New Drones Actually Save Drowning Victims
Drones carrying a rescue buoy were able to find and rescue simulated (and three real) drowning victims in half the time of a traditional lifeguard or one on a Jet Ski.
Don’t Forget the Fastest Vascular Access for Trauma
For trauma (or any) patients arriving in extremis, the IO route was fast and had a very high success rate compared to peripheral IV or central line.
BVM or ETT in Arrest – New RCT
Bag mask ventilation and endotracheal intubation were equal for airway management in patients with cardiac arrest in terms of good neurological outcome at 28-days.
Fast PEA | Slow PEA – Survival Difference
There is a difference between PEA rhythms. Slow rates of electrical activity had the usual dismal prognosis. But those with electrical rates >60 had survival and favorable neurological outcome comparable to VF/VT, 22% and 15% respectively.
Hyperoxia Post-arrest, NNH = 8
This study gives high quality evidence that hyperoxia post-arrest is harmful. For each hour of hyperoxia (PaO2 >300), risk of poor neurological outcome rose by 3%. Number needed to harm was 8.
Reducing Elderly Transports to the ED for Falls
Paramedics responding to elderly patients who had fallen in an assisted living facility followed a protocol that included discussing the case with the patient's primary care physician (PCP). This drastically reduced the number actually getting transported to the ED by 63% and was safe.
Force Protection for Ultra-Potent Opioids
Inadvertent poisoning with an opiate in the prehospital setting is unlikely, especially with routine personal protective equipment (gloves).
Why We Delay Volume Administration in Penetrating Trauma
In patients with penetrating trauma, it was better to allow prehospital hypotension and hasten transport for definitive repair prior to beginning volume resuscitation than to try to normalize vital signs in the field by giving IV fluid.
Which Compression to Ventilation Ratio Should You Use?
According to this large systematic review, in adults a 30:2 compression to ventilation ratio was better than 15:2. For kids, either ratio was better than compression only CPR, except under 1 year in which ventilations did not improve outcome beyond compression-only.
Lazarus Phenomenon – Delayed ROSC After CPR Termination
Delayed ROSC may occur after cessation of CPR - the so called Lazarus phenomenon. The incidence is around 6/1000 cases and usually occurred within 3-8 minutes after CPR cessation. All patients eventually died; 4 of 5 had PEA. It may be wise to allow 10 minutes before pronouncing death (or 4 days if the patient is actually named Lazarus).