/29/2014. In-Hospital Cardiac Arrest: Measuring Effectiveness and Improving Outcomes

Disclosures. Overview. Cardiopulmonary Arrest: Quality Measures 5/29/2014. In-Hospital Cardiac Arrest: Measuring Effectiveness and Improving Outcomes Disclosures In-Hospital Cardiac Arrest: Measuring Effectiveness and Improving Outcomes Research support from UCOP CHQI award J. Matthew Aldrich, MD Anesthesia & Critical Care UCSF Overview Epidemiology

More information

Conflict of Interest. Relevant Financial Relationships None. Off Label Usage None. American Heart Association BLS Guideline Committee Volunteer

Conflict of Interest. Relevant Financial Relationships None. Off Label Usage None. American Heart Association BLS Guideline Committee Volunteer Conflict of Interest Sarver Heart Center Resuscitation Research Group Cardiocerebral Resuscitation: A New Approach to Cardiac Arrest Bentley J. Bobrow, MD Medical Director Bureau of EMS & Trauma System

More information

in Cardiac Arrest Management Sean Kivlehan, MD, MPH May 2014

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

More information

Cardiac Arrest: CPR and Beyond

Cardiac Arrest: CPR and Beyond Transcript Details This is a transcript of an educational program accessible on the ReachMD network. Details about the program and additional media formats for the program are accessible by visiting: https://reachmd.com/programs/clinicians-roundtable/cardiac-arrest-cpr-and-beyond/3954/

More information

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. 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

More information

Cardiac Arrest January 2017 CPR /3/ Day to Survival Propensity Matched

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

More information

ORIGINAL INVESTIGATION. Improving In-Hospital Cardiac Arrest Process and Outcomes With Performance Debriefing

ORIGINAL INVESTIGATION. Improving In-Hospital Cardiac Arrest Process and Outcomes With Performance Debriefing ORIGINAL INVESTIGATION Improving In-Hospital Cardiac Arrest Process and Outcomes With Performance Debriefing Dana P. Edelson, MD, MS; Barbara Litzinger, BS; Vineet Arora, MD, MAPP; Deborah Walsh, MS, RN;

More information

THE FOLLOWING QUESTIONS RELATE TO THE RESUSCITATION COUNCIL (UK) RESUSCITATION GUIDELINES 2005

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

More information

Michigan Pediatric Cardiac Protocols. Date: November 15, 2012 Page 1 of 1 TABLE OF CONTENTS

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

More information

Introduction To ACLS,1 18 April 2011 INTRODUCTION TO ACLS

Introduction To ACLS,1 18 April 2011 INTRODUCTION TO ACLS Introduction To ACLS,1 INTRODUCTION TO ACLS EPIDEMIOLOGY In Singapore, every year about 2,400 people suffer from an acute myocardial infarction. Of these about 900 die as a result of sudden cardiac arrest,

More information

Advanced Resuscitation - Child

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

More information

Moving Codes Upstairs - How the ratio of PICU arrests is increasing and why it s a good thing

Moving Codes Upstairs - How the ratio of PICU arrests is increasing and why it s a good thing Moving Codes Upstairs - How the ratio of PICU arrests is increasing and why it s a good thing Robert A. Berg, MD, FCCM, FAHA, FAAP Division Chief, Critical Care Medicine The Children s Hospital of Philadelphia

More information

Advanced Cardiac Life Support (ACLS) Science Update 2015

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

More information

Feasibility of Biosignal-guided Chest Compression During Cardiopulmonary Resuscitation: A Proof of Concept

Feasibility of Biosignal-guided Chest Compression During Cardiopulmonary Resuscitation: A Proof of Concept BRIEF REPORT Feasibility of Biosignal-guided Chest Compression During Cardiopulmonary Resuscitation: A Proof of Concept Matthew L. Sundermann, MS, David D. Salcido, PhD, Allison C. Koller, and James J.

More information

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 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

More information

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 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

More information

New Therapeutic Hypothermia Techniques

New Therapeutic Hypothermia Techniques New Therapeutic Hypothermia Techniques Joseph P. Ornato, MD, FACP, FACC, FACEP Professor & Chairman, Emergency Medicine Virginia Commonwealth University Health System Richmond, VA Medical Director Richmond

More information

Disclosures. Extra-Corporeal Membrane Oxygenation During Cardio- Pulmonary Resuscitation ECPR April 22, 2016 ECG. Case. Case. Case Summary 4/22/2016

Disclosures. Extra-Corporeal Membrane Oxygenation During Cardio- Pulmonary Resuscitation ECPR April 22, 2016 ECG. Case. Case. Case Summary 4/22/2016 Extra-Corporeal Membrane Oxygenation During Cardio- Pulmonary Resuscitation ECPR April 22, 2016 Nothing to disclose. Disclosures Ivan J Chavez MD Case ECG History 60 y/o male No prior history of CAD In

More information

SCA SCA. Modern SCA Definition Sudden Cardiac Arrest: The Scourge Continues. What is Sudden Cardiac Arrest. Incidence-the mystery

SCA SCA. Modern SCA Definition Sudden Cardiac Arrest: The Scourge Continues. What is Sudden Cardiac Arrest. Incidence-the mystery Modern SCA Definition Sudden Cardiac Arrest: The Scourge Continues Ryan Schaefer RN, Electrophysiology & Project Adam Coordinator Sacred Heart Medical Center (1) Witnessed cardiac arrest; (2) within 1

More information

Simulation 15: 51 Year-Old Woman Undergoing Resuscitation

Simulation 15: 51 Year-Old Woman Undergoing Resuscitation Simulation 15: 51 Year-Old Woman Undergoing Resuscitation Flow Chart Flow Chart Opening Scenario Section 1 Type: DM Arrive after 5-6 min in-progress resuscitation 51 YO female; no pulse or BP, just received

More information

Michigan Pediatric Cardiac Protocols. Date: November 15, 2012 Page 1 of 1 TABLE OF CONTENTS

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

More information

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 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

More information

ACLS AND MORE. Ryan Clark D.O. Medical Education Fellow University of Massachusetts Medical School Baystate Medical Center

ACLS AND MORE. Ryan Clark D.O. Medical Education Fellow University of Massachusetts Medical School Baystate Medical Center ACLS AND MORE Ryan Clark D.O. Medical Education Fellow University of Massachusetts Medical School Baystate Medical Center FOCUS 1. The death of the pulse check 2. PEA and why you can stop memorizing the

More information

Portage County EMS Annual Skills Labs

Portage County EMS Annual Skills Labs Portage County EMS Annual Skills Labs Scope: Provide skills labs for all Emergency Medical Responders and First Response EMTs to assure proficiency of skills and satisfy the Wisconsin State approved Operational

More information

Resuscitation Outcomes Consortium: Overview and Update

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

More information

Future of Cardiac Arrest Management for Paramedics

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

More information

Cardiopulmonary Resuscitation in Adults

Cardiopulmonary Resuscitation in Adults Cardiopulmonary Resuscitation in Adults Fatma Özdemir, MD Emergency Deparment of Uludag University Faculty of Medicine OVERVIEW Introduction Pathophysiology BLS algorithm ALS algorithm Post resuscitation

More information

Prof Gavin Perkins Co-Chair ILCOR

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

More information

ADVANCED LIFE SUPPORT

ADVANCED LIFE SUPPORT ANSWERS IN ITALICS WITH REFERENCES 1. The guidelines suggest that in out-of-hospital cardiac arrests, attended but unwitnessed by health care professionals equipped with a manual defibrillator, the providers

More information

Advanced Resuscitation - Adult

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

More information

Beth Cetanyan, RN AHA RF Aka The GURU

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

More information

Out-of-hospital Cardiac Arrest. Franz R. Eberli MD, FESC, FAHA Cardiology Triemli Hospital Zurich, Switzerland

Out-of-hospital Cardiac Arrest. Franz R. Eberli MD, FESC, FAHA Cardiology Triemli Hospital Zurich, Switzerland Out-of-hospital Cardiac Arrest Franz R. Eberli MD, FESC, FAHA Cardiology Triemli Hospital Zurich, Switzerland Conflict of Interest I have no conflict of interest to disclose regarding this presentation.

More information

Incidence of and Survival from Sudden Cardiac Arrest

Incidence of and Survival from Sudden Cardiac Arrest Incidence of and Survival from Sudden Cardiac Arrest Vincent N Mosesso, Jr, MD Professor of Emergency Medicine University of Pittsburgh School of Medicine Disclosures Employer: University of Pittsburgh

More information

Out-of-Hospital Cardiac Arrest In North Carolina. Christopher Granger, M.D. Director, Duke CCU

Out-of-Hospital Cardiac Arrest In North Carolina. Christopher Granger, M.D. Director, Duke CCU Out-of-Hospital Cardiac Arrest In North Carolina Christopher Granger, M.D. Director, Duke CCU Disclosure Research contracts: AstraZeneca, Novartis, GSK, Sanofi-Aventis, BMS, The Medicines Company, Astellas,

More information

ACP Recertification Pre-Course: Pediatric Manual Defibrillation

ACP Recertification Pre-Course: Pediatric Manual Defibrillation 2010-2011 ACP Recertification Pre-Course: Pediatric Manual Defibrillation Pediatric Defibrillation - Overview Objectives Overview of Pediatric Defibrillation Etiology and Pathophysiology of Pediatric Defibrillation

More information

Pediatric Cardiac Arrest General

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

More information

Don t let your patients turn blue! Isn t it about time you used etco 2?

Don t let your patients turn blue! Isn t it about time you used etco 2? Don t let your patients turn blue! Isn t it about time you used etco 2? American Association of Critical Care Nurses National Teaching Institute Expo Ed 2013 Susan Thibeault MS, CRNA, APRN, CCRN, EMT-P

More information

The Importance of CPR in Sudden Cardiac Arrest

The Importance of CPR in Sudden Cardiac Arrest The Importance of CPR in Sudden Cardiac Arrest By Adrian Waller, Public Safety Manager, ZOLL Medical. Feb 2011 The Importance of CPR in Sudden Cardiac Arrest By Adrian Waller, Public Safety Manager, ZOLL

More information

Automated External Defibrillation Principle of Early Defibrillation States that all BLS personnel be trained, equipped and allowed to operate a if

Automated External Defibrillation Principle of Early Defibrillation States that all BLS personnel be trained, equipped and allowed to operate a if 1 2 3 4 5 6 Automated External Defibrillation Principle of Early Defibrillation States that all BLS personnel be trained, equipped and allowed to operate a if they are expected to respond to persons in

More information

ACLS Prep. Preparation is key to a successful ACLS experience. Please complete the ACLS Pretest and Please complete this ACLS Prep.

ACLS Prep. Preparation is key to a successful ACLS experience. Please complete the ACLS Pretest and Please complete this ACLS Prep. November, 2013 ACLS Prep Preparation is key to a successful ACLS experience. Please complete the ACLS Pretest and Please complete this ACLS Prep. ACLS Prep Preparation is key to a successful ACLS experience.

More information

ACLS. Advanced Cardiac Life Support Practice Test Questions. 1. The following is included in the ACLS Survey?

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

More information

Yolo County Health & Human Services Agency

Yolo County Health & Human Services Agency Yolo County Health & Human Services Agency Kristin Weivoda EMS Administrator John S. Rose, MD, FACEP Medical Director DATE: December 28, 2017 TO: Yolo County Providers and Agencies FROM: Yolo County EMS

More information

Out-of-hospital cardiac arrest is a leading cause of premature. Resuscitation Science

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;

More information

MICHIGAN. State Protocols. Pediatric Cardiac Table of Contents 6.1 General Pediatric Cardiac Arrest 6.2 Bradycardia 6.

MICHIGAN. State Protocols. Pediatric Cardiac Table of Contents 6.1 General Pediatric Cardiac Arrest 6.2 Bradycardia 6. MICHIGAN State Protocols Protocol Number Protocol Name Pediatric Cardiac Table of Contents 6.1 General Pediatric Cardiac Arrest 6.2 Bradycardia 6.3 Tachycardia PEDIATRIC CARDIAC PEDIATRIC CARDIAC ARREST

More information

Cardiopulmonary Resuscitation Feedback Devices for Adult Patients in Cardiac Arrest: A Review of Clinical Effectiveness and Guidelines

Cardiopulmonary Resuscitation Feedback Devices for Adult Patients in Cardiac Arrest: A Review of Clinical Effectiveness and Guidelines TITLE: Cardiopulmonary Resuscitation Feedback Devices for Adult Patients in Cardiac Arrest: A Review of Clinical Effectiveness and Guidelines DATE: 20 April 2015 CONTEXT AND POLICY ISSUES The incidence

More information

Update of CPR AHA Guidelines

Update of CPR AHA Guidelines Update of CPR AHA Guidelines Donald Hal Shaffner Course objective is to have an updated understanding of the American Heart Association s treatment algorithms for the management of cardiac decompensation

More information

RACE CARS: Hospital Response. David A. Pearson, MD Department of Emergency Medicine Carolinas Medical Center February 23, 2012

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

More information

AED Therapy for Sudden Cardiac Arrest: Focus on Exercise Facilities

AED Therapy for Sudden Cardiac Arrest: Focus on Exercise Facilities AED Therapy for Sudden Cardiac Arrest: Focus on Exercise Facilities Richard L. Page, M.D. University of Wisconsin School of Medicine and Public Health Disclosures I have no conflict of interest related

More information

Implementing the 2005 American Heart Association Guidelines improves outcomes after out-of-hospital cardiac arrest

Implementing the 2005 American Heart Association Guidelines improves outcomes after out-of-hospital cardiac arrest Implementing the 2005 American Heart Association Guidelines improves outcomes after out-of-hospital cardiac arrest Tom P. Aufderheide, MD,* Demetris Yannopoulos, MD, Charles J. Lick, MD, Brent Myers, MD,

More information

SYSTEMS BASED APPROACH TO OUT-OF-HOSPITAL CARDIAC ARREST

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

More information

Learning Station Competency Checklists

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

More information

1/24/2018. Taking Mechanical CPR to New Heights: Use of Automated Chest Compression Devices in Helicopter EMS Transport.

1/24/2018. Taking Mechanical CPR to New Heights: Use of Automated Chest Compression Devices in Helicopter EMS Transport. Taking Mechanical CPR to New Heights: Use of Automated Chest Compression Devices in Helicopter EMS Transport NAEMSP 2018 Annual Meeting January 8-13, 2018 San Diego, CA John W. Lyng, MD, FACEP, FAEMS,

More information

Circulation. 2011;124:58-66; originally published online June 20, 2011; doi: /CIRCULATIONAHA

Circulation. 2011;124:58-66; originally published online June 20, 2011; doi: /CIRCULATIONAHA Perishock Pause : An Independent Predictor of Survival From Out-of-Hospital Shockable Cardiac Arrest Sheldon Cheskes, Robert H. Schmicker, Jim Christenson, David D. Salcido, Tom Rea, Judy Powell, Dana

More information