Yearly Archives: 2013

Mechanical vs. Manual CPR

This is an important and well done study that again could not find any improvement with outcomes with the use of a mechanical chest compression device. This is a multicenter randomized clinical trial of 2589 patients with out-of-hospital cardiac arrest that compared outcomes between the LUCAS device and conventional CPR.

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AED use on commercial flights

In-flight automated external defibrillator use and consultation patterns. AM Brown, et al.  Prehosp Emerg Care, 2010. This 2010 article speaks to the issue of in-flight emergencies on commercial aircrafts, but also raises two broader themes:   AED use and availability in

Kids and Young Adults with SCA

Warning Symptoms and Family History in Children and Young Adults with Sudden Cardiac Arrest Jonathan A. Drezner, MD, Jessie Fudge, MD, Kimberly G. Harmon, MD, Stuart Berger, MD, Robert M. Campbell, MD, and Victoria L. Vetter, MD JABFM July–August 2012

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Efficacy of Early TPA in the ED

This study examines the outcomes of over 50,000 acute ischemic stroke patients who received TPA.
This comes from the “Get with the Guidelines Stroke Program”, a Quality Improvement program used by many stroke centers.

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HEMS in patients with major trauma

It would be hard if not impossible to conduct a randomized prospective study of HEMS vs. ground EMS for poly-trauma.  Thus, past studies have typically relied on retrospective database review, or have used the “before and after” approach (HEMS being the intervention added or taken away in a region).

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Prehospital IV Fluids in Trauma

Surprisingly, the role of prehospital crystalloid resuscitation for those patients with severe blunt trauma is still unclear. This well done study hopes to improve our understanding of the best approach to these patients.

Prehospital Diagnosis and Triage of STEMI

Studies examining accuracy of ER physicians also report variable numbers – 5.2% unnecessary cath activation; 9-14%, depending on false positive definition.  What should be the correct reference standard for EMS (without tele-ECG capability)?

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EMS Complications with STEMI

Among those patients who were diagnosed at home and transported to the hospital, 27% of these patients developed a significant adverse clinical event. The most common events were sinus bradycardia (57 out of 342), hypotension (52 out of 342), or cardiac arrest (13 out of 342).

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Family Presence During CPR

This is the first study to ever methodically examine of the effect of our actions on the families of cardiac arrest victims. This is a prospective cluster-randomized control study that wanted to see if actively encouraging the family to be present for the resuscitation of their loved one would be helpful to reduce symptoms of PTSD and depression at 90 days.

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As a health system, our successes in stroke treatment have been very modest as compared to STEMI care.  For every 100 suspected strokes presenting to a primary stroke center, only 9-30% of cases receive t-PA.

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