Fri, 4 December 2015
Neurologically intact recovery after out-of-hospital cardiac arrest remains dismal. In the United States, an 8% meaningful recovery rate is hopeful at best. The introduction of extracorporeal membrane oxygenation (ECMO) during cardiopulmonary resuscitation (CPR) is not new but has been shown to provide upwards of 27-30% meaningful recovery, when applied to the appropriate patient population. In 2011 we began extracorporeal CPR (ECPR) in our emergency department - a suburban non-academic center in San Diego, California, USA; the results have been very promising. As a result, we also began refining all aspects of resuscitation. What specific things did we change about the way we do resuscitation?
Does any of this make a difference? Well, review of CARES data (U.S.-based cardiac arrest registry) shows that the 2014 arrest recovery rate, with meaningful neurologic outcome, at our hospital was almost double that of the nationwide data. And of the 50 patients included in the CARES database for our hospital, only 4 of those were resuscitated with ECPR. Perhaps we are just paying better attention and providing better overall care throughout the resuscitation. Perhaps we can all improve our resuscitation outcomes.
Direct download: Cutting_Edge_Resuscitation_in_the_Community_ED_Joe_Bellezzo.mp3
Category:general -- posted at: 12:30pm AEST
Thu, 3 December 2015
Reuben Strayer takes us through the myriad uses of Ketamine, and dispells some myths in the process. A Special K classic.
Direct download: Ketamine-_How_to_Use_it_Fearlessly_For_All_its_Indications_by_Strayer_OF.mp3
Category:general -- posted at: 11:24am AEST
Wed, 2 December 2015
Is Suspended Animation only in the realms of science fiction, or is this a realsitic treatment option? Mervyn Singer questions if we can prevent secondary reperfusion injury following cerbral ischaemia.