Welcome to the April 2015 REBELCast, where Swami, Matt, and I are going to tackle a couple of articles just published this year. Today we are going to specifically tackle:
- Topic #1: Basic Life Support (BLS) vs Advanced Cardiac Life Support (ACLS) in Out of Hospital Cardiac Arrest (OHCA)
- Topic #2: PROMISE Trial – Anatomic vs Functional Testing for Coronary Artery Disease (CAD)
April 2015 REBELCast Podcast
What clinical questions will be covered in the April 2015 REBELCast?
- Question #1: Does Advanced Cardiac Life Support (ACLS) or Basic Life Support (BLS) have larger beneficial effects on outcomes for Out of Hospital Cardiac Arrest (OHCA)?
- Question #2: Does anatomic testing with coronary computed tomographic angiography (CCTA) result in improved health outcomes over functional testing in symptomatic patients with suspected CAD?
What specific articles will we be covering?
- Article #1: Saghavi P et al. Outcomes After Out-of-Hospital Cardiac Arrest Treated by Basic vs Advanced Life Support. JAMA Intern Med 2015; 175 (2): 196 – 204 (25419698)
- Article #2: Douglas PS et al. Outcomes of Anatomic versus Functional Testing for Coronary Artery Disease. NEJM 2015 [epub ahead of print] (25773919)
What is the clinical bottom line for the above clinical questions:
- Bottom Line #1: Patients with OHCA who receive BLS have a higher survival to hospital discharge, survival to 90days, and more have better neurologic functioning vs patients who receive ACLS
- Bottom Line #2: An initial strategy of using CCTA for noninvasive testing in symptomatic patients with suspected CAD is not associated with better clinical outcomes compared to functional testing over median follow-up of two years. It was, however, associated with higher radiation exposure and downstream testing.
March 2015 REBELCast Show Notes
For more on the above topics checkout:
ACLS vs BLS
- Ken Milne at The Skeptics Guide to Emergency Medicine: SGEM #64 – Classic EM Papers (OPALS Study)
- Salim Rezaie at REBEL EM: Chest Pain – Coronary CT Angiography in the ED
- Rory Spiegel at EM Nerd: The Case of the Anatomic Heart Part 2