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CPR performed by laymen benefits from being done on a hard surface rather than on a mattress, though neither group met the AHA recommended depth of 5cm.
Source
Effectiveness of Lay Bystander Hands-Only Cardiopulmonary Resuscitation on a Mattress versus the Floor: A Randomized Cross-Over Trial. Ann Emerg Med. 2023 Feb 23;S0196-0644(23)00026-4. doi: 10.1016/j.annemergmed.2023.01.012. Online ahead of print.
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In this secondary analysis of the ALPS trial (Amiodarone, Lidocaine, or Placebo Study), researchers found that early administration of amiodarone (within 8 minutes) is associated with greater functional survival in OHCA with initial shockable rhythm when compared to placebo.
Source
Survival by Time-to-Administration of Amiodarone, Lidocaine, or Placebo in Shock-Refractory Out-of-Hospital Cardiac Arrest. Acad Emerg Med. 2023 Mar 4. doi: 10.1111/acem.14716. Epub ahead of print.
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This multicenter randomized controlled trial (the INCEPTION trial), comparing ECPR vs conventional CPR for refractory cardiac arrest, showed no improvement in neurologically intact survival at 30 days.
Source
Early Extracorporeal CPR for Refractory Out-of-Hospital Cardiac Arrest. N Engl J Med. 2023 Jan 26;388(4):299-309. doi: 10.1056/NEJMoa2204511.
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In this systematic review and meta-analysis, researchers found the epinephrine in standard doses, high doses, and with vasopressin lead to an improvement in ROSC and survival to hospital admission in out of hospital cardiac arrest (OHCA) but did not improve survival to discharge or functional neurologic outcome.
Source
Epinephrine in Out-of-Hospital Cardiac Arrest: A Network Meta-analysis and Subgroup Analyses of Shockable and Nonshockable Rhythms. Chest. 2023 Jan 31:S0012-3692(23)00165-4. doi: 10.1016/j.chest.2023.01.033. Epub ahead of print.
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In this study of firefighters performing CPR with feedback devices, researchers found that compression depth decreased over the course of a two-minute chest compression cycle while compression rate stayed within goal.
Source
Temporal analysis of continuous chest compression rate and depth performed by firefighters during out of hospital cardiac arrest. Resuscitation. 2023 Feb 16;185:109738. doi: 10.1016/j.resuscitation.2023.109738. Epub ahead of print.
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A full moon has no association with EMS activation patterns in the United States.
Source
Full moons are not associated with increases in emergency medical services (EMS) activations (911 calls) in the United States. Am J Emerg Med. 2022 Nov;61:227-228. doi: 10.1016/j.ajem.2022.07.044. Epub 2022 Jul 20.
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Targeting a lower oxygen saturation (90-94%), compared to standard care (98-100%), in patients who were resuscitated after out-of-hospital cardiac arrest (OHCA) until admission to the intensive care unit did not significantly improve survival to hospital discharge.
Source
Effect of Lower vs Higher Oxygen Saturation Targets on Survival to Hospital Discharge Among Patients Resuscitated After Out-of-Hospital Cardiac Arrest: The EXACT Randomized Clinical Trial. JAMA. 2022 Nov 8;328(18):1818-1826. doi: 10.1001/jama.2022.17701.
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Empiric calcium administration in PEA arrest not only failed to improve ROSC, but also had no impact when ECG features of hyperkalemia and acute myocardial ischemia were present.
Source
Effect of Calcium in Patients with Pulseless Electrical Activity and Electrocardiographic Characteristics Potentially Associated with Hyperkalemia and Ischemia-Sub-study of the Calcium for Out-of-hospital Cardiac Arrest (COCA) trial. Resuscitation. 2022 Nov 17;S0300-9572(22)00712-2. doi: 10.1016/j.resuscitation.2022.11.006. Online ahead of print.
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For the treatment of refractory ventricular fibrillation (VF) in out-of-hospital cardiac arrest, survival to hospital discharge was more common among patients who received double sequential external defibrillation (DSED) and vector-change (VC) defibrillation than those who received standard defibrillation.
Source
Defibrillation Strategies for Refractory Ventricular Fibrillation. N Engl J Med. 2022 Nov 6. doi: 10.1056/NEJMoa2207304. Online ahead of print.
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In this large, single-center prospective cohort implementation study, paramedics were able to apply a modified Canadian C-spine rule to assess low risk trauma patients and transport a large proportion of them to a higher level of care without spinal precautions.
