38 min.
LHP E79 - Head Up CPR – Not So FAST The EMS Lighthouse Project
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- Geneeskunde
Show Notes:EMS History is full of interventions we've rapidly adopted, often at great expense and withdisruption of existing processes, that later turned out to, how should I say this..... not work.Want examples? MAST and high-volume crystalloids in trauma. Mechanical compressiondevices, high-dose epinephrine, indiscriminate calcium administration in cardiac arrest. Do Ieven need to mention backboards?The next bright shiny thing promising to revolutionize cardiac arrest resuscitation is Head-UpCPR. It's certainly expensive and disruptive, but does it improve outcomes? What is theevidence?Dr. Jarvis has thoughts. He goes deep on this topic, using a recent paper on Head-Up CPR todiscuss how he evaluates new interventions for adoption. Oh, and he has thoughts on science ingeneral.
Citations:1. Moore JC, Pepe PE, Scheppke KA, Lick C, Duval S, Holley J, Salverda B, Jacobs M, Nystrom P,Quinn R, et al.: Head and thorax elevation during cardiopulmonary resuscitation usingcirculatory adjuncts is associated with improved survival. Resuscitation. 2022;October;179:9–17.2. Swaminathan A: Heads Up! There is No Association with Improved Outcomes for Head UpCPR: Why We Must Read Past the Abstract.RebelEM. Available at https://rebelem.com/heads-up-there-is-no-association-with-improved-outcomes-for-head-up-cpr-why-we-must-read-past-the-abstract/.3. Mohan M, Swaminathan AK: Heads Up! Data Dredging Coming Through: Heads UpCardiopulmonary Resuscitation Does Not Improve Outcomes. Annals of Emergency Medicine.2023;February;81(2):244–5.3. Jarvis J: Not so fast: More evidence needed in head-up CPR.ems1.com. Available athttps://www.ems1.com/ems-products/cpr-resuscitaCon/arCcles/not-so-fast-more-evidence-needed-in-head-up-cpr-ZK2O7yt5eb8jryYm/. Accessed December 9, 2023.4. Moore JC: Faster Cme to automated elevation of the head and thorax duringcardiopulmonary resuscitation increases the probability of return of spontaneous circulation.ResuscitaCon. 2022;Jan(170):62–9.5. Pepe PE, Scheppke KA, Antevy PM, Crowe RP, Millstone D, Coyle C, Prusansky C, Garay S, EllisR, Fowler RL, et al.: Confirming the Clinical Safety and Feasibility of a Bundled Methodology toImprove Cardiopulmonary Resuscitation Involving a Head-Up/Torso-Up Chest CompressionTechnique. Crit Care Med. 2019;March;47(3):449–55.6. Metro Fire Chiefs: First-In Responders Providing Neuroprotective (“Heads-Up”) CPR as theStandard of Care for Emergency Medical Services Systems.NFPA. Available at https://www.nfpa.org/-/media/Files/Membership/member-secCons/Metro-Chiefs/Urban-Fire-Forum/2023/UFF23_NPCPR-PosiCon-Statement.ashx. Accessed November 4, 2023.
Show Notes:EMS History is full of interventions we've rapidly adopted, often at great expense and withdisruption of existing processes, that later turned out to, how should I say this..... not work.Want examples? MAST and high-volume crystalloids in trauma. Mechanical compressiondevices, high-dose epinephrine, indiscriminate calcium administration in cardiac arrest. Do Ieven need to mention backboards?The next bright shiny thing promising to revolutionize cardiac arrest resuscitation is Head-UpCPR. It's certainly expensive and disruptive, but does it improve outcomes? What is theevidence?Dr. Jarvis has thoughts. He goes deep on this topic, using a recent paper on Head-Up CPR todiscuss how he evaluates new interventions for adoption. Oh, and he has thoughts on science ingeneral.
Citations:1. Moore JC, Pepe PE, Scheppke KA, Lick C, Duval S, Holley J, Salverda B, Jacobs M, Nystrom P,Quinn R, et al.: Head and thorax elevation during cardiopulmonary resuscitation usingcirculatory adjuncts is associated with improved survival. Resuscitation. 2022;October;179:9–17.2. Swaminathan A: Heads Up! There is No Association with Improved Outcomes for Head UpCPR: Why We Must Read Past the Abstract.RebelEM. Available at https://rebelem.com/heads-up-there-is-no-association-with-improved-outcomes-for-head-up-cpr-why-we-must-read-past-the-abstract/.3. Mohan M, Swaminathan AK: Heads Up! Data Dredging Coming Through: Heads UpCardiopulmonary Resuscitation Does Not Improve Outcomes. Annals of Emergency Medicine.2023;February;81(2):244–5.3. Jarvis J: Not so fast: More evidence needed in head-up CPR.ems1.com. Available athttps://www.ems1.com/ems-products/cpr-resuscitaCon/arCcles/not-so-fast-more-evidence-needed-in-head-up-cpr-ZK2O7yt5eb8jryYm/. Accessed December 9, 2023.4. Moore JC: Faster Cme to automated elevation of the head and thorax duringcardiopulmonary resuscitation increases the probability of return of spontaneous circulation.ResuscitaCon. 2022;Jan(170):62–9.5. Pepe PE, Scheppke KA, Antevy PM, Crowe RP, Millstone D, Coyle C, Prusansky C, Garay S, EllisR, Fowler RL, et al.: Confirming the Clinical Safety and Feasibility of a Bundled Methodology toImprove Cardiopulmonary Resuscitation Involving a Head-Up/Torso-Up Chest CompressionTechnique. Crit Care Med. 2019;March;47(3):449–55.6. Metro Fire Chiefs: First-In Responders Providing Neuroprotective (“Heads-Up”) CPR as theStandard of Care for Emergency Medical Services Systems.NFPA. Available at https://www.nfpa.org/-/media/Files/Membership/member-secCons/Metro-Chiefs/Urban-Fire-Forum/2023/UFF23_NPCPR-PosiCon-Statement.ashx. Accessed November 4, 2023.
38 min.