Aaron Eberhardt @Post5NightMD
Father, DG EM Attending...opinions expressed here are my own... Joined March 2018-
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Denver Medics Remember to focus on full chest recoil while managing cardiac arrest as part of high performance CPR. Helps to mitigate elevated intra-thoracic pressure. Leads to better cardiac filling to increase cardiac output. And better coronary perfusion. Small details matter.
@ben_fisher_ @DenvERdgmd @buchana_jab @ClayBurlew @DenverEMed Off the cuff In hemodynamically stable patient, 12 lead MAY influence transport destination or education on refusals. Depending on EKG changes the clinical picture is muddy. Is the arrhythmia/changes a result of BCI or did it lead to MVC for instance. Complicated EMS issue.
@HansvanSchuppen Excellent points. Thanks for commenting. I’m not sure the collective “we” have a great understanding of the alterations of cerebral vasmotor response early in OHCA, prior to significant acidosis etc. And certainly in post ROSC, tight PaCO2 become important.
Hyperventilation during cardiac arrest has 2 negative effects. 1. Increases intrathoracic pressure > decreases venous return > cardiac output. 2. Decreases PaCO2 > arterial vasoconstriction > Lowers cerebral blood flow. Watch the rate and the volume of delivered breaths!
@EMSAvenger Could not agree more. Too important a skill not to pay attention to. Thanks for commenting
Shock refractory V-fib is frequently a mistaken identity. Most v-fib seen after a few shocks is likely recurrent v-fib.
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