Kurt Bramer from Advanced CPR Solutions comes back for a final look at Head-Up CPR as we pull all the pieces from the earlier four episodes together. Dr. Joe Holley is back to bring in the latest research into the process as well. We will tie all this back to the global health disaster that is sudden cardiac arrest. Recent research from across the emergency medical community has pointed to impressive improvements in both return of spontaneous circulation (ROSC) as well as survival to discharge and neurologically intact survival when compared to conventional supine CPR performance. We’ll have links below to some of those studies and papers. Research Bibliography for Head-Up CPR Studies The episode is co-hosted again by our regular hosts, Sam Bradley and Jamie Davis. Elevated CPR Series Episode One Elevated CPR Series Episode Two Elevated CPR Series Episode Three Elevated CPR Series Episode Four CARES Registry for Cardiac Arrest Stats Follow up on more of these segments as we continue to look at the current research trends in future episodes and what is on the horizon for the future. The episode was co-hosted by Sam Bradley and Jamie Davis. Scroll down for Podcast Discussion Summary Thank you as always to Paragon Medical Education Group for their long-term support of the Disaster Podcast. Dr. Joe Holley and the team at Paragon continue to provide excellent and customized disaster response training to jurisdictions around the U.S. and internationally as well. Podcast Discussion Summary Head-Up CPR Research Update Jamie and Sam discussed the upcoming podcast episode, which will focus on wrapping up the last four episodes about head-up CPR and recent research. They mentioned the challenges of implementing new approaches in rural systems with volunteer staff. Sam noted that Dr. Joe and Kurt Bramer have been working on presenting the information in a way that can be applied responsibly. Joe briefly mentioned that SENA teams were activated to assist with floods in Seattle. The main focus of the episode will be on the latest data on head-up CPR, including improved physiology, survival rates, and neurological function, particularly for non-shockable rhythms like asystole. Advantages of Head-Up CPR Studies Sam, Kurt, and Joe discussed the significance of two seminal studies on head-up CPR. The 2016 preclinical animal study showed significant improvement in perfusion when compared to standard CPR, with a synergistic effect when using additional devices like the ITD and suction cup. The 2022 independent registry analysis demonstrated that head-up CPR resulted in a five times greater likelihood of neurologically intact survival compared to conventional CPR, even up to 20 minutes post-cardiac arrest. Joe explained that the bundled care approach for cardiac arrest patients involves multiple components, including appropriate ventilation, high-quality CPR, and post-resuscitation care, all of which contribute to improved outcomes. Bystander CPR System Implementation The discussion focused on the importance of proper implementation of bystander CPR, AEDs, and advanced techniques like impedance threshold devices and suction cup CPR to improve patient outcomes, particularly neurologic ones. Kurt emphasized the need for a system-wide approach, from first responders to hospital care, highlighting successful partnerships like Louisville’s, where continuity of care is prioritized. Jamie inquired about best practices for implementing this system-wide approach, to which Kurt responded with examples from different regions, noting that while ideal partnerships exist, proactive agencies can still achieve good outcomes even with less supportive hospitals. Cardiac Arrest Resuscitation Bundle Implementation The team discussed the importance of addressing multiple aspects of cardiac arrest resuscitation simultaneously, as highlighted by Joe, who emphasized that successful outcomes require implementing all elements of the care bundle equally. Jamie inquired about training approaches, to which Joe responded that effective training involves both initial instruction and ongoing feedback through quality improvement processes, stressing that successful resuscitations require adherence to the entire bundle rather than just some components. Prioritizing Tasks in Resuscitation Joe and Kurt discussed the importance of prioritizing tasks during resuscitation, emphasizing the need to focus on the overall process rather than individual steps. They highlighted the benefits of the Head-Up CPR model, which organizes priorities and reduces chaos during medical emergencies. Kurt explained that this method allows for more efficient and coordinated delivery of therapies, leading to better patient outcomes. Head-Up CPR Survival Benefits The group discussed two significant studies on CPR techniques. Kurt presented findings from a 2023 preclinical study showing that early administration of head-up CPR resulted in a 40% 24-hour survival rate compared to 9%...
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