Cardiac Arrest
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Targeted temperature management (TTM) after cardiac arrest - LITFL

Targeted temperature management (TTM) after cardiac arrest - LITFL | Cardiac Arrest | Scoop.it
Targeted temperature management (TTM), Therapeutic hypothermia, Post-cardiac arrest resuscitation care
Ryde Station's insight:
Although we don't actively cool cardiac arrest post ROSC in NSW Ambulance, it is always good to stay ahead of what is current best practice. Whilst some early data showed good improvements in outcomes from cooling to 32 degrees, and particularly with the prehospital activation of the cooling, two recent large and rigorous RCT's have shown no benefit to cooling to this range. The new paradigm is targeted temperature management to 36 degrees, and the avoidance of higher temperature ranges.
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The association between systolic blood pressure on arrival at hospital and outcome in adults surviving from out-of-hospital cardiac arrests of presumed cardiac aetiology - Resuscitation

Ryde Station's insight:

NSW ambulance interventions to achieve a SBP>100 post ROSC are boluses/infusion of adrenaline.  This article highlights that not pursuing this endstate as part of our post cardiac arrest care can lead to lower survival rates.

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STARTproject.info

STARTproject.info | Cardiac Arrest | Scoop.it
START Second Tier Arrest Response Trial START is a six-month feasibility study exploring the operational and logistical opportunities and challenges for new technologies in Out-of-Hospital Cardiac ...
Ryde Station's insight:

The training package for the Second Tier Arrest Response Trial can be found here, whilst in theory it runs in a radius from the bankstown HEMS base, the Road Retrieval crews range around so we may find ourselves getting backed up by them on a 1A.  Regardless, there is some great info in here on the mechanics and theory behind some of the most important concepts in prehospital managment of cardiac arrest.  The mechanical CPR devices are being assessed in the trial, but what is really important here are getting the basics right, as they are the factors that have evidence to show their benefit in cardiac arrest.  I strongly reccomend having a good read through this resource.

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Cardiac Arrest Centres

Cardiac Arrest Centres | Cardiac Arrest | Scoop.it
“ Prehospital Emergency Medicine”
Ryde Station's insight:
A couple of links to papers on the concept of setting up centralised cariac arrest centres much the same as the Major Trauma Centre system.
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Advanced Airway Management in Cardiac Arrest

Advanced Airway Management in Cardiac Arrest | Cardiac Arrest | Scoop.it
“ Research from JAMA — Association of Prehospital Advanced Airway Management With Neurologic Outcome and Survival in Patients With Out-of-Hospital Cardiac Arrest”
Ryde Station's insight:
Big numbers in this Japanese paper, and it shows worse neurological outcomes for OHCA patients who have advanced airways of any kinds established, compared with BVM.
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Down with “down” time! | Resus M.E!

Down with “down” time! | Resus M.E! | Cardiac Arrest | Scoop.it
“ A man in his 40s has a witnessed collapse and CPR is immediately started. Paramedics are on scene within 5 minutes and initiate advanced cardiac life support.”
Ryde Station's insight:
What do you describe as downtime in handover?
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