Podcast 537:  Thoughts on Cardiac Arrest

<p><strong>Contributor:  Don Stader, MD</strong></p> <p><strong>Educational Pearls:</strong></p> <ul> <li style="font-weight: 400;"><span style= "font-weight: 400;">High-quality compressions are an essential, and probably one of the most important, part of cardiac arrest </span></li> <li style="font-weight: 400;"><span style= "font-weight: 400;">Actual evidence for drugs in cardiac arrest included in ACLS are limited, including epinephrine, bicarbonate, amiodarone, etc.</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">Early defibrillation for ventricular tachycardia (VT) or ventricular fibrillation (VF) has a plethora of supporting evidence</span></li> <li style="font-weight: 400;"><span style= "font-weight: 400;">Double-sequential defibrillation (nearly simultaneous defibrillation using 2 machines) may be considered for refractory dysrhythmias like VF</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">tPA during a cardiac arrest can be considered in the setting of massive PE (although the evidence supporting this practice is poor)</span></li> <li style="font-weight: 400;"><span style= "font-weight: 400;">Ending a cardiac arrest resuscitation is a difficult decision and use of ultrasound may be helpful to assess for meaningful cardiac function/activity</span></li> </ul> <p><strong>References</strong></p> <p><span style="font-weight: 400; font-size: 10pt;">Link MS, Berkow LC, Kudenchuk PJ, Halperin HR, Hess EP, Moitra VK, Neumar RW, O'Neil BJ, Paxton JH, Silvers SM, White RD, Yannopoulos D, Donnino MW . Part 7: Adult Advanced Cardiovascular Life Support: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2015 Nov;132(18 Suppl 2):S444-64. </span></p> <p><span style="font-weight: 400; font-size: 10pt;">Wang Y, Wang M, Ni Y, Liang B, Liang Z. Can Systemic Thrombolysis Improve Prognosis of Cardiac Arrest Patients During Cardiopulmonary Resuscitation? A Systematic Review and Meta-Analysis.J E