When considering 14 RCTs on use of antiarrhythmic drugs for shockable cardiac arrest, there was no benefit for survival to discharge or survival with good neurological outcome. Lidocaine improved ROSC vs placebo.
It is estimated that to place an endotracheal tube (ETT) successfully in 30-60 seconds, using direct laryngoscopy, would take 3-5 years of experience and 137-243 endotracheal intubations (ETI). Increased experience did not reduce the time chest compressions were paused. The key take home is that ETI during CPR is really hard. Be prepared.
For adults with out-of-hospital cardiac arrest, initial laryngeal tube insertion by emergency medical service providers was associated with improved 72-hour survival, return of spontaneous circulation, hospital survival, favorable neurologic outcome, and airway success compared to initial endotracheal tube insertion.
Epinephrine for out-of-hospital cardiac arrest improved overall 30-day survival (3.2%, epi vs 2.4%, placebo) but did not improve survival to discharge with a good neurological outcome. In fact, more patients who received epinephrine and survived had severe neurological impairment than in the placebo group.
There were no statistically significant differences in pressure-bag flow rates for 1L of NS through all three ports of a standard triple-lumen catheter (TLC) compared to a 16 gauge peripheral venous catheter (PVC) or a 6Fr sheath introducer. On gravity-flow, it was not statistically different from a 16 gauge PVC. But 14ga PVC and 8.5Fr sheath rates were superior in both instances.