Digital Supplement, Special Topics

December 2017 Supplement, EMS State of the Science: Advances in Cardiac Arrest Resuscitation

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Trends & Changes in Cardiac Resuscitation

By Karl B. Kern, MD

A new paradigm of early transport to an ECMO/PCI center with ongoing mechanical chest compressions may change how refractory cardiac arrest victims are treated.

Double Defibrillation

By Peter J. Kudenchuk, MD, FACP, FACC, FAHA, FHRS

There’s limited clinical evidence to support treating refractory v fib with double defibrillator biphasic shocks.

ECMO & Refractory OHCA

By Demetris Yannopoulos, MD

Use of ECMO in the post-resuscitation management of patients in OHCA refractory cardiac arrest has yielded highly promising results by providing a therapeutic platform that, when applied early and within 60 minutes from the 9-1-1 call, can potentially double survival.

ECMO & ECPR

By Sean Slack, DO, Hill Stoecklein, MD, Joseph E. Tonna, MD, FAAEM, & Scott T. Youngquist, MD, MS, FAEMS, FAHA

Through early identification of ECMO candidates and the delivery of excellent prehospital care en route, EMS providers are on the front line of this potential lifesaving intervention for cardiac arrest patients.

Prehospital Cath Lab Activation

By Jason Kruger, MD, & Scott Wiebe, EMT-P

Partnering with local hospitals, Lincoln (Neb.) Fire & Rescue developed a simple criteria for sending alerts to the catheterization lab for patients in witnessed, shockable cardiac arrest.

Progressive Systemwide Collaboration

By Michael J. Jacobs, EMT-P, & Karl A. Sporer, MD, FACEP, FACP

After establishing successful cardiac arrest protocols, the Alameda County EMS system explores using mechanical CPR as a bridge to extracorporeal membrane oxygenation (ECMO).