Blog Archives

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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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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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.

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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Previous studies have clearly demonstrated that almost all humans have the propensity to hyperventilate almost all of the time in these high profile cases. Hyperoxia and hyperventilation have both been demonstrated to worsen outcomes in these patients.

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This study looks at the locations of 600 or so cardiac arrest cases that occurred in public. The top 5 locations categories by annual out of hospital cardiac arrests per site. They calculated the number of sites required to Yield 1 OHCA per year.

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