Cardiac Arrest Survival with Joe Powell

In this episode, Steve, Dan, and Holly talk about cardiac arrest response with the EMS coordinator at Rialto Fire, Joe Powell. After looking at Rialto Fire departments stats, Joe realized they had to do something different. At Rialto Fire, they have committed to the steps laid out in the ‘wheel of survival’ which means continuous compressions, no matter what, for 25-30 minutes on-scene so they can achieve ROSC as often as possible. Their stats on cardiac survivability have improved significantly since implementing this and they have multiple studies published in JEMS.

Learning Points: 

  • Wheel of survival steps:
    • 1. Manual CPR
    • 2. CPR continued with stat pads (placing pads anterior/posterior vs anterior/anterior)
    • 3. Airway management
    • 4. Auto-pulse (continuous compressions)
    • 5. Heads up. Sitting the patient up 30 degrees.
    • 6. Apneic oxygenation.
    • 7. Intubation Capnography Rescuepod
    • 8. Nasogastric Tube
    • 9. Intravenous Line
    • 10. Transport decision based on end-tidal CO2
  • Post ROSC care
  • “Heads up” CPR decreases ICP, increases cerebral perfusion, and increases coronary perfusion
  • Alternatives to epinephrine
  • Utstein criteria: witness cardiac arrest, shockable rhythm, CPR prior to arrival.
  • Four acceptable pauses of compressions and what it “buys” the patient:
    • 1. Feedback device
    • 2. Placing pads (posterior)
    • 3. Place mechanical CPR device
    • 4. Starting a mechanical device

      Content Creator: Steve Williams
      CAPCE Course Number: 20-EMTP-F3-7213
      Total CE Hours: 1.5
      Level: Advanced