Welcome back to a special edition, or should I say “skeptical edition” of REBELCast. We have started to do something new by inviting guests onto the show to discuss papers in the literature they find interesting. This month I had the pleasure of working with Ken Milne, an emergency room physician in Canada. Today, Ken and I are going to specifically discuss a new device that recently got FDA approval for CPR in Out of Hospital Cardiac Arrest (OHCA), and the question we are trying to answer is:
Is active Compression Decompression CPR with Augmentation of Negative Intrathoracic Pressure for Treatment of Out-of-Hospital Cardiac Arrest superior to standard CPR?
April 2015 “Skeptical Edition” REBELCast Podcast
Who is our guest this month on REBELCast?
Our guest this month is Ken Milne, MD (Twitter: @thesgem) who has a fantastic podcast of his own called The Skeptics Guide to Emergency Medicine or The SGEM for short. The SGEM is a knowledge translation (KT) project started in 2012. The goal of the SGEM is to cut the KT window from over 10 years down to 1 year. The SGEM does this by using social media to provide the audience with high quality, clinically relevant, critically appraised, evidence based information, so you can provide EM patients with the best possible care. The SGEM consists of a weekly blog and 20min podcast. Each week Ken invites a guest skeptic to perform a critical appraisal on a recent article while trying to find the right balance between education and entertainment.
Finally, the SGEM uses a validated and reliable tool from the McMaster University the home of evidence based medicine. The tool comes from the Best Evidence in Emergency Medicine (BEEM) group. It is used to probe the literature.
What clinical question will be covered in the April 2015 “Skeptic Edition” REBELCast?
- Question: Is active Compression Decompression CPR with Augmentation of Negative Intrathoracic Pressure for Treatment of Out-of-Hospital Cardiac Arrest superior to standard CPR?
What specific article will we be covering?
- Article: Aufderheide et al. Comparative Effectiveness of Standard CPR versus Active Compression Decompression CPR with Augmentation of Negative Intrathoracic Pressure for Treatment of Out-of-Hospital Cardiac Arrest: Results from a Randomized Prospective Study. Lancet. 2011 January 22; 377(9762): 301–311. PMCID: PMC3057398
What is the clinical bottom line for the above clinical question:
- Bottom Line: It is not clear if this device works in improving survival with good neurologic outcomes for patients with OHCA, but this study does not prove that it does.