Cardiac Arrest


We have a significant way to go with respect to our cardiac arrest management.

‘Cardiopulmoary Resuscitation is attempted in nearly 30,000 people who suffered OHCA in England each year, but survival rates are low and compare unfavourably to a number of other countries’ –  Resuscitation to Recovery 2017

25% of patients get a ROSC with 7-8% of patients surviving to hospital discharge, which as mentioned is hugely below some countries.

In this podcast we run through cardiac arrest management and the associated evidence base, right from chest compressions, through to drugs, prognostication and ceasing resuscitation attempts.

Make sure you take a look at the papers and references yourself and we would love to hear you feedback!

Enjoy!

SimonRob & James

References & Further Reading

Resuscitation to Recovery Document

Kids Save Lives“: Educating Schoolchildren in Cardiopulmonary Resuscitation Is a Civic DutyThat Needs Support for Implementation. Böttiger BW. J Am Heart Assoc. 2017

Association Between Tracheal Intubation During Adult In-Hospital Cardiac Arrest and Survival.Andersen LW. JAMA. 2017

Double sequential Defibrillation therapy for out-of-hospital cardiac arrests: the London experience. Emmerson AC, et al. Resuscitation. 2017

Dual sequential defibrillation: Does one plus one equal two? Deakin CD. Resuscitation. 2016

Thrombolysis during resuscitation for out-of-hospital cardiac arrest. Böttiger BW. N Engl J Med. 2008

Mechanical versus manual chest compression for out-of-hospital cardiac arrest (PARAMEDIC): a pragmatic, cluster randomised controlled trial. Perkins GD. Lancet. 2015

Mechanical chest compressions and simultaneous defibrillation vs conventional cardiopulmonary resuscitation in out-of-hospital cardiac arrest: the LINC randomized trial. Rubertsson S. JAMA. 2014

Effect of epinephrine on survival after cardiac arrest: a systematic review and meta analysis. Patanwala AE. Minerva Anestesiol. 2014

Impact of cardiopulmonary resuscitation duration on survival from paramedic witnessed out-of-hospital cardiac arrests: An observational study. Nehme Z. 2016 Mar;100:25-31. doi: 10.1016/j.resuscitation.2015.12.011. Epub 2016 Jan 13.

Predicting in-hospital mortality during cardiopulmonary resuscitationSchultz SC. Resuscitation. 1996

Accuracy of point-of-care focused echocardiography in predicting outcome of resuscitation in cardiac arrest patients: A systematic review and meta-analysis. Tsou PY. Resuscitation. 2017

End-tidal CO2 as a predictor of survival in out-of-hospital cardiac arrest. Eckstein M. Prehosp Disaster Med. 2011

LITFL; cessation of CPR

Comments

7 comments on “Cardiac Arrest”
  1. David Baden says:

    Dear Simon, Rob en James,

    Thank you for again an excellent podcast.

    Wanted to let you know that in the Netherlands it is standard practice too pre-charge the defibrillator before the ritme check and dump the charge if it is not necessary. The rational is that every interruption of cpr causes a drop in coronary and brain perfusion. Because it is standard practice the dumping is routine and we don’t even do a ritme check without the beeping sound of a charged defibrillator. Safety is always something you have to think about, we always take the standard measure of hands off and oxygen away the moment we do a ritme check. Something to think about is that a conducted hit from a defibrillator is not something that potentially causes a lot of damage and there are studies that you can continue cpr during defibrillation if you are wearing gloves.

    Continue the great work on the podcast,

    Kind regards,

    David Baden
    Emergency resident Hoorn, the Netherlands

    1. Simon Laing says:

      Thanks David

      Really interesting to hear, interesting the big difference in regional practice and to see if we will soon follow your lead!

      Cheers

      Simon

  2. Russell Pyne says:

    As a CFR this chat obviously goes way beyond my role but as someone who is potentially first on scene – the discussion around getting the patient into a better space if possible if definitely something I will bear in mind going forward. Also fully support the idea of getting as many people trained in hands-on CPR as possible.

    1. Simon Laing says:

      Thanks Russell, glad it was useful.

      Simon

  3. Dominick Walenczak says:

    I must say, I emphatically disagree with the use of Naloxone in actual cardiac arrest. There is no data to actually support it.

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