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Emergency Room physician Dr. Amy Gutman has seen it all—and she's not afraid to tell the truth about what's killing her patients. Known as “Tough Love MD,” Amy blends compassion with blunt honesty, challenging the culture of quick fixes, patient satisfaction scores, and a medical system that too often keeps people “comfortable” instead of healthy.Drawing from her own journey with obesity, chronic illness, and a learning disability, Amy offers an empowering message of hope: the solution is simple—but not easy—and it starts with good nutrition, daily movement, and the belief that you're better than your circumstances.In this eye-opening conversation, Amy shares what it's like to work on the front lines where 85% of patients have chronic, preventable diseases, yet few are ready to make the lifestyle changes that could truly save their lives. From the shift in medicine from survival rates to Yelp-style reviews, to the dangers of the “kind lie,” Amy pulls back the curtain on a system that rewards keeping patients happy rather than well.If you've ever wondered why your doctor might not tell you the whole truth, or how tough love can actually be the most compassionate care of all, this episode will change the way you see medicine—and yourself. Keep your eyes open for Amy's new book arriving soon - Powerhouse Living: Lead Your Life Like a Resuscitation!
Reference: Jessen et al. Pharmacological interventions for the acute treatment of hyperkalaemia: A systematic review and meta-analysis. Resuscitation 2025 Date: August 6, 2025 Guest Skeptic: William Toon is a paramedic who, this past May achieved over 50 years of continuous EMS certification. His professional path has taken him from front-line paramedic to national presenter, expert witness, flight […] The post SGEM#484: The Warrior – Pharmacological Interventions for the Acute Treatment of Hyperkalemia first appeared on The Skeptics Guide to Emergency Medicine.
A story about drunk raccoons on the local news- thank goodness for local news!Check out the segment here ★ Support this podcast on Patreon ★
In this Bible Story, we witness the righteous anger of Jesus. During the Passover, corrupt money-changers and religious leaders exploit people’s desire to worship. So Jesus fashions a whip and drives them out. This story is inspired by John 2:13-23, John 3: 1-21, Numbers 21:4-9. Go to BibleinaYear.com and learn the Bible in a Year.Today's Bible verse is John 2:15 from the King James Version.Episode 178: As Jesus entered the temple gates during Passover, His eyes were open to the corruption of that sacred place. Where there should have been awe and a sense of holiness, a marketplace existed. Instead of forgiveness, the religious leaders were requiring fees. Jesus could not stand this happening in God’s temple, so He drove out the buyers, sellers, and the money changers! The temple priests challenged Him on this but Jesus did not falter. Later that evening though, one of the Pharisees came to Him to know more about who He was and what He came to do.Hear the Bible come to life as Pastor Jack Graham leads you through the official BibleinaYear.com podcast. This Biblical Audio Experience will help you master wisdom from the world’s greatest book. In each episode, you will learn to apply Biblical principles to everyday life. Now understanding the Bible is easier than ever before; enjoy a cinematic audio experience full of inspirational storytelling, orchestral music, and profound commentary from world-renowned Pastor Jack Graham.Also, you can download the Pray.com app for more Christian content, including, Daily Prayers, Inspirational Testimonies, and Bedtime Bible Stories.Visit JackGraham.org for more resources on how to tap into God's power for successful Christian living.Pray.com is the digital destination of faith. With over 5,000 daily prayers, meditations, bedtime stories, and cinematic stories inspired by the Bible, the Pray.com app has everything you need to keep your focus on the Lord. Make Prayer a priority and download the #1 App for Prayer and Sleep today in the Apple app store or Google Play store.Executive Producers: Steve Gatena & Max BardProducer: Ben GammonHosted by: Pastor Jack GrahamMusic by: Andrew Morgan SmithBible Story narration by: Todd HaberkornSee omnystudio.com/listener for privacy information.
In Episode #42 of EM Logic, Dr. Pregerson highlights new research on occult ventricular fibrillation seen only on bedside echo and reviews the DOSE VF trial showing improved survival with dual sequential defibrillation. He also connects pearls from prior episodes on heads-up CPR and hypokalemic arrest. Read more in the Show Notes.
In this episode of The Crux True Survival Story Podcast, hosts Kaycee McIntosh and Julie Henningsen unravel the harrowing tale of 7-year-old Calena Areyan Gruber, who miraculously survived a catastrophic accident during sailing camp in Biscayne Bay, Miami. The story highlights the resilience and incredible survival instincts of a child caught in an underwater disaster caused by a massive commercial barge. The episode also delves into the tragic loss of three other young sailors, the regulatory failures in maritime safety, and the urgent need for reform to prevent similar tragedies. The podcast underscores the unpredictable nature of life and the extraordinary capabilities of human survival, particularly in children. 00:00 Introduction to the Crux True Survival Story Podcast 00:31 Setting the Scene: A Tragic Day in Miami Bay 09:53 The Collision: A Catastrophic Event 12:34 Kalina's Extraordinary Survival 16:18 The Aftermath: Rescue and Recovery 24:23 Calls for Maritime Safety Reforms 28:46 Reflections on Youth Sailing Safety 31:23 Conclusion and Listener Engagement who miraculously survived a catastrophic accident during sailing camp in Biscayne Bay, Miami. The story highlights the resilience and incredible survival instincts of a child caught in an underwater disaster caused by a massive commercial barge. The episode also delves into the tragic loss of three other young sailors, the regulatory failures in maritime safety, and the urgent need for reform to prevent similar tragedies. The podcast underscores the unpredictable nature of life and the extraordinary capabilities of human survival, particularly in children. 00:00 Introduction to the Crux True Survival Story Podcast 00:31 Setting the Scene: A Tragic Day in Miami Bay 09:53 The Collision: A Catastrophic Event 12:34 Calena's Extraordinary Survival 16:18 The Aftermath: Rescue and Recovery 24:23 Calls for Maritime Safety Reforms 28:46 Reflections on Youth Sailing Safety 31:23 Conclusion and Listener Engagement Miami Bay Miracle Podcast - References and Sources Primary Incident Sources ABC News "2 children dead after barge strikes sailboat from youth sailing program: Officials" July 29, 2025 https://abcnews.go.com/US/miami-beach-sailboat-capsized-youth-sailing-program/story?id=124149834 CBS Miami "Two children dead after sailboat and barge collision off Miami Beach, officials say" August 5, 2025 https://www.cbsnews.com/miami/news/two-children-killed-sailboat-barge-collision-off-miami-beach/ CNN "Third girl dies after sailboat and barge collision in Miami" August 3, 2025 https://www.cnn.com/2025/08/03/us/miami-boat-accident-crash-death CBS Miami "Third girl dies after sailboat crash with barge near Miami Beach, family and officials confirm" August 4, 2025 https://www.cbsnews.com/miami/news/10-year-old-miami-beach-boat-crash-victim-ari-buchman-died/ Survivor and Family Information Fox Business "Miami sailboat crash survivor's family issues statement after deadly incident" August 2025 https://www.foxbusiness.com/lifestyle/miami-sailboat-crash-survivor-stared-death-face-lawyer-says NBC 6 South Florida "Parents of Calena Gruber, Miami sailing camp tragedy survivor, speak" August 2025 https://www.nbcmiami.com/news/local/family-of-7-year-old-miami-sailing-camp-tragedy-survivor-speaks/3672444/ PEOPLE Magazine "Family of 7-Year-Old Girl Who Survived Miami Boat Crash That Killed 3 Say It's a 'Miracle She's Alive'" August 2025 https://www.yahoo.com/news/articles/family-7-old-girl-survived-100808752.html Miami Herald via Sun Sentinel "'It's a miracle she's alive.' Girl injured in boat crash was trapped under barge" August 4, 2025 https://www.sun-sentinel.com/2025/08/04/girl-seriously-injured-after-biscayne-bay-barge-sailboat-crash-recovering-family-says/ Legal and Investigation Coverage WLRN "Attorney for survivor of deadly sailboat crash calls tragedy 'preventable'" August 5, 2025 https://www.wlrn.org/law-justice/2025-08-04/attorney-for-survivor-of-deadly-sailboat-crash-calls-tragedy-preventable Local 10 WPLG "Lawsuit IDs owner of barge in deadly Biscayne Bay crash with youth sailing camp boat" August 8, 2025 https://www.local10.com/news/local/2025/08/08/lawsuit-ids-owner-of-barge-in-deadly-biscayne-bay-crash-with-youth-sailing-camp-boat/ Leesfield & Partners "Leesfield & Partners Representing Family of Girl, 7, Injured in Miami Beach Deadly Sailboat Crash" August 5, 2025 https://www.floridainjurylawyer-blawg.com/leesfield-partners-representing-family-of-girl-7-injured-in-miami-beach-deadly-sailboat-crash/ Boating Safety Statistics U.S. Coast Guard Boating Safety "2023 Recreational Boating Statistics" 2024 https://www.uscgboating.org/library/accident-statistics/Recreational-Boating-Statistics-2023-Ch2.pdf American Boating Association "Boating Fatality Facts" May 30, 2025 https://americanboating.org/boating_fatality.asp Children's Safety Network "Boating Safety" https://www.childrenssafetynetwork.org/infographics/boating-safety Child Drowning and Near-Drowning Research Children's Safety Network "The Facts On Childhood Drowning" https://www.childrenssafetynetwork.org/infographics/facts-childhood-drowning American Red Cross "Drowning Prevention & Facts" https://www.redcross.org/get-help/how-to-prepare-for-emergencies/types-of-emergencies/water-safety/drowning-prevention-and-facts.html Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine "Neurologic long term outcome after drowning in children" August 15, 2012 https://sjtrem.biomedcentral.com/articles/10.1186/1757-7241-20-55 NeuroLaunch "Near-Drowning's Psychological Impact: Long-Term Effects and Recovery" September 15, 2024 https://neurolaunch.com/psychological-effects-of-near-drowning/ Maritime Safety and Regulation Information NOAA Fisheries "Understanding Vessel Strikes" https://www.fisheries.noaa.gov/insight/understanding-vessel-strikes Frontiers in Marine Science "A Global Review of Vessel Collisions With Marine Animals" April 14, 2020 https://www.frontiersin.org/journals/marine-science/articles/10.3389/fmars.2020.00292/full Witness Accounts and Community Response Sailing Anarchy Forums "Two children dead after barge hits sailboat in Biscayne Bay" July 28, 2025 https://forums.sailinganarchy.com/threads/two-children-dead-after-barge-hits-sailboat-in-biscayne-bay.252661/ WLRN "Sailboat crash victims ages 7 and 13, says Coast Guard. Two other kids in critical condition" July 29, 2025 https://www.wlrn.org/south-florida/2025-07-29/biscayne-bay-sailboat-crash-victims-ages-7-and-13-two-other-kids-hospitalized-in-critical-condition Key Facts Confirmed by Multiple Sources: Incident Details: Date: July 28, 2025 Time: Approximately 11:15 AM Location: Between Hibiscus Island and Monument Island, Biscayne Bay, Miami Beach Victims: 6 total (5 children ages 7-13, 1 adult counselor age 19) Casualties: Deceased: Mila Yankelevich (7), Erin Ko Han (13), Arielle Buchman (10 - died August 4) Survivors: Calena Areyan Gruber (7), one unnamed child, adult counselor (19) Survivor Information: Calena Areyan Gruber from Seattle Parents: Karina Gruber Moreno and Enrique Areyan Viqueira Attorney: Justin B. Shapiro, Leesfield & Partners Released from Jackson Memorial Hospital: August 1, 2025 Injuries: Lacerations and contusions throughout body Trapped under 60-foot barge before swimming to safety Legal/Investigation: Coast Guard and Florida Fish and Wildlife Commission investigating Barge owned by Waterfront Construction (Jorge Rivas) Tugboat under 26 feet (no licensed captain required) Multiple lawsuits filed alleging negligence
Moderator: Marian Galovic (Zurich, Switzerland) Guest: Federico Semeraro (Bologna, Italy) In this episode, Galovic speaks with Semeraro about how artificial intelligence is transforming cardiac arrest care and neuroprognostication. From retrospective studies to future clinical applications, they explore the potential and ethical challenges of integrating AI as a supportive team member in neurocritical care.
In this episode, Dr. Sergio Zanotti discusses ECPR–Extracorporeal Cardiopulmonary Resuscitation. ECPR is still be considered a niche therapy, but its relevance and availability are increasing. He is joined by Dr. Adam Green, a practicing intensivist at Cooper University Health Care and an Associate Professor of Medicine at Cooper Medical School of Rowan University (CMSRU). Dr. Green is the director of research for the division of Critical Care and has authored over 50 peer-reviewed publications. He has been part of the ECMO team at Cooper since its inception. Additional resources: Extracorporeal cardiopulmonary resuscitation for refractory cardiac arrest. The Lancet Respiratory Medicine 2025: https://www.sciencedirect.com/science/article/pii/S2213260025001225 Effect of Intra-arrest Transport, Extracorporeal Cardiopulmonary Resuscitation, and Immediate Invasive Assessment and Treatment on Functional Neurologic Outcome in Refractory Out-of-Hospital Cardiac Arrest. JAMA 2022: https://jamanetwork.com/journals/jama/fullarticle/2789313 Association between increasing institutional experience with ECPR and outcomes in patients with out-of-hospital cardiac arrest: A nationwide multicenter observational study in Japan (the JAAM–OHCA registry) RESUSCITATION 2025: https://www.resuscitationjournal.com/article/S0300-9572(24)00862-1/fulltext Early Extracorporeal CPR for Refractory Out-of-Hospital Cardiac Arrest. N Eng J of Med 2023: https://www.nejm.org/doi/full/10.1056/NEJMoa2204511 Books mentioned in this episode: The Perfect Predator: A Scientist's Race to Save Her Husband from a Deadly Superbug. By S. Strathdee and T Patterson: https://amzn.to/3Hxjmez
Behind the Knife's General Surgery Oral Board Review Course includes 123 Audio Scenarios + 10 Interactive Video Scenarios + 97 Operative Descriptions that cover all SCORE topic. Each scenario includes two parts. The first part is a perfectly executed oral board scenario that mimics the real thing. Scenarios are 5 to 7 minutes long and include a variety of tactics and styles. If you are able to achieve this level of performance in your preparation you are sure to pass the oral exam with flying colors. The second part introduces high-yield commentary to each scenario. This commentary includes tips and tricks to help you dominate the most challenging scenarios in addition to practical, easy-to-understand teaching that covers the most confusing topics we face as general surgeons. We are confident you will find this unique, dual format approach a highly effective way to prepare for the test. All of our premium courses are available via our website and apps (iOS and Android). Users can take notes, pin chapters and download content for offline viewing. Learn more about the General Surgery Oral Board Review Course at https://app.behindtheknife.org/premium/general-surgery-oral-board-review **Institutional Discounts Available - Please email hello@behindtheknife.org to learn more.** Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.
Ethics in the field of infectious disease can be a delicate interplay between treating the individual patient and protecting the collective health of a society. Sometimes these two mandates go hand in hand; at other times they can appear to be in conflict. In this episode of Communicable, Dr. Angela Huttner invites Drs. Zeb Jamrozik (Melbourne, Australia) and Beenish Syed (Karachi, Pakistan), two members of ESCMID's Ethics Advisory Committee, to unpack different scenarios encountered in the field of infectious disease from an ethics standpoint: how one ethically allocates scarce resources like antimicrobials; whether there is ethical justification for coercive public-health measures like lockdowns; and whether the need to collect evidence to advance patient care could include other models besides opt-in informed consent. This episode was edited by Dr. Kathryn Hostettler and peer reviewed by Dr. Goulia Ohan of Yerevan State Medical University, Yerevan, Armenia.Further reading:Barosa M, et al. The Ethical Obligation for Research During Public Health Emergencies: Insights From the COVID-19 Pandemic. Med Health Care Philos 2024. DOI: 10.1007/s11019-023-10184-6Symons X, et al. Why should HCWs receive priority access to vaccines in a pandemic? BMC Med Ethics 2021. DOI: 10.1186/s12910-021-00650-2Thorsteinsdottir B and Madsen BE. Prioritizing health care workers and first responders for access to the COVID19 vaccine is not unethical, but both fair and effective – an ethical analysis. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 2021. DOI: 10.1186/s13049-021-00886-2Huttner A, Leibovici L, Theuretzbacher U, Huttner B, Paul M. Closing the evidence gap in infectious disease: point-of-care randomization and informed consent. Clin Microbiol Infect 2017;23(2):73-77. DOI: 10.1016/j.cmi.2016.07.029
In this episode, we get some expert tips on pediatric resuscitation and access considerations. This is part of the 3rd Annual Emergency Medicine - High Risk, Don't Miss conference from Colorado ACEP. This episode features PEM physician, Dr. Patrick Joynt.
Host: Emer Joyce Guest: Christian Hassager Want to watch that extended interview? Go to: https://esc365.escardio.org/event/1812?resource=interview Want to watch the full episode? Go to: https://esc365.escardio.org/event/1812 Disclaimer ESC TV Today is supported by Bristol Myers Squibb and Novartis. This scientific content and opinions expressed in the programme have not been influenced in any way by its sponsors. This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. The ESC is not liable for any translated content of this video. The English-language always prevails. Declarations of interests Stephan Achenbach, Emer Joyce, Christian Hassager, Nicolle Kraenkel and Theresa McDonagh have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede. Davide Capodanno has declared to have potential conflicts of interest to report: Bristol Myers Squibb, Daiichi Sankyo, Sanofi Aventis, Novo Nordisk, Terumo. Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada. Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson.
Every spring for over 50 years, the Trauma, Critical Care, and Acute Care Surgery conference, best known simply as the MATTOX conference, is held in Las Vegas (https://www.trauma-criticalcare.com/). The conference is unique in that it is entirely focused on practice-changing clinical education. It's a damn good time too! A favorite feature is the annual debates. Today, we are featuring a showdown between Drs. Teddy Puzo and Joseph Dubois as they battle it out over the use of a DIRECT TO OR TRAUMA RESUSCITATION STRATEGY. You can listen on the podcast or watch the debate with accompanying slides on our website or app. Let's get ready to RUMMMBLLLEEEE! Video Link: https://www.youtube.com/watch?v=-DTTGBaLcHo TRAUMA SURGERY VIDEO ATLAS: https://app.behindtheknife.org/course-details/trauma-surgery-video-atlas Preparing for the deadliest injuries is challenging, and currently available resources are limited. That is why we created the Behind the Knife Trauma Surgery Video Atlas. Be ready for the most complex injuries, like penetrating trauma to the neck, audible bleeding from the IVC, and pelvic hemorrhage, with 24 scenarios. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen
Cardiac arrest in the operating room presents unique challenges that standard Advanced Cardiovascular Life Support (ACLS) protocols simply were not designed to address. This eye-opening exploration with APSF author, Zachary Smith, reveals why traditional resuscitation guidelines fall short when emergencies strike during surgery and anesthesia care.The dynamics of cardiac arrest differ dramatically in the perioperative environment. While out-of-hospital arrests typically stem from arrhythmic events, OR emergencies often result from hemorrhage, embolism, hypoxemia, or critical drug reactions like malignant hyperthermia or local anesthetic toxicity. These scenarios demand immediate, specialized interventions beyond standard ACLS algorithms.Physical constraints further complicate matters. What happens when cardiac arrest occurs while a patient is positioned prone, lateral, or in steep Trendelenburg? Traditional compressions become impossible, and emerging research suggests prone CPR might actually be superior in some scenarios. Moreover, the advanced monitoring capabilities in the OR – arterial lines, central venous pressure readings, and echocardiography – provide critical data not incorporated into standard protocols.The American Society of Anesthesiologists has responded with their Perioperative Resuscitation and Life Support Certificate program, addressing these gaps through specialized training that combines ACLS principles with OR-specific knowledge. Ready to enhance your skills beyond basic ACLS? Explore the ASA's certificate program to earn patient safety CME credits while gaining life-saving expertise tailored to the unique challenges of the operating room. Your specialized knowledge could make all the difference when seconds count.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/264-rethinking-resuscitation-in-the-operating-room-beyond-acls/© 2025, The Anesthesia Patient Safety Foundation
The 2017 NEJM study, ALPS, compared amiodarone, lidocaine, and placebo for refractory shockable rhythms in adults with out of hospital cardiac arrest. They found no significant difference in survival to hospital discharge or functional survival between any of the arms. If that study has left you confused, you're not alone. And you're in luck. Tanner Smida joins us again to discuss his latest paper using something called target trial emulation to assess the difference in ROSC and survival to discharge between amiodarone and lidocaine. This is a great discussion of his paper, the methodology, and how we can put his results into the context of ALPS.Citations:1.Smida T, Crowe R, Price BS, Scheidler J, Martin PS, Shukis M, Bardes J: A retrospective ‘target trial emulation' comparing amiodarone and lidocaine for adult out-of-hospital cardiac arrest resuscitation. Resuscitation. 2025;March;208:110515.2. Kudenchuk PJ, Brown SP, Daya M, Rea T, Nichol G, Morrison LJ, Leroux B, Vaillancourt C, Wittwer L, Callaway CW, et al.: Amiodarone, Lidocaine, or Placebo in Out-of-Hospital Cardiac Arrest. N Engl J Med. 2016;May 5;374(18):1711–22.3.Hernán MA, Robins JM: Using Big Data to Emulate a Target Trial When a Randomized Trial Is Not Available: Table 1. Am J Epidemiol. 2016;April 15;183(8):758–64.
The final instalment of our series “Perioperative Pain Management” is a panel discussion where we answer the question: What are the various challenges and strategies in managing perioperative pain, particularly with regard to opioid use? The discussion covers the complexities of opioid de-escalation in preoperative periods, the benefits and risks of opioid-free anesthesia, and the use of multimodal approaches. We also touch on the coordination of patient care across multiple specialties and the impact of intraoperative practices on postoperative pain management and long-term opioid use. The session emphasizes the importance of patient education, consistent communication, and empowered collaboration among healthcare providers. The speakers on the panel are; Tim Miller, Professor of Anesthesiology at Duke University Medical Center, Fauzia Hasnie, Consultant Lead, Opioid Multidisciplinary Pain Management Clinic, Joint Lead, Combined Sickle-Opioid Virtual Multidisciplinary Clinic Guy's & St Thomas' NHS Foundation Trust, and Esteban Salas Rezola, Specialist in Anaesthesiology, Resuscitation and Pain Therapy at Hospital General Alicante. Chaired by John Whittle, Clinical Academic working in Perioperative Translational Medicine at UCL and Honorary Consultant in Perioperative Medicine, Anaesthesia and Critical Care at University College Hospitals London. The three presentations which accompany this piece are here: https://topmedtalk.libsyn.com/perioperative-pain-management-the-opioid-epidemic-and-opioid-reduction-strategies https://topmedtalk.libsyn.com/perioperative-pain-management-opioid-reduction-service https://topmedtalk.libsyn.com/perioperative-pain-management-opioid-sparing-analgesia-strategies-guided-by-nol-index
In Week 5 of 6 in A Resuscitation of Stars AKA "Summer Camp for Adults", we hear from Joel about the power of light and where we're shining and directing our light. We continue to hear from members of the church and an echoing of the sentiment of being a "marvelous light" to the world.
Remember when we used to use stacked shocks for ventricular arrhythmias or load patients up with high doses of epinephrine and bicarb? Over the last 25 years, resuscitation guidelines have evolved and it's our job to stay updated on the current protocols.Here to help us break down what's changed and what still works is Dr. Ashish Panchal, Chair of Emergency Cardiovascular Care for the AHA and host of the In the Heart of Care podcast. We discuss how a common cardiac arrest scenario would be treated from 2000 to today, highlighting key guideline changes like the shift to neuroprotective strategies, high-quality CPR, and post-arrest care.Tune in to stay current and hear how science continues to shape the way we save lives!Topics discussed in this episode:How AHA guidelines are developedDr. Panchal's research and impactEarly 2000s resuscitation guidelines“Save the brain” approach in the 2010sHow medication use has evolved, like epinephrineThe current focus on high-performance CPR and neuroprotective strategiesPost-arrest care and survivorshipBalancing clinical trends with scientific validationHow nurses can stay current on AHA guidelinesCheck out the In the Heart of Care Podcast here:https://rqipartners.com/podcast/Mentioned in this episode:CONNECT
In Week 4 of 6 in A Resuscitation of Stars AKA "Summer Camp for Adults", we hear from John about opening ourselves up to God, letting the light in, and teaching from Genesis 1. We also recap Worship Night where 25 people were baptized and hear from some of the congregation of the impact of that night.
Islanders! Are these lovers trying to just win the game? Or are they there for the right reasons? Amy Phillips is joined by cohosts Emily Dorezas (@emdorezas) and Jaime Moyer (@jamdetroit) to thoroughly discuss every Islander on Love Island from episodes 14 to 20. From the villa to casa amore and purgatory island with Olandria and Nic. No thong is left unturned and no twerk is left undiscussed. FOR SOLAR/RENEWABLE ENERGY/BATTERIES CONTACT MY HUZZBAND BRRRREEEHHHTTT:brett.guennel@sunrun.comFor more Drama, Darling, and exclusive content, subscribe to:http://Patreon.com/dramadarling Follow Drama, Darling on Instagram:https://www.instagram.com/dramadarlingshow/ Follow Amy Phillips on Instagram:https://www.instagram.com/meetamyphillips/Email Drama, Darling with comments, questions and drama:DramaDarlingz@gmail.com
This piece focuses on strategies for opioid-sparing anesthesia guided by the NOL Index, emphasizing the variability in patient responses to opioids. The importance of monitoring nociception, using advanced devices and techniques to customize opioid dosing, reduce side effects, and confirm the effectiveness of regional anesthesia. Our presenter shares personal experiences from their professional life and case studies, illustrating the benefits and challenges of implementing multimodal and opioid-free anesthesia approaches. The talk highlights the need for individualized treatment strategies in critical care and anesthesia. Presented by Esteban Salas Rezola, Specialist in Anaesthesiology, Resuscitation and Pain Therapy at Hospital General Alicante.
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On this month's EM Quick Hits podcast: Dr. Mathew MacArther on Occipital Nerve Block, Dr. Ian Chernoff on PoCUS in Pulmonary Embolism, Dr. Hans Rosenberg on Myelopathy, Dr. Shawn Segeren on Team Resuscitation, Dr. Brit Long on Incidental Neutropenia and Dr. Kylie Booth on Peer Programs. Please help ensure continued Free Open Access of the entire EM Cases Learning System by donating here: https://emergencymedicinecases.com/donation/
Send us a textDoes heaven really exist? Does everyone go there when they die? Can we know for sure that we will go to heaven? In this podcast, you'll learn the answers to these questions from a man who has studied over fifteen hundred near- death experiences. Best -selling author John Burke joins Brian, Terry and Dan for this exciting edition of FINISH STRONG. He shares thrilling accounts of heaven from people who were clinically dead but came back to life. These near- death survivors include people from various professions, cultures and faiths. They include people of all ages including children. John has even interviewed blind people who describe the amazing things they “saw” after they died! The common experiences of these near -death survivors point to the heaven described in the Bible. However, not all of these people experienced heaven. Some described going to a place they could only describe as hell. Don't miss this amazing discussion. As you listen to John Burke, you'll discover that heaven is even more amazing than you could ever imagine!imagineheaven.netSupport the showFearless Faith Websiteffaith.orgTo leave a review - Open Finish Strong on the Apple Podcast app and scroll down until you see "Ratings & Reviews". There will be a link to click so that you can "Write A Review"FacebookYouTubeInstagram
We're joined by Dallas-area cardiac arrest management thought leaders from Best EMS and Parker County Hospital District to discuss the Resuscitation Academy. Where did this thing start? How can you and your service benefit? What RA lessons have we implemented here at MCHD? Learn how to improve your cardiac arrest survival rates without breaking the bank. REFERENCES 1. https://www.resuscitationacademy.org
This episode covers newborn resuscitation.Written notes can be found at https://zerotofinals.com/paediatrics/neonatology/newbornresuscitation/Questions can be found at https://members.zerotofinals.com/Books can be found at https://zerotofinals.com/books/The audio in the episode was expertly edited by Harry Watchman.
When faced with the challenge of reviving a patient in cardiac arrest, paramedics rely on an arsenal of tools, techniques, and medications. Among these are two stalwarts of advanced cardiac life support (ACLS): amiodarone and lidocaine. Although both drugs have long been included in protocols as viable options for shockable cardiac arrests, a new study published in Resuscitation sheds fresh light on their effectiveness, offering compelling insights into why lidocaine might deserve a closer look. The research, led by Tanner Smida, MD/PhD candidate at West Virginia University, employed a meticulous approach known as “target trial emulation.” This method is designed to minimize bias in observational studies, aligning results more closely with what randomized controlled trials would reveal. The study analyzed data spanning five years, from 2018 to 2023, drawing on over 23,000 cardiac arrest cases treated by EMS professionals in real-world settings.
In this episode of STEMulating Conversations, we sit down with Dr. Katherine Y. Brown, affectionately known as The CPR Lady—a title earned not just from her passion for teaching lifesaving skills, but from a life committed to reviving potential in every form. From going door to door in her community to teach CPR, to leading efforts that breathe life into careers, organizations, and people, Dr. Brown has made “resuscitation” more than a medical term—it's her mission. Whether she's saving lives, uplifting others, or reigniting purpose, she reminds us that revival is always possible. Join us for an inspiring conversation about purpose, perseverance, and the power of showing up—heartbeat by heartbeat. Dr. Brown is a passionate volunteer with the American Heart Association, having trained over 300,000 people internationally in CPR and wants to ensure that everyone is trained in this life saving technique. Learn more about Dr. Brown's CPR work by listening to her TEDx Talk
This conversation delves into the critical aspects of tourniquet management in trauma care, focusing on the distinction between tourniquet conversion and replacement, the importance of resuscitation, and the physiological implications of prolonged tourniquet use. The speakers discuss techniques for safe conversion, the challenges faced in the field, and the assessment of limb salvageability, emphasizing the need for preparedness and patient assessment in high-stress environments. This conversation delves into the complexities of patient care in trauma situations, focusing on the challenges faced by medics in making critical decisions about limb salvage, managing acidosis, and understanding reperfusion injury. The speakers emphasize the importance of resuscitation, the need for adequate resources, and the moral dilemmas that arise in emergency medical situations. They provide practical advice for medics on how to navigate these challenges effectively while ensuring patient safety and care quality.TakeawaysTourniquet conversion is essential in trauma care.Understanding the difference between conversion and replacement is crucial.Resuscitation is a key factor before converting a tourniquet.The two-hour mark for tourniquet use is based on physiological considerations.Prolonged tourniquet time can lead to significant metabolic issues.Be prepared for reperfusion injury when converting a tourniquet.Confidence in tourniquet conversion skills is often lacking among providers.Patient assessment is critical before converting a tourniquet.Limb salvageability can vary and should be assessed carefully.The decision to convert a tourniquet should prioritize patient stability. Imperfect situations require difficult decisions in patient care.Triage decisions are crucial when resources are limited.Resuscitation is the primary goal in trauma care.Understanding reperfusion injury is essential for medics.Managing acidosis can significantly impact patient outcomes.Blood transfusions are critical in trauma situations.Medics must be prepared for potential complications.Always monitor and assess the patient's condition continuously.Reading medication labels is vital for safe practice.Confidence in converting tourniquets is essential for medics.Chapters00:00 Introduction to Tourniquet Management02:56 Understanding Tourniquet Conversion vs. Replacement06:10 Resuscitation Goals and Tourniquet Timing08:58 Physiological Implications of Prolonged Tourniquet Use11:47 Techniques for Safe Tourniquet Conversion15:09 Challenges in Tourniquet Management17:53 Assessing Limb Salvageability and Patient Stability25:44 Navigating Imperfect Situations in Patient Care30:32 Triage Decisions: When to Save a Limb31:03 Understanding Reperfusion Injury and Its Challenges35:43 Managing Acidosis in Trauma Patients46:34 Advice for Medics: The Importance of ConversionThank you to Delta Development Team for in part, sponsoring this podcast.deltadevteam.comFor more content, go to www.prolongedfieldcare.orgConsider supporting us: patreon.com/ProlongedFieldCareCollective or www.lobocoffeeco.com/product-page/prolonged-field-care
Shelly, Mawi, Paul, and Stephen have a great discussion on volume resuscitation strategies, maximum blood products given, and what to give when pH is whack. The nephrologist has some knowledge to drop....
In Episode #38 of EM Logic, Dr. Pregerson reviews what you can do before intubation in order to prevent triggering a subsequent cardiac arrest. Read more details here in the Show Notes.
Jaclyn Duncan, RN shares details of a research study on preparing nurses to support family presence in resuscitation.
In this episode of the PFC Podcast, Dennis and Alex delve into the complexities of burn resuscitation, discussing recent advancements in fluid management and the importance of urine output monitoring. They explore the historical context of burn care, the role of glycocalyx in fluid dynamics, and evaluate various resuscitation protocols. The conversation emphasizes the need for careful fluid management to avoid complications and improve patient outcomes, particularly in emergency and military settings.TakeawaysBurn injuries require specialized and intensive care.Fluid management is critical in burn resuscitation.The glycocalyx plays a significant role in fluid dynamics.Urine output is a key indicator of patient status.Over-resuscitation can lead to severe complications.Plasma therapy shows promise in improving outcomes.Historical protocols may need reevaluation based on new evidence.Monitoring urine output is essential for adjusting fluid therapy.Collaboration with burn centers is crucial in managing severe cases.Understanding the physiological changes in burn patients is vital.Chapters00:00 Introduction to Burn Resuscitation03:09 Understanding Burn Injuries and Their Management06:00 Fluid Management in Burn Patients09:05 The Role of Glycocalyx in Fluid Dynamics12:04 Evaluating Burn Resuscitation Protocols15:08 Comparing Fluid Resuscitation Strategies17:51 The Importance of Urine Output Monitoring20:47 Outcomes of Different Resuscitation Approaches24:01 Recommendations for Burn Care in the Field26:59 Final Thoughts on Burn ResuscitationThank you to Delta Development Team for in part, sponsoring this podcast.deltadevteam.comFor more content, go to www.prolongedfieldcare.orgConsider supporting us: patreon.com/ProlongedFieldCareCollective or www.lobocoffeeco.com/product-page/prolonged-field-care
Hint...It has nothing to do with the formula. Posting tomorrow.Thank you to Delta Development Team for in part, sponsoring this podcast.deltadevteam.comFor more content, go to www.prolongedfieldcare.orgConsider supporting us: patreon.com/ProlongedFieldCareCollective or www.lobocoffeeco.com/product-page/prolonged-field-care
In 1960, Norwegian toymaker Åsmund Lærdal began selling his latest invention - a life-size training dummy designed to teach mouth-to-mouth resuscitation.Resusci Anne is made of soft plastic and resembles an unconscious person. Åsmund wanted as many people as possible to be trained in this new method of life saving and he hoped that a female manikin would be less threatening to trainees.Anne's now believed to have saved the lives of more than two million people around the world.Jacqueline Paine speaks to Åsmund's son Tore Lærdal, who explains how his father had been inspired by a near-death experience Eye-witness accounts brought to life by archive. Witness History is for those fascinated by the past. We take you to the events that have shaped our world through the eyes of the people who were there. For nine minutes every day, we take you back in time and all over the world, to examine wars, coups, scientific discoveries, cultural moments and much more. Recent episodes explore everything from football in Brazil, the history of the ‘Indian Titanic' and the invention of air fryers, to Public Enemy's Fight The Power, subway art and the political crisis in Georgia. We look at the lives of some of the most famous leaders, artists, scientists and personalities in history, including: visionary architect Antoni Gaudi and the design of the Sagrada Familia; Michael Jordan and his bespoke Nike trainers; Princess Diana at the Taj Mahal; and Görel Hanser, manager of legendary Swedish pop band Abba on the influence they've had on the music industry. You can learn all about fascinating and surprising stories, such as the time an Iraqi journalist hurled his shoes at the President of the United States in protest of America's occupation of Iraq; the creation of the Hollywood commercial that changed advertising forever; and the ascent of the first Aboriginal MP.(Photo: Åsmund Lærdal with Resusci Anne in water rescue. Credit: Lærdal Medical)
Contributor: Aaron Lessen, MD Educational Pearls: Point-of-care ultrasound (POCUS) is used to assess cardiac activity during cardiac arrest and can identify potential reversible causes such as pericardial tamponade Ultrasound could be beneficial in another way during cardiac arrest as well: pulse checks Manual palpation for detecting pulses is imperfect, with false positives and negatives Doppler ultrasound can be used as an adjunct or replacement to manual palpation for improved accuracy Options for Doppler ultrasound of carotid or femoral pulses during cardiac arrest: Visualize arterial pulsation Use color doppler Numerically quantify the flow and correlate this to a BP reading - slightly more complex Doppler ultrasound is much faster than manual palpation for pulse check Can provide information almost instantaneously without waiting the full 10 seconds for a manual pulse check The main priority during cardiac arrest resuscitation is to maintain quality compressions If pulses are unable to be obtained through Doppler within the 10-second window, resume compressions and try again during the next pulse check References Cohen AL, Li T, Becker LB, Owens C, Singh N, Gold A, Nelson MJ, Jafari D, Haddad G, Nello AV, Rolston DM; Northwell Health Biostatistics Unit. Femoral artery Doppler ultrasound is more accurate than manual palpation for pulse detection in cardiac arrest. Resuscitation. 2022 Apr;173:156-165. doi: 10.1016/j.resuscitation.2022.01.030. Epub 2022 Feb 4. PMID: 35131404. Summarized by Meg Joyce, MS1 | Edited by Meg Joyce & Jorge Chalit, OMS3 Donate: https://emergencymedicalminute.org/donate/
Wrapping up a series of 5 episodes, Dr Jarvis finishes his discussion of mechanical CPR devices (MCDs) talking about papers from Utah, Vienna, Anchorage, and Cincinnati and then gives his take on how to interpret the literature and put it into practice.Papers discussed:1) Youngquist ST, Ockerse P, Hartsell S, Stratford C, Taillac P: Mechanical chest compression devices are associated with poor neurological survival in a statewide registry: A propensity score analysis. Resuscitation. 2016;September;106:102–7.2) Zeiner S, Sulzgruber P, Datler P, Keferböck M, Poppe M, Lobmeyr E, Van Tulder R, Zajicek A, Buchinger A, Polz K, et al.: Mechanical chest compression does not seem to improve outcome after out-of hospital cardiac arrest. A single center observational trial. Resuscitation. 2015;November;96:220–5.3) Levy M, Yost D, Walker RG, Scheunemann E, Mendive SR: A quality improvement initiative to optimize use of a mechanical chest compression device within a high-performance CPR approach to out-of-hospital cardiac arrest resuscitation. Resuscitation. 2015;July;92:32–7.4) Morgan S, Gray JJ, Sams W, Uhl K, Gundrum M, McMullan J: LUCAS Device Use Associated with Prolonged Pauses during Application and Long Chest Compression Intervals. Prehospital Emergency Care. 2023;March 9;28(1):114–7.5) Grunau B, Reynolds J, Scheuermeyer F, Stenstom R, Stub D, Pennington S, Cheskes S, Ramanathan K, Christenson J: Relationship between Time-to-ROSC and Survival in Out-of-hospital Cardiac Arrest ECPR Candidates: When is the Best Time to Consider Transport to Hospital? Prehospital Emergency Care. 2016;September 2;20(5):615–22. FAST25 | May 19-21, 2025 | Lexington, KY
Welcome to Episode 44 of “The 2 View,” the podcast for EM and urgent care nurse practitioners and physician assistants! Show Notes for Episode 44 of “The 2 View” – The Pitt, Cardiac Arrest in Young People, and Influenza Associated Encephalopathy. Segment 1 – Fraud and Conspiracy and Schemes, Oh My! Florida Physician Assistant Pleads Guilty to a $7.3 Million Health Care Fraud Conspiracy. United States Attorney's Office: District of New Hampshire. United States Department of Justice. Justice.gov. December 3, 2024. https://www.justice.gov/usao-nh/pr/florida-physician-assistant-pleads-guilty-73-million-health-care-fraud-conspiracy Nurse Practitioner Sentenced To Five Years In Prison For $11.2 Million Disability Loan Fraud Scheme. United States Attorney's Office: Sothern District of New York. United States Department of Justice. Justice.gov. February 5, 2025. https://www.justice.gov/usao-sdny/pr/nurse-practitioner-sentenced-five-years-prison-112-million-disability-loan-fraud The Board of Certification for Emergency Nursing. BCEN. February 17, 2023. http://www.bcen.org Segment 2 – Prehospital Tourniquet Application Rittblat M, Gendler S, Tsur N, Radomislensky I, Ziv A, Bodas M. The cost of saving lives: Complications arising from prehospital tourniquet application. WILEY Online Library. Acad Emerg Med. December 16, 2024. https://onlinelibrary.wiley.com/doi/10.1111/acem.15070 The Center for Medical Education. 2 View: Emergency medicine PAs & NPs: 41 - RCVS and CVT, CPR Care Science, Prehospital Tourniquets, Blood Pressure. 2 View: Emergency Medicine PAs & NPs. January 22, 2025. https://2view.fireside.fm/41 Segment 3 – Cardiac Arrest in Young People Chia MYC, Lu QS, Rahman NH, et al. Characteristics and outcomes of young adults who suffered an out-of-hospital cardiac arrest (OHCA). NIH: National Library of Medicine – National Center for Biotechnology Information. PubMed. Resuscitation. February 2017. https://pubmed.ncbi.nlm.nih.gov/27923113/ Parekh S. Teen athlete saved after cardiac arrest speaks out: What to know about lifesaving role of CPR, AEDs in schools. GMA. ABC News. September 6, 2024. https://www.goodmorningamerica.com/wellness/story/teen-athlete-saved-after-cardiac-arrest-speaks-lifesaving-113460919 The Center for Medical Education. 2 View: Emergency medicine PAs & NPs: 42 - Pink Cocaine, Holiday Heart Syndrome, Pertussis, Research Updates, and More! 2 View: Emergency Medicine PAs & NPs. February 12, 2025. https://2view.fireside.fm/42 Tseng Z, Nakasuka K. Out-of-Hospital Cardiac Arrest in Apparently Healthy, Young Adults. JAMA Network. Jamanetwork.com. February 20, 2025. https://jamanetwork.com/journals/jama/article-abstract/2830678 Segment 4 – Influenza Associated Encephalopathy Fazal A, Reinhart K, Huang S, et al. Reports of Encephalopathy Among Children with Influenza-Associated Mortality - United States, 2010-11 Through 2024-25 Influenza Seasons. CDC: Morbidity and Mortality Weekly Report (MMWR) Morb Mortal Wkly Rep. February 27, 2025. https://www.cdc.gov/mmwr/volumes/74/wr/mm7406a3.htm Surtees R, DeSousa C. Influenza virus associated encephalopathy. NIH: National Library of Medicine – National Center for Biotechnology Information. PMC: PubMed Central. Arch Dis Child. June 2006. https://pmc.ncbi.nlm.nih.gov/articles/PMC2082798/ Segment 5 – The Pitt Max. The Pitt | official trailer | Max. Accessed March 27, 2025. https://www.youtube.com/watch?v=ufR_08V38sQ The Pitt. Max. Accessed March 27, 2025. https://www.max.com/shows/pitt-2024/e6e7bad9-d48d-4434-b334-7c651ffc4bdf Recurring Sources Center for Medical Education. Ccme.org. http://ccme.org The Proceduralist. Theproceduralist.org. http://www.theproceduralist.org The Procedural Pause. Emergency Medicine News. Lww.com. https://journals.lww.com/em-news/blog/theproceduralpause/pages/default.aspx The Skeptics Guide to Emergency Medicine. Thesgem.com. http://www.thesgem.com Trivia Question: Send answers to 2viewcast@gmail.com Be sure to keep tuning in for more great prizes and fun trivia questions! Once you hear the question, please email us your guesses at 2viewcast@gmail.com and tell us who you want to give a shout-out to. Be sure to listen in and see what we have to share!
In this episode of the Saving Lives Podcast, we discuss a study from Intensive Care Medicine that explores whether baseline serum chloride and pH affect outcomes with balanced fluids versus saline. The findings from the PLUS trial show no significant interaction, but intriguing trends suggest that hyperchloremic patients may benefit more from balanced fluids. The Vasopressor & Inotrope HandbookI have written "The Vasopressor & Inotrope Handbook: A Practical Guide for Healthcare Professionals," a must-read for anyone caring for critically ill patients (check out the reviews)! You have several options to get a physical copy. Amazon: https://amzn.to/47qJZe1 (Affiliate Link)My Store: https://eddyjoemd.myshopify.com/products/the-vasopressor-inotrope-handbook (Use "podcast" to save 10%)Citation: Ramanan M, Hammond N, Billot L, Delaney A, Devaux A, Finfer S, Li Q, Micallef S, Venkatesh B, Young PJ, Myburgh J; PLUS Investigators. Serum chloride concentration and outcomes in adults receiving intravenous fluid therapy with a balanced crystalloid solution or 0.9% sodium chloride. Intensive Care Med. 2025 Feb;51(2):249-258. doi: 10.1007/s00134-024-07764-2. Epub 2025 Feb 10. PMID: 39928118.
On the corner of Skyland Drive and 23 in a little town called Sylva in Western North Carolina, sit's PJ's gas station. One hot summer day back in 2005, I was filling up the tank in a convalescent transport van on my very first day as an EMT-Basic. That's the most basic, entry-level certification of […]
Medsider Radio: Learn from Medical Device and Medtech Thought Leaders
In this episode of Medsider Radio, we had an insightful discussion with Drs. Asha Parekh and Adam Power, co-founders of Front Line Medical Technologies. The company's COBRA-OS (Control of Bleeding, Resuscitation, Arterial Occlusion System) is a compact, minimally invasive device, designed for temporary aortic occlusion in trauma situations. Asha has a PhD in Biomedical Engineering from Western University, and combines technical expertise with entrepreneurial leadership. Adam is an academic and practicing vascular surgeon at Western University, with extensive training from institutions including Dalhousie, McMaster, and Mayo Clinic.In this interview, they discuss how their clinical-engineer partnership accelerated development, their approach to clinical studies for regulatory clearance across multiple geographies, and their strategic decision to avoid VC funding during early development—and how that decision paid off.Before we dive into the discussion, I wanted to mention a few things:First, if you're into learning from medical device and health technology founders and CEOs, and want to know when new interviews are live, head over to Medsider.com and sign up for our free newsletter.Second, if you want to peek behind the curtain of the world's most successful startups, you should consider a Medsider premium membership. You'll learn the strategies and tactics that founders and CEOs use to build and grow companies like Silk Road Medical, AliveCor, Shockwave Medical, and hundreds more!We recently introduced some fantastic additions exclusively for Medsider premium members, including playbooks, which are curated collections of our top Medsider interviews on key topics like capital fundraising and risk mitigation, and 3 packages that will help you make use of our database of 750+ life science investors more efficiently for your fundraise and help you discover your next medical device or health technology investor!In addition to the entire back catalog of Medsider interviews over the past decade, premium members also get a copy of every volume of Medsider Mentors at no additional cost, including the latest Medsider Mentors Volume VII. If you're interested, go to medsider.com/subscribe to learn more.Lastly, if you'd rather read than listen, here's a link to the full interview with Asha Parekh and Adam Power.
Do you find yourself saying: “Hey, what's the big idea with that newfangled whole blood in the refrigerator next to the trauma bay?” Like using whole blood but not sure why? Don't like using whole blood but not sure why? Join us for a 30 minute power session in whole blood where we try to get you the information you need to know! Hosts: - Michael Cobler-Lichter, MD, PGY4/R2: University of Miami/Jackson Memorial Hospital/Ryder Trauma Center @mdcobler (X/twitter) - Eva Urrechaga, MD, PGY-8, Vascular Surgery Fellow University of Pennsylvania Recent graduate of University of Miami/Jackson Memorial Hospital/Ryder Trauma Center General Surgery Residency @urrechisme (X/twitter) - Eugenia Kwon, MD, Trauma/Surgical Critical Care Attending: Loma Linda University Recent graduate of University of Miami/Jackson Memorial Hospital/Ryder Trauma Center Trauma/CC Fellowship - Jonathan Meizoso, MD, MSPH Assistant Professor of Surgery, 6 years in practice University of Miami/Jackson Memorial Hospital/Ryder Trauma Center @jpmeizoso (twitter) Learning Objectives: - Describe the proposed benefits of whole blood resuscitation in trauma - Identify current problems with synthesizing the existing literature on whole blood resuscitation in trauma - Propose needed areas for future research regarding whole blood resuscitation in trauma Quick Hits: 1. There is significant heterogeneity in study design across whole blood resuscitation studies, complicating comparison 2. There is likely a mortality benefit to whole blood resuscitation in trauma, however this is likely dependent on the specific population 3. Future research directions should focus on prospective randomized work to try and better quantify the exact benefit of whole blood, and determine in which populations this benefit is actually realized References 1. Hazelton JP, Ssentongo AE, Oh JS, Ssentongo P, Seamon MJ, Byrne JP, Armento IG, Jenkins DH, Braverman MA, Mentzer C, Leonard GC, Perea LL, Docherty CK, Dunn JA, Smoot B, Martin MJ, Badiee J, Luis AJ, Murray JL, Noorbakhsh MR, Babowice JE, Mains C, Madayag RM, Kaafarani HMA, Mokhtari AK, Moore SA, Madden K, Tanner A 2nd, Redmond D, Millia DJ, Brandolino A, Nguyen U, Chinchilli V, Armen SB, Porter JM. Use of Cold-Stored Whole Blood is Associated With Improved Mortality in Hemostatic Resuscitation of Major Bleeding: A Multicenter Study. Ann Surg. 2022 Oct 1;276(4):579-588. doi: 10.1097/SLA.0000000000005603. Epub 2022 Jul 18. PMID: 35848743. https://pubmed.ncbi.nlm.nih.gov/35848743/ 2. Sperry JL, Cotton BA, Luther JF, Cannon JW, Schreiber MA, Moore EE, Namias N, Minei JP, Wisniewski SR, Guyette FX; Shock, Whole Blood, and Assessment of Traumatic Brain Injury (SWAT) Study Group. Whole Blood Resuscitation and Association with Survival in Injured Patients with an Elevated Probability of Mortality. J Am Coll Surg. 2023 Aug 1;237(2):206-219. doi: 10.1097/XCS.0000000000000708. Epub 2023 Apr 11. PMID: 37039365; PMCID: PMC10344433. https://pubmed.ncbi.nlm.nih.gov/37039365/ 3. Meizoso JP, Cotton BA, Lawless RA, et al. Whole blood resuscitation for injured patients requiring transfusion: A systematic review, meta-analysis, and practice management guideline from the Eastern Association for the Surgery of Trauma. J Trauma Acute Care Surg. 2024;97(3):460-470. doi:10.1097/TA.0000000000004327 https://pubmed.ncbi.nlm.nih.gov/38531812/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen
Last episode we described the literature showing no survival benefit to patients with the AutoPulse device. Fear not, I wasn't ignoring the LUCAS, I just felt it deserved it's own episode. We'll cover the LINC and PARAMEDIC randomized controlled trials and the secondary analysis of LINC in shockable rhythms. I switched to a new production process using a new mic (Rode NT1) and started using ecamm to record. Yes, I know there is a bit of AV dysynchrony.. I'm working on it. I still have a lot to learn about ecamm but am optimistic about it. Citations on LUCAS device:1. Rubertsson S, Lindgren E, Smekal D, Östlund O, Silfverstolpe J, Lichtveld RA, Boomars R, Ahlstedt B, Skoog G, Kastberg R, et al.: Mechanical Chest Compressions and Simultaneous Defibrillation vs Conventional Cardiopulmonary Resuscitation in Out-of-Hospital Cardiac Arrest: The LINC Randomized Trial. JAMA. 2014;January 1;311(1):53–61.2. Perkins GD, Lall R, Quinn T, Deakin CD, Cooke MW, Horton J, Lamb SE, Slowther A-M, Woollard M, Carson A, et al.: Mechanical versus manual chest compression for out-of-hospital cardiac arrest (PARAMEDIC): a pragmatic, cluster randomised controlled trial. The Lancet. 2015;385(9972):947–55.3. Hardig BM, Lindgren E, Östlund O, Herlitz J, Karlsten R, Rubertsson S: Outcome among VF/VT patients in the LINC (LUCAS IN cardiac arrest) trial—A randomised, controlled trial. Resuscitation. 2017;June;115:155–62. Citations on Jeff's Tamiflu Rant1. Jefferson T, Jones M, Doshi P, Spencer EA, Onakpoya I, Heneghan CJ: Oseltamivir for influenza in adults and children: systematic review of clinical study reports and summary of regulatory comments. BMJ. 2014;348:g2545.2. Jefferson T, Jones MA, Doshi P, Del Mar CB, Hama R, Thompson MJ, Onakpoya I, Heneghan CJ: Risk of bias in industry-funded oseltamivir trials: comparison of core reports versus full clinical study reports. BMJ Open. 2014;4(9):e005253.3. Jefferson T: The Tamiflu Story: Why We Need Access To All Data From Clinical Trials. Open Knowledge Foundation Blog. FAST25 | May 19-21, 2025 | Lexington, KY
Our story so far.. episode 92 looked at a study showing lower survival from in-hospital cardiac arrest in patients treated with mechanical compression devices. Episode 93 discussed an implementation study of implementing LUCAS devices in a system with high quality pit crew CPR also showing lower survival, despite spending lots of time in training on how to optimally apply the LUCAS to avoid prolonged compression interruptions and movement. Now we're diving into the literature around AutoPulse, the load-distributing band device. We'll cover two randomized controlled trials and one well-done observational study comparing AutoPulse to manual CPR. Don't worry, LUCAS studies will be in the next episode.Citations1. Hallstrom A, Rea TD, Sayre MR, Christenson J, Anton AR, Mosesso VN, Van Ottingham L, Olsufka M, Pennington S, White LJ, et al.: Manual Chest Compression vs Use of an Automated Chest Compression Device During Resuscitation Following Out-of-Hospital Cardiac Arrest: A Randomized Trial. JAMA. 2006;June 14;295(22).2. Ong MEH, Ornato JP, Edwards DP, Dhindsa HS, Best AM, Ines CS, Hickey S, Clark B, Williams DC, Powell RG, et al.: Use of an Automated, Load-Distributing Band Chest Compression Device for Out-of-Hospital Cardiac Arrest Resuscitation. JAMA. 2006;June 14;295(22).3. Wik L, Olsen J-A, Persse D, Sterz F, Lozano M, Brouwer MA, Westfall M, Souders CM, Malzer R, Van Grunsven PM, et al.: Manual vs. integrated automatic load-distributing band CPR with equal survival after out of hospital cardiac arrest. The randomized CIRC trial. Resuscitation. 2014;June;85(6):741–8.