Welcome to the February 2015 REBELCast, where Swami, Matt, and I are going to tackle two critical care topics that come up frequently in clinical practice in both the pre-hospital setting as well as the emergency department. Today we are going to specifically tackle:
Topic #1: Administration of Rapid Sequence Intubation (RSI) Medications via an Intraosseous line.
Topic #2: Compressions During Charging (CDC) in Out of Hospital Cardiac Arrest (OHCA)
February 2015 REBELCast Podcast
What clinical questions will be covered in the February 2015 REBELCast?
Question #1: Is the administration of RSI medications via intraosseous (IO) access effective in providing optimal intubating conditions?
Question #2: Does compression during defibrillator charging shorten shock pause duration and/or improve clinical outcomes during shockable out of hospital cardiac arrest?
What specific articles will we be covering?
Article #1: Barnard EBG et al. Rapid sequence induction of anaesthesia via the intraosseous route: a prospective observational study. Emerg Med J 2014. (24963149)
Article #2: Cheskes S et al. Compressions During Defibrillator Charging shortens Shock Pause duration and Improves Chest Compression Fraction During Shockable Out of Hospital Cardiac Arrest. Resuscitation 2014; 85 (8): 1007 – 11. (24830868)
What is the clinical bottom line for the above clinical questions:
Bottom Line #1: IO administration of RSI medications was effective in achieving good intubating conditions and 1st pass success rate was comparable to that seen with IV medication administration.
Bottom Line #2: Compression during defibrillator charging does decrease shock pause duration and improve chest compression fraction in shockable OHCA, but a larger sample size is required to determine the impact of this on clinical outcomes
February 2015 REBELCast Show Notes
For more on the above topics checkout:
- Salim Rezaie on ALiEM: Intraosseous Rapid Sequence Intubation
- Rick Abbott from Life in the Fast Lane: Clear!!!
- Salim Rezaie on REBEL EM: CPR: Hands-on or Hands-off Defibrillation
- Ken Milne at The Skeptics Guide to Emergency Medicine: SGEM #107 – You Can’t Touch This – Hands On Defibrillation
- A MUST LISTEN: Scott Weingart Interviews Cliff Reid –> Podcast 82 – Mind of the Resuscitationist
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