Prevalence of COVID-19 in OHCA: Implications for Bystander CPR

We undertook a cohort investigation of OHCA attended by emergency medical services (EMS) in Seattle and King County, WA from January 1 to April 15, 2020. Patients where EMS attempted resuscitation (EMS treated) and where EMS responded but did not provide resuscitation because of signs of irreversible death (dead on EMS arrival) were included. Our population-based OHCA registry systematically abstracts information about OHCA presentation, treatment, and outcome from dispatch audio recordings, defibrillator electronic data, prehospital … Continue reading Prevalence of COVID-19 in OHCA: Implications for Bystander CPR

Research Analysis: Preventing downstream consequences of EMS assaults

The National Association of EMTs (NAEMT) recently published a survey on member experiences with violence in the prehospital setting. They received nearly 2,200 responses from mostly paramedics and EMTs detailing not only their exposure to violence, but also the role violence plays on their perceptions of safety, provider knowledge of reporting systems, agency policies and procedures, as well as the types of education and training … Continue reading Research Analysis: Preventing downstream consequences of EMS assaults

Research Analysis: Status epilepticus: Pick your antidote

Results from the Established Status Epilepticus Treatment Trial (ESETT) were recently published in New England Journal of Medicine (NEJM), providing medical directors with a research-centric resource to turn to when epileptic patients don’t respond to traditional benzodiazepines. Specifically, ESETT was an NIH and FDA funded joint effort by the Neurological Emergencies Treatment Trials (NETT) Network and the Pediatric Emergency Care Applied Research Network (PECARN) in … Continue reading Research Analysis: Status epilepticus: Pick your antidote

Causes of Chest Compression Interruptions During OHCA

Abstract Background Interruptions in chest compressions contribute to poor outcomes in out‐of‐hospital cardiac arrest. The objective of this retrospective observational cohort study was to characterize the frequency, reasons, and duration of interruptions in chest compressions and to determine if interruptions changed over time. Methods and Results All out‐of‐hospital cardiac arrests treated by the Seattle Fire Department (Seattle, WA, United States) from 2007 to 2016 with … Continue reading Causes of Chest Compression Interruptions During OHCA

Targeted Temperature Management at 33 Versus 36 Degrees: A Retrospective Cohort Study

Abstract Objectives: To determine the association between targeted temperature managementgoal temperature of 33°C versus 36°C and neurologic outcome after out-of-hospital cardiac arrest. Design: This was a retrospective, before-and-after, cohort study. Setting: Urban, academic, level 1 trauma center from 2010 to 2017. Patients: Adults with nontraumatic out-of-hospital cardiac arrest who received targeted temperature management. Interventions: Our primary exposure was targeted temperature management goal temperature, which was changed from 33°C to 36°C in April of 2014 at the study hospital. Primary … Continue reading Targeted Temperature Management at 33 Versus 36 Degrees: A Retrospective Cohort Study

Research analysis: Using continuous feedback to drive cardiac arrest care improvements

The Municipal Emergency Medical Services of Vienna implemented a standardized post-resuscitation feedback system and performed a two-year evaluation of its impact on performance and patient outcomes. They recently published their results in “Resuscitation.” Within 48 hours of every out-of-hospital cardiac arrest (OHCA) from August 2013 through July 2015 (n = 2466) providers received comprehensive feedback on their performance related to “compression rate, compression ratio, ventilation … Continue reading Research analysis: Using continuous feedback to drive cardiac arrest care improvements

Machine learning as a supportive tool to recognize cardiac arrest in emergency calls

Background Emergency medical dispatchers fail to identify approximately 25% of cases of out of hospital cardiac arrest, thus lose the opportunity to provide the caller instructions in cardiopulmonary resuscitation. We examined whether a machine learning framework could recognize out-of-hospital cardiac arrest from audio files of calls to the emergency medical dispatch center. Methods For all incidents responded to by Emergency Medical Dispatch Center Copenhagen in … Continue reading Machine learning as a supportive tool to recognize cardiac arrest in emergency calls

Research Analysis: More than 1-in-20 EMT deaths are due to suicide

A study out of the University of Arizona College of Medicine was recently published online in Preshospital Emergency Care. The researchers looked at all deaths that occurred in Arizona, as well as the deaths of Arizona residents in another state or country, between 2009 and 2015. Of the 350,998 adult deaths recorded, all were categorized as either suicide or non-suicide via the listed ICD-10 code. The suicides were then further … Continue reading Research Analysis: More than 1-in-20 EMT deaths are due to suicide

Research Analysis: Key takeaways from PART and Airways-2 Trials

JAMA recently published two randomized control trial airway studies comparing endotracheal intubation (ETI) with either a laryngeal tube (LT) or supraglottic airway (SGA) device intubation during out of hospital cardiac arrest (OHCA).  While each study came to a slightly different conclusion, both provide fodder for the ongoing debate around advanced airway management during a cardiac arrest in the prehospital setting. SUMMARY OF THE PART TRIAL … Continue reading Research Analysis: Key takeaways from PART and Airways-2 Trials

Research Analysis: Intubation curriculum increases first pass success

Researchers with Air Methods Corporation recently published the results of their novel airway management curriculum in Prehospital Emergency Care. The curriculum, known as the Helicopter Advanced Resuscitation Training (HeART), focuses on combining critical thinking on the part of providers with established best practices in airway management. This 25-month retrospective observational study includes over 5,000 patients that underwent rapid sequence intubation (RSI) by providers stationed at … Continue reading Research Analysis: Intubation curriculum increases first pass success