If you've had an MI with a STEMI or a new LBBB the decision to go to the cath lab is pretty straight forward. If you've collapsed with a cardiac arrest of presumed cardiac aetiology (the majority of them) and gained a ROSC (return in spontaneous circulation) then the decision to go the the lab immediately is pretty variable and can depend of the clinicians involved, the ECG or the system within which you work.
The Resus Council and the European Society of Cardiology have some guidance on the topic and that is a must read. Today we have a look at a commonly quoted paper in the literature, The PROCAT database, to see if we can shed some light on the topic.
We'd love to hear feedback and comments on the podcast in the comments section. Enjoy!
Immediate percutaneous coronary intervention is associated with better survival after out-of-hospital cardiac arrest: insights from the PROCAT (Parisian Region Out of hospital Cardiac ArresT) registry. Dumas F. Circ Cardiovasc Interv. 2010 Jun 1;3(3):200-7. doi: 10.1161/CIRCINTERVENTIONS.109.913665. Epub 2010 May 18.
I haven't always read papers and with the time pressures of training and life it's impossible for us to be on top of all of the literature. But over the last few years I've come across some papers that I wish others had told me about.
For some of you this will all be a recap but for others hopefully it will spark an interest and get you to have a look at the papers yourself. We all know that it is extremely rare that one paper alone will or should change our practice but hopefully it's the interest and further questions into a topic that can come out of these papers. Enjoy!
Emergency Department Patients With Atrial Fibrillation or Flutter and an Acute Underlying Medical Illness May Not Benefit From Attempts to Control Rate or Rhythm. Scheuermeyer FX. Ann Emerg Med. 2015 May
So the long awaited new NICE Guidelines on Sepsis have just been released. I'm no sepsis expert, I'm not on a panel involved with the guidelines but I am someone who is going to be trying to use these guidelines everyday at work with multiple patients and I'm not the only one....we all are!
In this podcast we run through some of the main points brought up in the new guidelines. Talk about some potential difficulties and join toward some useful resources such as the brilliant flow charts developed by the Sepsis Trust.
Let us know your thought and feedback either via the site www.TheResusRoom.co.uk or on twitter @TheResusRoom. Enjoy!
We have a look at papers covering platelet transfusions for patients on antiplatelets who suffer intracerebral bleeds, the optimal dose for procedural sedation with ketamine in children, a new meta-analysis on the sensitivity of early CT in suspected sub arachnoid haemorrhage and finish up with an amazing case report regarding a hypothermic cardiac arrest
Make sure you go and have a look at the papers yourself to see what the evidence means to you.
Optimal dosing of intravenous ketamine for procedural sedation in children in the ED-a randomized controlled trial. Kannikeswaran N. Am J Emerg Med. 2016 Apr 2. pii: S0735-6757(16)30011-0. doi: 10.1016/j.ajem.2016.03.064. [Epub ahead of print]
Platelet transfusion versus standard care after acute stroke due to spontaneous cerebral haemorrhage associated with antiplatelet therapy (PATCH): a randomised, open-label, phase 3 trial. Baharoglu MI. Lancet. 2016 May 9. pii: S0140-6736(16)30392-0. doi: 10.1016/S0140-6736(16)30392-0. [Epub ahead of print]
Sensitivity of Early Brain Computed Tomography to Exclude Aneurysmal Subarachnoid Hemorrhage: A Systematic Review and Meta-Analysis. Dubosh NM. Stroke. 2016 Mar;47(3):750-5. doi: 10.1161/STROKEAHA.115.011386. Epub 2016 Jan 21.