Does Single Dose Epinephrine Improve Outcomes for Patients with Out-of-Hospital Cardiac Arrest and Bystander CPR or a Shockable Rhythm?

Background: A single dose epinephrine protocol (SDEP) for out-of-hospital cardiac arrest (OHCA) achieves similar survival to hospital discharge (SHD) rates as a multidose epinephrine protocol (MDEP). However, it is unknown if a SDEP improves SHD rates among patients with a shockable rhythm or those receiving bystander cardiopulmonary resuscitation (CPR).

Methods: This pre-post study, spanning 11/01/2016-10/29/2019 at 5 North Carolina EMS systems, compared pre-implementation MDEP and post-implementation SDEP in patients ≥18 years old with non-traumatic OHCA.

Occupational decompression sickness: A case report.

Decompression sickness describes the clinical pathology that ensues when rapid decompression from a highly pressurized environment causes the formation of venous and extravascular inert gas bubbles. Symptoms vary widely, commonly including arthralgias, myalgias, paresthesias, and numbness. Severe and potentially life-threatening pathology, such as neurologic impairment, cardiopulmonary instability, and gastrointestinal hemorrhage, can occur as well.

Out-of-Hospital Cold Water Immersion for Classic (Non-Exertional) Heat Stroke Guided by Real-Time Core Temperature Monitoring: A Case Series.

Heat stroke is a problem that occurs primarily in the out-of-hospital environment. "Cool first, transport second" has been emphasized in consensus statements and systematic reviews regarding the treatment of exertional heat stroke by both EMS and the sports medicine/athletic training communities. However, there remains little guidance on cooling recommendations for the out-of-hospital care of non-exertional heat stroke or classic heat stroke.

One and Done Epinephrine in Out-of-Hospital Cardiac Arrest? Outcomes in a Multiagency United States Study.

Background: Cardiac arrest guidelines recommend epinephrine every 3-5 minutes during cardiac arrest resuscitation. However, it is unclear if multiple epinephrine doses are associated with improved outcomes. The objective of this study was to determine if a single-dose epinephrine protocol was associated with improved survival compared to traditional multidose protocols.

Manual versus Mechanical Delivery of High-Quality Cardiopulmonary Resuscitation on a River-Based Fire Rescue Boat.

Objectives: Studies have demonstrated the efficacy of mechanical devices at delivering high-quality cardiopulmonary resuscitation (HQ-CPR) in various transport settings. Herein, this study investigates the efficacy of manual and mechanical HQ-CPR delivery on a fire rescue boat.

Methods: A total of 15 active firefighter-paramedics were recruited for a prospective manikin-based trial.