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SGEM#238: The Epi Don’t Work for OHCA

The Skeptics' Guide to EM

This was a before and after study to see if advanced cardiac life support (ACLS) techniques, including IV epinephrine, would improve survival to discharge. There was also no increase in survivors with good neurological outcomes with ACLS. JAMA 2009, Hagihara et al. Reference: Perkins et al.

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Issue #3: The Latest in Critical Care, 6/5/23

PulmCCM

There was no significant difference in survival with a favorable neurologic outcome at 30 days (20% vs 16% nominally favoring the ECMO group, P=0.52) or at 6 months. Read in NEJM Aspiration vs tube thoracostomy for primary spontaneous pneumothorax.

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Airway POCUS | ECPR vs. ACLS

JournalFeed

ECPR vs. ACLS Spoon Feed: Early extracorporeal cardiopulmonary resuscitation (ECPR, aka ECMO) was not superior to standard advanced cardiac life support (ACLS) for 180-day survival with good neurological outcome, but there may be a silver lining.

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SGEM#350: How Did I Get Epi Alone? Vasopressin and Methylprednisolone for In-Hospital Cardiac Arrests

The Skeptics' Guide to EM

You arrive and see that the Advanced Cardiac Life Support (ACLS) algorithm is being followed for adult cardiac arrest patients with pulseless electrical activity (PEA). This study provided weak evidence in support of using corticosteroids for IHCA as part of a VSE protocol.