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When providing respiratory support to preterm infants with a facemask, avoid excessive force on the face that is associated with apnea and bradycardia.

Source
Exerted force on the face mask in preterm infants at birth is associated with apnoea and bradycardia. Resuscitation. 2024;194:110086.

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Tidal volume (TV) delivered is hard to control during cardiac arrest, and evidence has shown that over-ventilation can be detrimental in physiological parameters integral to cardiac arrest survival. Small bags were thus integrated into a single EMS system to help combat over-ventilation. Paradoxically, large bags had a greater likelihood of return of spontaneous circulation (ROSC) in out of hospital cardiac arrests (OHCA).

Source
Association of small adult ventilation bags with return of spontaneous circulation in out of hospital cardiac arrest. Resuscitation. 2023 Dec:193:109991. doi: 10.1016/j.resuscitation.2023.109991. Epub 2023 Oct 5.

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A prospective, observational study demonstrated that giving sodium bicarbonate to patients undergoing mechanical ventilation or CPR resulted in an increase in end-tidal CO₂ values in as quickly as 17 seconds and lasted for 7 minutes.

Source
End-tidal carbon dioxide after sodium bicarbonate infusion during mechanical ventilation or ongoing cardiopulmonary resuscitation. Am J Emerg Med. 2023 Nov 25:76:211-216. doi: 10.1016/j.ajem.2023.11.027. Online ahead of print.

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In this focused update to the AHA Guidelines for Cardiopulmonary Resuscitation (last updated 2020), the study group recommended against routine use of calcium in cardiac arrest while recommending for a targeted temperature control strategy in patients who do not follow commands post ROSC, among other recommendations.

Source
American Heart Association. 2023 American Heart Association Focused Update on Adult Advanced Cardiovascular Life Support: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2023 Dec 18. doi: 10.1161/CIR.0000000000001194. Epub ahead of print.

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The International Liaison Committee on Resuscitation (ILCOR) released updates on a broad range of resuscitation practices. Check-out this JournalFeed to stay up to date!

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Today we are covering a new, joint scientific statement from the American Heart Association and Neurocritical Care Society regarding care of patients who suffered cardiac arrest and subsequently had ROSC.

Source
Critical Care Management of Patients After Cardiac Arrest: A Scientific Statement From the American Heart Association and Neurocritical Care Society. Circulation. 2023 Nov 28. doi: 10.1161/CIR.0000000000001163. Online ahead of print.

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For the majority of out-of-hospital cardiac arrest (OHCA) patients undergoing standard (30:2 compressions:breaths) cardiopulmonary resuscitation (CPR) prior to definitive airway placement, bag-valve mask (BVM) ventilations did not achieve adequate lung volumes most of the time. Receiving adequate BVM ventilations >50% of the time was associated with significantly higher rates of return of spontaneous circulation (ROSC) and survival.

Source
Bag-Valve-Mask Ventilation and Survival from Out-of-Hospital Cardiac Arrest: A Multicenter Study. Circulation. 2023 Nov 12. doi: 10.1161/CIRCULATIONAHA.123.065561. Epub ahead of print.

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This RCT found residents using a pediatric cardiac arrest app better adhered to the pediatric cardiac arrest algorithm when compared to those using a PALS visual aid or no aid at all.

Source
Effectiveness of a Novel Tablet Application in Reducing Guideline Deviations During Pediatric Cardiac Arrest: A Randomized Clinical Trial. JAMA Netw Open. 2023 Aug 1;6(8):e2327272. doi: 10.1001/jamanetworkopen.2023.27272.

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In this video review, information contained in out-of-hospital cardiac arrest (OHCA) patient handoffs was highly variable, which is an area for quality improvement and standardization. Try this checklist!

Source
Emergency Medical Services handoff of patients in cardiac arrest in the Emergency Department: A retrospective video review study of duration and details of handoff. Resuscitation. 2023 Aug;189:109834. doi: 10.1016/j.resuscitation.2023.109834. Epub 2023 May 16.

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A full-body CT protocol in resuscitated adults with out of hospital cardiac arrest (OHCA) more often - and more quickly - found the cause of arrest than standard of care CT but did not improve neurologically intact survival.