
The Future of CPR
I got to interview two cutting edge researchers on what CPR will look like in the next decade; their answers were fascinating.
Flow-Enhanced CPR
They discuss the use of the impedance threshold device and the active-compression/decompression device to augment flow during CPR. See the results of the ResQ trial listed below to see what this does in cardiac arrest patients.
Note: Dr. Lurie is the founder, chief medical officer, and a major shareholder of the company that manufactures these two devices. Dr. Yannopoulos has no conflicts of interest.
Reperfusion Injury Protection
Stutter CPR is giving 3 cycles of 20 seconds of compressions/ventilations, 20 seconds of pause. In pigs, this has markedly reduced the reperfusion injury when resuscitating a patient with prolonged arrest.
New Medications
Sodium nitroprusside (in addition to small doses of epi and flow-enhanced CPR) increases flow to the heart and the brain. May also blunt reperfusion injury to heart and brain. In addition adenosine and cyclosporine A may have a role as well.
Note: None of this is ready for clinical use–this may be the future, it is not the present
Want More?
- A presentation on the topic by Dr. Yannopoulos
- Read the ResQ Trial (Lancet 2011;377(9762):301–311)
Update
- Recent 15-minute pig cardiac arrest study provides continued evidence of ischemic post-conditioning (Resuscitation Volume 84, Issue 8, August 2013, Pages 1143–1149)
- Review article on the physiology of CPR
Additional New Information
More on EMCrit
EMCrit 222 – Demetris Yannopoulos on ECPR-the Minneapolis Way [ECMO](Opens in a new browser tab)
EMCrit 191 – Cardiac Arrest Update(Opens in a new browser tab)
Additional Resources
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We have successfully done PCI on several out-of-hospital cardiac arrest patients during ongoing CPR using LUCAS, a gas driven sternal compression device. Outcomes have been good; had a patient just recently who was discharged after a couple of days with no neurological sequelae. There are some published similar cases. It’s amazing how effective the compressions are, some patients have to be sedated as they become awake and aware.
Absolutely Simon. In fact Dr. Lurie believes that integrating the active-compression decompression device into the LUCAS along with the ITD would be the ultimate set-up.
okay, I must admit when the resq trial came out I was a bit skeptical. Intuitively it seemed to be counter to other new developments in CPR such as making it simpler..push hard, fast and dont stop…etcetc. As a prehospital provider it still concerns me from a human factors viewpoint that adding more devices and increasing the complexity of CPR once again may simply discourage more bystanders to start. for trained providers…I dont mind relearning CPR if it has been proven to help outcomes. This interview has dispelled most of my skepticism and it was great to hear these two… Read more »
I’m wondering about the utility of PEEP in cardiac arrest. I’ve heard several anti-PEEP (in cardiac arrest) arguments, but considering the goals of compression/decompression CPR with an ITD it seems that PEEP might help to further increase preload and forward flow.
Also, it was unclear to me whether these strategies are being pursued for all cardiac arrest patients or only those in v-fib. We don’t see too many patients still in v-fib at the 15 minute mark, even with bystander CPR.
Rebecca, I believe right now it is being pursued only in pigs, but I believe these techniques will be for all initial rhythms if the animal data translates to humans.
Scott!!!!!!!! Curse you my friend! OK, ‘curse you’ was kind of strong, but holy cow, how could have you missed the boat on this one? The Res-Q-Pod and the CPR device that Dr Lurie sells is not only “not ready for prime time” but very likely might be an all-out sham. But in the interest of being fair, I will say that the evidence at this point is not sufficient to support or refute the use of these devices. I first became suspicious of the ResQPod when the AHA, out of nowhere, placed it on the 2005 update with a… Read more »
Dave,
I’ve been waiting for a topic that can get people fired up. As out-of-hospital CPR trials go, the ResQ trial was quite big and got published in the Lancet, which at least the Brits would consider quite a legitimate journal. It was after that trial that I began to look at these devices seriously, b/c the literature up until that point had been equivocal. I hopefully am going to get Dr. Lurie and Dr. Yannopoulos to respond directly, but if not I will be back with more. Thanks again, my friend.
Yes Dave has echoed a lot of my initial skepticism. The literature suggests that both devices alone do not improve survival and the resq trial said that both devices together appeared to improve survival over and above standard CPR. this does seem illogical . Does one successful trial meet our resuscitation needs? Well CRASH 2, seemed to for TXA and trauma. Why? because the intervention is simple and costs about seventy dollars AU. Its true the same laws of economy do not apply to these two devicese and their application to prehospital CPR. Dave is right about the concern with… Read more »
I know Dr. Lurie, and he is a man of impeccable integrity who deeply cares about saving lives. He has devoted his life to researching cardiac arrest not in order to make money but in order to advance a field which had gone nowhere for years. He has helped to resuscitate resuscitation science from a dismal one to a hopeful one. If a device has a good rationale, he will study it. If this device turns out to actually work when rigorously studied, then someone has to actually manufacture and market it, or it will never be available. Dr. Lurie… Read more »
For what it’s worth, the ITD does not actually require intubation. It can be used with a blind airway like the King, or even on a well-sealed BVM mask.
Dave, I don’t even know where to start, but I’ll try to be brief. First your statement “the device [ITD] he is selling requires intubation Dr Lurie claims that intubation is a must.” This is absolutely incorrect. Use of an ITD with a facemask is strongly recommended (www.advancedcirculatory.com) and has been shown to be effective in cardiac arrest (Use of an inspiratory ITD on a facemask and ET tube to reduce intrathoracic pressures during the decompression phase of ACD-CPR. Plaisance et al. Crit Care Med 2005.) In the most recent, largest-ever, human trial of ACD-CPR with an ITD (ResQTRIAL), published… Read more »
Dr Frascone, thankyou for further information. May I ask if you can inform us of how your EMS providers are trying to perform ETI without chest compression interruption? I suspect it is with video laryngoscopy, correct? This is the only way I would know currently of achieving this..apart from surgical airway…the other option though is the Fastrach or AirQ ILMA placement then blind tube through them…is that the option yu have chosen? I find it interesting that the face mask ventilation produced the best overall survival outcome in the study you cited. This is in line with data out of… Read more »
Minh, you are correct. It is a videolaryngoscope trial. We are comparing the Storz CMAC and the King Vision scopes in a single crossover design. We are 6 months into the one year study. To your second comment, we have published an abstract which demonstrated decreased cerebral perfusion in a porcine model, in marginal pressure states, with SGA’s vs ETI. A colleague and co-author of the ResQ Trial, Dr. Brian Mahoney, Hennepin County Medical Center, has IRB approval and is about to begin a study in the ED looking at the same thing in humans. Should be interesting. RJ
RJ, that sounds freakin awesome. Am I correct that your EMS providers in the trial are getting to play with either the CMAC or the King Vision…in the field? Can I come work with them..fantastic trial..one of the first I know of comparing those devices in a prehospital setting. I was trying to get a proposal going for a similar aeromedical study comparing The King Vision with DL..but it fell through..so great to hear your study is underway..I really look forward to hearing the results and reading the paper!
ETI is posh possible without stopping compressions. It is a matter of practice and training. Not everytime but often. It is the time to raise the bar…
Dr Frascone, I looked up some of your references you cited in your response. I assume when you are referring to prehospital ETI and improved outcomes with the Wang 2012 article you mean this conference abstract? http://emspatientperspective.com/2012/03/16/a-positive-wang-intubation-study/ Thankyou as I was not aware of that one and look forward to reading the full published article when it comes out. My take on all the literature and discussion is that the jury is still out on this idea of what is the best prehospital airway management in out of hospital cardiac arrest patients. retrospective reviews such as this ( and the… Read more »
A lot of the prehospital ETI research in cardiac arrest should find a negative survival benefit due to the ridiculously low compression fraction for the entire code! Research in areas with good compression fractions has had favorable outcomes.
One of my questions with the ROC-PRIMED trial was that it appeared to show that the ITD was no better or no worse than the sham. It seemed that their study was attempting to do too much at once (differing styles of CPR, ITD, and a targeted ventilation rate). One could argue that any benefits seen by the ITD were due to a lower, more controlled ventilation rate thanks to the blinky-light on the ITD. I know another detractor is the cost of the ITD device, which given no large survival benefit seen will certainly slow its adoption. It would… Read more »
Oops, should have read the supplement to hear their comments on the trial! 🙂
Their comments to my first point: they acknowledge the deficiencies but state they intended to include some of the tests together due to the fact that they were intended to be tested together. Although I’m not exactly satisfied that the trial proved they were mutually exclusive in their benefit from the controlled ventilation rate. However, they state there are more trials coming out which will show benefit.
Very interesting podcast, I especially found the part on ischemia/reperfusion injury refreshing. Another, perhaps better researched, agent one could consider in the immediate post-ROSC period is sevorflurane. These patients will typically spend a while in the ED, where depending on your setup, maintaining anesthesia with sevo wouldn’t be too complicated (compared to the ICU). However, where I practice in Europe, we tend to maintain with fentanyl/midazolam or propofol/remifentanil, although we have sevo at our disposal in the trauma bay… Here’s an interesting reference though: Meybohm P, Gruenewald M, Albrecht M, Zacharowski KD, Lucius R, Zitta K, Koch A, Tran N,… Read more »
In 1987 I had a pt who was resuscitated with a toilet plunger on his chest. Little did I know I would be responding by blog to an audio interview I had with Dr. Yannopoulos 25 years later. Since 1987 we have learned a lot about the physiology of CPR, how to optimize the chest as a bellows to move more blood to the heart and brain, lower ICP, and have finally begun to improve outcomes after cardiac arrest. It has captured the imagination of many and it is fascinating! In our interview we tried to share what we think… Read more »
Dr. Lurie, thank you for taking the time to write this comment; I think all of the readers will take these words to heart.
thankyou Dr Lurie for both your interview and the response here. I enjoyed hearing you and Dr Yannapolous share your thoughts and research anecdotes. When I started using ketamine sedation in patients with agitated schizophrenia for aeromedical retrieval four years ago, there were similar nay sayers…there still are but thats what research is for. I understand the committment it takes to prove something is safe, effective yet totally contrary to established beliefs. Its good to hear someone speak with conviction on something they believe will help patients and advance our understanding. I look forward to reading and hearing more of… Read more »
Indeed, as Dr Smith stated, I made some hasty comments that attack character rather just sticking to my main point. Dr Lurie, you took the high road and are a gentleman. My apologies. I will reiterate my intended message like this: Although Dr Weingart has no obligation to restrict any type of speaker on his program and made a very clear statement of conflict of interest (and has no obligation to do that either) the fact remains that Dr Lurie is the inventor of these two devices and has some personal interest in seeing that they succeed. With proper disclosures… Read more »
Dave, well done; thank you for that. I honestly don’t know the proper course for physician innovators. Folks like Dan Cook, inventor of the AirQ ILA and Dr. Lurie are espousing products that they have devoted a good deal of their lives to and truly believe are going to save lives. Yet you are correct, we must always consider all biases when evaluating the literature. Problem is, independent researchers rarely want to do large scale, funded studies on ideas and techniques that they themselves did not invent or conceptualize. After ResQ what will happen next? Best we can hope for… Read more »
For one who has just discovered this blog and podcast series – it almost takes more time to read the comments than to hear the extensive podcast on the Future of CPR. My Thoughts: SUPERB job in ALL ways by Scott Weingart who has brought together two cutting edge state-of-the-art researcher clinicians in the field. NO WHERE ELSE would one have opportunity to hear this great discussion. As one with 30 years experience in academics – I am as sensitive to potential “promotion” as anyone – but I did NOT in any way, shape or form get that from the… Read more »
Dr Lurie I may not have close to the amount of letters behind my name as the usual poster on this site, but first and foremost I would like to thank you for your effort in to the science of resuscitation. Well I never had the chance to use the ACD device I have used the ITD on a number of out of hospital cardiac arrests before the take over of our health system and the protocols we must follow changed to a provincal standard. Every patient I had the oppertunty to use the ITD on combined with uninturupted CPR… Read more »
I have known and worked with Dr. Lurie for twenty years. I could not be more startled nor baffled by anyone questioning his ethics. But that is not what I wanted to contribute to here. I read with interest the comments above of Minh Le Cong about endotracheal intubation without stopping chest compressions. Allow me to describe how it is done in my system – Hennepin County (Minneapolis). Typically 3 of my colleague first responders arrive in about 3.5 minutes and initiate continuous hands only CPR, place the King Airway #4 inflated with 60 cc (reduced from 80 after the… Read more »
I’m very interested in the KingLT inflation volumes, are there any papers available? We see a lot of first-line KingLT insertions in my area.
Brian and others–Who would be the best person in the resuscitation community to talk about these new potential problems with SGAs in cardiac arrest. I want to get someone on the show ASAP b/c this is an incredibly important shift in the new paradigm many of us have adopted over the past couple of years.
good call. My gut hunch based on anaesthetic literature and practice is that LMA type designs should not present this problem of occluding the carotid arteries. The King LT and similar designs with big balloons may present an issue theoretically in humans. Frankly its something I had never thought of worrying about but its good to raise and discuss it if there has been some animal data to suggest an issue.
I could speak to it if you would like.
Keith Lurie would be excellent of course.
Do you have a phone number I could call you at to discuss this?
My office phone is 612-873-5689
thanks Brian, thats very helpful! Sounds like you dont need a video laryngoscope to do this. This is an area of resuscitation practice that can do with some tidying up. Traditionally we thought ETI was crucial because everyone dies without an airway, right? I still remember back in my hospital residency days, having an arguement with the anaesthesiology crew who turned up to a cardiac arrest, they wanted to tube before I could deliver a shock for VF..and they had stopped CPR to do the tube! This whole idea of stopping CPR to get the tube in needs to be… Read more »
We don’t interrupt compressions to intubate in my neck of the woods and we also don’t use VL either. Pretty similar setup to what Brian described, except our firefighters handle CPR. We also see a lot of KingLT placement first-line, but it isn’t required.
I’ll second Christopher’s experiences. In all of the cardiac arrests I’ve had as a paramedic where I have been in charge of the airway, I have only had to hold compressions to intubate twice. Both of these situations were in patients with difficult anatomy and poor visualization. I usually instruct the firefighter/EMT to continue CPR and I have another EMT assisting me. I insert the laryngescope, suction if necessary, usually get good visualization of the cords (often with the help of external laryngeal manipulation) and am able to pass the ETT without ever having to stop compressions. If the patient… Read more »
I will add a few comments to these excellent tips. When I teach my residents to intubate during compressions, we always use a bougie b/c once that has passed the cords, the compressions have no effect on the ability to subsequently railroad the tube. Bougies just slip in easier with no hang-up from stylet bends and you are putting a much smaller object through the moving cords. Further, I have started using a trick I picked up on the Society of Airway Management forums, though I am blanking as to the author. The trick is, once you have inserted the… Read more »
I totally second that. In cardiac arrest patient, I always try direct laryngoscopy first with ongoing chest compressions (manual or LUCAS), using a standard Macintosh blade, external manipulation if needed and no cricoid pressure, then try to pass a styleted ET tube. So far I only once had to stop the compressions for a few second, just for the time to pass the tube through the cords. Laryngeal motion is minimal during properly performed compressions. Would intubation fail, I would then grab a ILMA. I have always wondered where the (mis)beliefs surrounding tracheal intubation during ongoing CPR come from, and… Read more »
Before I write any more I want to be sure that any readers know that I am one of the principal investigators in the ResQTrial published in the Lancet January, 2011. I have no financial conflicts at all. Great question on why take out a perfectly good functioning KingLT? These are my ideas behind that. I welcome all of your suggestions to improve on this approach. 1. I believe that the endotracheal balloon does a better job isolating the trachea against aspiration than the KingLT balloon. I don’t know this – just believe it. 2. I believe that there are… Read more »
Our area adopted the “work them where you find them until ROSC or you call it” model. I’m very interested to hear about your results with on-going mechanical CPR and caths, as this could potentially alter our CPR strategy.
Is the Lucas radioleucent? The London air ambulance physician response unit has a zoll autopulse which they occasionally take people to the cath lab on as the output is so good but apparently the band makes primary PCI a nightmare. My understanding is zoll are working on a new band to mitigate this.
Zoll has video of a cath being performed with the AutoPulse going and it didn’t appear to cause much problems for that interventionalist. It does appear to inhibit some of the view, but no more than manual CPR would.
The LUCAS-1 and LUCAS-2 present a challenge in height restrictions, otherwise their suction-cup end does not obscure the view any more than manual CPR does. Physio also has videos of caths being performed with the LUCAS device operating.
PCI is possible with the Lucas going on (see ref. below), but I’ve been told only oblique views are possible (although the paper did not mention it).
Larsen, A. I., Hjørnevik, Å. S., Ellingsen, C. L., & Nilsen, D. W. T. (2007). Cardiac arrest with continuous mechanical chest compression during percutaneous coronary intervention?A report on the use of the LUCAS device.
Resuscitation, 75(3), 454–459.
Physio-Control does offer a carbon fiber back plate for LUCAS that is completely radiolucent for use in the cath lab. Because the LUCAS electronics are in the hood of the device, not the backboard, it lends itself very well for imaging in most projections; the Straight Cranial, Straight Caudal, Straight Lateral, LOA/ROA Cranial, and LOA/ROA Caudal projections. LUCAS is widely used in cath labs in Europe and is the most published mechanical chest compression device on the market for this purpose. There are several life-saving cases presented (e.g. a recent press-release from St Georges hospital in London http://www.stgeorges.nhs.uk/press291.asp) as well… Read more »
Wow, carbon-fiber–nice. that must be a pretty and expensive version.
Thanks Brian. What you describe makes sense and is a very reasonable approach. You asked for suggestions to improve it. here is one. use a portable ventilator to control IPPV. This way you can ensure precise delivery of minute volume, PEEP and even FiO2. Most importantly you can control the ventilation rate. As Christopher has alluded to, its my opinion that the ResQ pod device may exert its benefit in controlling provider delivered hand ventilation rates. Extrapolation from prehospital TBI and ETI research would suggest that possibly some of the demonstrated harmful association between prehospital ETI may be due to… Read more »
One other suggestion to improve. Replace the King LT with the Fastrach ILMA. One device does both jobs as SGA as well as intubating device. Learning curve for Fastrach ILMA in the published literature is about 15-20 successful intubations. For successful ventilation its even less, about 5 attempts to get useful proficiency. AS long as you teach the anatomy and mechanics of the design of the ILMA to novices, they can insert and successfully ventilate with a high rate of success. Last simulation session I ran for one of the air retrieval crews, I taught a novice ( one of… Read more »
fantastic tips. You can tell I have never tried to tube someone during compressions. Its just not what we do down under…or at least at the places where I worked. Routinely, we would stop compressions to get the tube in. I have thought if i had to then I would Fastrach ILMA them..all blind technique…I got no. problem with that. But DL during compressions..you have convinced me to tell the compressor to keep going and ignore what I am doing in the mouth!
You can usually time it to pass the cords during your rhythm check if its bouncing around too much, but often a little bit of ELM will put it into view without problem.
I have recently changed by technique in Cardiac arrest with all the literature re: never stopping CPR and do the bougie/ETT with good success the bougie makes it easy to hit the target.
That with an N of 2 so far.
Wonderful podcasts. I think we may be rapidly approaching the point where any new intra- or post-arrest therapies need to be assessed, at least as one cohort if not as the sole test arm, in patients who also receive appropriate therapeutic hypothermia. The outcomes that the best centers are seeing in the chilled patients, both quantitatively (in numbers saved) and qualitatively (in prolonged downtimes, comorbidities, and often extensive periods of low- or no-flow), suggests that these patients are experiencing a fundamentally different post-arrest physiological course. Since so many of the problems we’re facing are, as discussed in the podcast, really… Read more »
Brandon, Yes I agree with you in spirit. But remember in the control groups of the best hypothermia studies, Vfib OOHCA patients still had a 25% neurologically intact survival rate. So for the most part making the post-arrest course include hypothermia will increase the study’s power, but not necessarily sway the results so long as both groups either got it or did not get it. But then you can argue the smaller points that a patient who has been cooled has a fundamentally different physiology and that is why I agree, once hypothermia has become a true rather than stated… Read more »
I think we’re on the same page. Just to illustrate the point, though, let’s take the example of epi. I’ve come full circle on this, because in the past I was extremely underwhelmed at the apparent immortality of a drug that has repeatedly failed to demonstrate any improvements in neurologically-intact survival to discharge. Unquestionably it got us more ROSC, but so what if they all died later anyway? But now, with the improvements in post-ROSC care, mostly hypothermia (and perhaps things like early PCI, or even neat stuff like ECMO), we’re doing better and better at managing these sick resuscitated… Read more »
I understand where you are coming from, but it is a numbers game. If epi would have shown a 5% increase in neurologically intact survivors of vfib with hypothermia, then it still should have shown 2.5% increase without unless there is a specific effect epi has only on hypothermia patients. However if that 2.5% wound up being an insig. p-value then hypothermia perhaps would have turned a negative study positive.
I suppose my fantasy is that with the right synergy the improvement in numbers would be much better than that, but you’re right overall, of course.
Incidentally, the Beth Israel Deaconess in Boston is reporting a retrospective survey of in-hospital arrests where, after supposedly normalizing all the other variables, they’ve shown a significant correlation between time to epi administration and outcomes — all the way out through discharge. Not a perfect endpoint, and obviously not directly portable to out-of-hospital settings, but still seems groundbreaking; I believe it’s under review at the NEJM now.
I thought the podcast was one of the best and found Dr Lurie’s knowledge and enthusiasm to be really stimulating and exciting. However enthusiasm and desire to do the best for our patients can lead us to down the wrong path and that’s the reason why we need to have good quality RCTs with as much blinding as possible. Having read the trial there are two concerns. The first is that the trial sponsor had more than the usual amount of input, in the paper’s own words “The sponsor (Advanced Circulatory Systems) helped investigators to obtain government funding, design the… Read more »
Greg, I hear what you are saying, but if the exclusions are planned before the study’s start then they can only affect the external generalizability and do not affect the internal validity of a study. Intention to treat only comes into play on patients who met inclusion, but for whatever reason did not achieve the treatment of their group. still, i hear what you are saying.
Thanks for tbe podcast, I have learned so much, it has really halped make me a better paramedic.
With the King LTSD, you can also perform a tube exchange with a bougie, which would theoretically cause no disruption of compressions, and give you a cuffed tube in the trachea. For those of you who have first response units using this device, it could be an option for you.
Bougies…..what CAN’T they do?
Dan, Have you successfully done this maneuver? Many of us have tried and found it to be difficult or impossible despite the theoretical potential. The port is ill-suited to this purpose though I am quite fond of the device.
I find this discussion of exchanging a perfectly working King LT for a cuffed ETI to be fascinating. I confess I have never used a King LT. LMA type devices I have used a lot. It is not easy to pass a bougie into the trachea blindly via a LMA type device. It is reported though and done under fibreoptic guidance in one report I read via a LMA Supreme. I have never been successful blind bougie insertion with standard LMAs and must admit I would not pass a bougie via the ILMA for fear of injuring the larynx or… Read more »
I have only done it in the sim lab and manikins, not on a real patient. In that area, it has worked pretty well, although I most likely would not be using it in practice. In my area, only ALS providers would be performing ETI or placing the King, (no EMT-I/AEMT support, only basic) so since I or my partner would have been the ones placing the airway, as Dr. Le Cong said, it doesn’t make sense. If I got a patent airway, I’d be very happy with it. Just putting it out there to see what feedback there is… Read more »
Thanks Dan. Just given me a great idea for my next prehospital podcast. Mechanical ventilation using extraglottic airways..the experience of the Royal Flying doctor service of Australia. It can be done! My take is that you need a really good reason to remove a functioning extraglottic airway , prehospital or ED. Its reasonable to have one or two ETI attempts if yu really want because at least you know yu can reinsert the extraglottic and be back to square one. But remember Cliff Reids words in our interview. Your penis length or female equivalent will remain the same regardless of… Read more »
One observation, one concern. Observation—During my recent trip to the University of Massachusetts to regain my ACLS-Instructor rating, I was required to teach the practical portion of an ACLS class to a group of 20 senior medical students. Each one of them were able to intubate the resuscitation mannequin during continuous chest compressions while using the McGrath MAC video laryngoscope, whereas, without this device, they were almost completely unable to manage the mannequin’s airway, save for the students who elected to pursue Anesthesia (1) and Emergency Medicine (2). Videolaryngoscopy–it’s here and it’s better. Videolaryngoscopy (with a MAC shaped blade) makes… Read more »
insert the bougie before you get to the vallecula by @emcrit http://t.co/NLlwmWjj
The Future of Cardiopulmonary Resuscitation (CPR) http://t.co/Rg7gTYM3
Not to add another voice to a clearly-controversial topic… …but I notice that nobody, including Scott, has mentioned the fact that the FDNY ran a trial with the ResQPod, used in all out-of-hospital cardiac arrests that were attended by FDNY Paramedics. (I know. I was there.) The following is an excerpt from a SEMSCO bulletin dated May of 2010: ” Starting 1/5/2010, NYC used the ResQPOD on 744 cardiac arrests and managed 541 arrests without the device during a 90 day period. Sustained ROSC (Return Of Spontaneous Circulation) was 18.28% in the ResQPOD group versus 25.14% without the ResQPOD for… Read more »
Yep,
I’ve been waiting for a while now for the publication of the NYC study. As I think you elude to, raw stats in this form of study are useless, the propensity analysis will be interesting, though it has been 2 years now, so one wonders if it was a non-sig and unlikely to be published result.
Can I gently request that all comments are posted with real rather than nicknames–much thanks.