Cardiocerebral Resuscitation

Improving cardiac arrest survival


 
 

Keith Wesley, MD, FACEP | From the July 2009 Issue | Wednesday, June 27, 2007


Kellum MJ, Kennedy KW, Ewy GA: Cardiocerebral resuscitation improves survival of patients with out-of-hospital cardiac arrest. American Journal of Medicine. 2006. 119(4):335–340.

The Science

A paramedic service in my home state of Wisconsin, along with two services in Tucson, Ariz., elected to study the effect of compression only CPR in witnessed cardiac arrest. All patients had an oral airway placed and 100 percent oxygen applied by non-rebreather mask. Artificial ventilations were withheld until three rounds (two minutes of 100 compression/min) of CPR along with AED if in a shockable rhythm or return of spontaneous circulation. Two minutes of CPR was performed before AED use, and only one shock was administered at a time, which was then followed by immediate CPR. Prior to the study, 19 percent of patients with witnessed cardiac arrests found in a shockable rhythm survived. Following implementation of the new protocols, 57 percent survived.

The Street

This is the first cardiac arrest outcomes study using anything similar to the new AHA 2005 guidelines. The decision to defer ventilations is consistent with what many feel to be the circulatory phase of cardiac arrest, during which the primary goal is to promote coronary and cerebral artery perfusion with effective chest compression. Studies demonstrate that artificial ventilations impede perfusion in this phase of cardiac arrest, speculated to be from four to 10 minutes after collapse, which is when the majority of EMS arrivals occur. Now that the 2005 AHA guidelines are being taught, it will be interesting to see if these results can be duplicated.




Connect: Have a thought or feedback about this? Add your comment now
Related Topics: Patient Care, Cardiac and Circulation, Research, Jems Features

Author Thumb

Keith Wesley, MD, FACEP

Keith Wesley, MD, FACEP, is the Minnesota State EMS medical director and the EMS medical director for HealthEast Ambulance in St. Paul, Minn. and and can be reached at drwesley@emsconsulting.net.

BROWSE FULL BIO & ARTICLES >

What's Your Take? Comment Now ...

Featured Careers & Jobs in EMS





 

Get JEMS in Your Inbox

 

Fire EMS Blogs


Blogger Browser

Today's Featured Posts

 

EMS Airway Clinic

Simulation-Based Assessment Facilitates Learning & Enhances Clinical Judgment

Simulation is an educational tool that can be used to develop and refine clinical skills of the student in a controlled environment before they progress to becoming practicing clinicians.
More >

Multimedia Thumb

NYC September 11 Commemoration

Tolling of the bell begins the anniversary ceremony.
Watch It >


Multimedia Thumb

Wrong Fuel Cited in New Mexico Air Ambulance Crash

Plane received jet fuel instead of aviation fuel.
Watch It >


Multimedia Thumb

Wake County EMS PAT

Physical ability test demonstration.
Watch It >


Multimedia Thumb

NYC Sept. 11 Anniversary

View images from the ceremony at Ground Zero.
More >


Multimedia Thumb

13th Anniversary of Sept. 11 Terror Attack

The nation remembers the fallen.
More >


Multimedia Thumb

Building Explosion, Collapse in Paris Suburb

Death toll rises to eight after blast in Rosny-sous-Bois.
More >


Multimedia Thumb

Braun Ambulances' EZ Door Forward

Helps to create a safer ambulance module.
Watch It >


Multimedia Thumb

VividTrac offered by Vivid Medical - EMS Today 2013

VividTrac, affordable high performance video intubation device.
Watch It >


Multimedia Thumb

Field Bridge Xpress ePCR on iPad, Android, Kindle Fire

Sneak peek of customizable run forms & more.
Watch It >


More Product Videos >