The Prehospital & Transport Medicine Research Program Sunnybrook & Women’s College Health Sciences Centre.

Slides:



Advertisements
Similar presentations
Third Annual EMS R ESEARCH S UMMIT Third Annual EMS R ESEARCH S UMMIT.
Advertisements

Ventilation techniques used by lifeguards Bo Løfgren, MD, PhD Honorary Associate Professor in Resuscitation and Emergency Medicine Department of Internal.
Simulated Protected Code Blue Randy Wax, MD, FRCPC Rod MacDonald, RRT Human Simulation Program, Mount Sinai Hospital/ University of Toronto Peter Brindley,
Survival benefits and policy conflicts in Sepsis
A Randomized Trial of Protocol-Based Care for Early Septic Shock Andrea Caballero, MD January 15, 2015 LSU Journal Club The ProCESS Investigators. N Engl.
Final version 1, RESUSCITATION OUTCOMES CONSORTIUM C ontinuous C hest C ompressions Trial Final version 1,
Benchmarking Utilizing the Cardiac Arrest Registry to Enhance Survival (CARES) Surveillance Database BACKGROUND Among victims of out-of-hospital cardiac.
HIGH PERFORMANCE CPR KEEP IN MIND……. GOOD SHOULD NEVER BE GOOD ENOUGH Mantra #1.
In-hospital Cardiac Arrest: First and foremost, Chest Compressions Charles L Campbell MS MD Associate Professor of Medicine University of Kentucky College.
Termination of Resuscitation (TOR) By Primary Care Paramedics Implementation Trial Research by Ontario’s Base Hospitals in Collaboration with the Sunnybrook.
Peel/Halton 2010 CME Sheldon Cheskes, MD CCFP(EM) FCFP Medical Director Sunnybrook – Osler Centre for Prehospital Care Li Ka Shing Knowledge Institute,
FROM CEM SEPSIS TOOLKIT PAPERS TO COVER NGUYEN EARLY LACTATE CLEARANCE IS ASSOCIATED WITH IMPROVED OUTCOME IN SEVERE SEPSIS AND SEPTIC SHOCK P Single.
Targeted Temperature Management TTM-trial investigators
ZOLL AutoPulse ® Non-invasive Cardiac Support Pump.
Many thanks to Dr. Kudenchuk for sharing his slides
Systemic inflammatory response syndrome score at admission independently predicts mortality and length of stay in trauma patients. by R2 黃信豪.
Tranexamic Acid (TXA) Trial Study Key Points. Inclusion Criteria O Trauma Patients over age 18 with sustained blunt or penetrating injury within 3 hours.
Out-of-Hospital Cardiac Arrest Survival after the Sequential Implementation of 2005 AHA Guidelines for Compressions, Ventilations, and Induced Hypothermia.
Pneumatic Chest Compression Device for CPR Kyra Ceceris, Daniel Metzinger, Tina Mornak University of Pittsburgh Senior Design – BioE Mentor:
Presenter Disclosure Information Colby Rowe FINANCIAL DISCLOSURE: No relevant financial relationship exists No Unlabeled/Unapproved Uses in Presentation.
The Prehospital & Transport Medicine Research Program Sunnybrook Health Sciences Centre.
Importance of CPR Robert S. Cole. Credit where Credit is Due Adapted from presentation by Ahamed Idris, MD, –Professor of Emergency Medicine University.
Paediatric Resuscitation Guidelines 2005
6th June 2004 By Norah A A Al Khathlan M.D. JOURNAL CLUB A Comparison of High-Dose and Standard-dose Epinephrine in Children with Cardiac Arrest NEJM 350;17April.
Toronto Invasive Bacterial Diseases Network  Collaborative network of all hospital and largest private microbiology laboratories in metropolitan Toronto/Peel.
Prepared by the Division of Emergency Medical Services Refresher Course Medical Incident Report Form Education Module for 2009 Prepared by the Division.
Therapeutic Hypothermia in Out of Hospital Cardiac Arrest towards
Capnography Could Make You a Rock Star! Mike McEvoy, PhD, RN, CCRN, NRP Staff RN – CTICU and Resuscitation Committee Chair Albany Medical Center, New York.
Significant factors in predicting sustained ROSC (return of spontaneous circulation) in paediatric patients with traumatic out- of-hospital cardiac arrest.
Daniel Davis, MD UCSD Center for Resuscitation Science New Frontiers in Resuscitation Science.
Why Emergency Physicians Don’t Care about Cardiac Arrest and Should. Robert Swor, DO Professor, Emergency Medicine Oakland University William Beaumont.
The Devil is in the Details R. J. Frascone, MD, FACEP R. J. Frascone, MD, FACEP Medical Director EMS Medical Director EMS Regions Hospital EMS, St. Paul,
2015 THE STATE OF RESUCITATION.  Chain of Survival  Immediate Recognition  Early CPR  Rapid Defib  Effective ALS  Intergrated Post Care  CAB not.
Slides courtesy of Mark Estes, MD Role of AED’s Concept Developed 1977 Implantable cardioverter defibrillator 1979 AED developed.
CPR: Push Hard(er), Push Fast(er) Mike McEvoy, PhD, NRP, RN, CCRN EMS Coordinator – Saratoga County, NY EMS Editor – Fire Engineering magazine Chair –
Ruchika Husa, MD OSU Wexner Medical Center SCD and Therapeutic Hypothermia.
Issues in Trauma Lynne Fulton May 27, Intro No basics My backround “Demanded efficient and thoughful care by other team members” Observing a patient.
ITU Teaching Friday 5 th April 2013 Association of Prehospital Advanced Airway Management With Neurologic Outcome and Survival in Patients With Out-of-Hospital.
University of Texas Southwestern Resuscitation Research Projects University of Texas Southwestern Resuscitation Research Projects.
CPR in the ED: R U Ok? Mike McEvoy, PhD, RN, CCRN, NRP Resuscitation Committee Chair and Sr. Staff Nurse CTICU – Albany Medical Center EMS Coordinator.
Out-of-hospital hypertonic resuscitation following severe traumatic brain injury: A randomized control trial (JAMA. 2010;304(13):1455–64)
Top Papers in Critical Care 2013 Janna Landsperger RN, MSN, ACNP-BC.
Dallas 2015 TFQO: Michael Sayre COI #400 EVREV 1: Mohamud Daya COI #327 EVREV 2: Jan-Thorsten Gräsner COI #230 Taskforce: BLS BLS 363: CPR Prior to Defibrillation.
Dallas 2015 TFQO: Allan de Caen COI #38 EVREV 1: Tia Raymond COI #153; EVREV 2: Jonathan Egan COI #44 Taskforce: Peds The role of invasive vascular monitoring.
What is the ideal chest compression:ventilation ratio?
Helicopter On-Scene Response Program Instructor Notes
Dallas 2015 TFQO: Judith Finn EVREVs: Judith Finn #227 / Dion Stub #COI Taskforce: EIT Cardiac Arrest Centres.
Dallas 2015 TFQO: Robert Greif EVREVs: Dana Edelson, COI #334 Robert Greif, COI #344 Taskforce: EIT EIT 645: Debriefing of resuscitation performance.
Termination of Resuscitation (TOR) By Primary Care Paramedics Implementation Trial Research by Ontario’s Base Hospitals in Collaboration with the Sunnybrook.
LINC Trial LUCAS in cardiac arrest trial. What is LINC? A multicenter, randomized, controlled trial designed to evaluate the efficacy and safety of: LUCAS.
Do IV Meds Matter in Out-of-Hospital Cardiac Arrest? Summary and Comment by John A. Marx, MD, FAAEM Published in Journal Watch Emergency Medicine December.
Sunnybrook Trauma Unit Michael H Ford MD FRCSC. Tory Regional Trauma Centre - Facts and Stats Serving greater Toronto area and south central Ontario The.
Dallas 2015 TFQO: Jonathan Witt (COI #418) EVREVs: Steve Lin (COI #137), Thomas Pellis (COI #186) and Katie Dainty (COI #) Taskforce: ALS ALS 428 : Antiarrhythmic.
Top 10 Journal Articles Marilyn McLeod, MD, FACEP March 13, 2011.
Continuing Education Summary ICEMA CPR Update 2010.
Date of download: 5/28/2016 Copyright © The American College of Cardiology. All rights reserved. From: Recent Advances in Cardiopulmonary Resuscitation:
A pilot randomized controlled trial Registry #: NCT
PCP CODE STEMI– Do the Clothes Fit? May 16, 2013 OBHG/MAC Annual General Meeting Richard Verbeek, Medical Director.
Abstract Cardiopulmonary Resuscitation with Rescue Breathing Is Superior to Hands-Only Cardiopulmonary Resuscitation for Children and Infants: Results.
COMPUTER DRIVEN DECISION MAKING IN EMS Mohamud Daya MD, MS Professor of Emergency Medicine Oregon Health & Science University.
Top 5 papers of Prehospital care Recommended by Torpong.
(Remember Airway, Breathing and Circulation)
Emergency Measures for Life Support in the Hospital Setting
Using Ultrasound in the Decision to Terminate Cardiac Resuscitation

CRASH 2 Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2):
What is LINC? A multicenter, randomized, controlled trial
HeartSafe Community A Proposal to Make Your City the Best Place in the World to be if you have a Sudden Cardiac Arrest.
Presentation transcript:

The Prehospital & Transport Medicine Research Program Sunnybrook & Women’s College Health Sciences Centre

Funding Agencies

Resuscitation Outcomes Consortium

ROC Sites

Toronto Regional RESCUeNET TORONTO Regional RESuscitation RESearch oUt of hospital NETwork TORONTO Regional RESuscitation RESearch oUt of hospital NETwork

Toronto Regional RESCUeNET Sites l Durham l Hamilton l Muskoka l Ontario Air Ambulance Program l Peel l Simcoe l Toronto l York

The ROC Structure: The 30,000 Foot Overview

Registry Protocol

Registry l Epidemiological Databank (  registry) of: –Out-of-Hospital Cardiac Arrests –Major trauma l Population based (includes all cases) l In-hospital outcomes l Regional specific information to the Service / Base Hospital –Web-based and password protected l Form the basis of a Canadian Registry of Out-of-Hospital Resuscitation l CIHI – linkage with other data sets (trauma, cardiac care, stroke, oncology)

Proposed Protocols Cardiac

CPR: Back to the Basics

Compelling Evidence Negative Impact NeutraII mpact Positive Impact

More Compelling Evidence l Cobb – observational (3 years-639 pts vs 2 years-478 pts) –90 seconds CPR prior to shock –survival to hosp discharge (30% vs 24%) l Wik – randomized (200 pts) –3 minutes of CPR –survival to hosp discharge (22% vs 15%) l Abella – prospective observational study – 2005 (67 pts) –Ventilations rates of 20/min (61%) (AHA guidelines are 10 to 12/min) l Wik – prospective observational study – 2005 (176 pts) –Rate of compression 64/min (AHA guidelines are 100/min) –Depth of compression 34 mm (AHA guidelines are 38 to 52 mm) –Hands off time 48% (38% when exclude ECG & shock analysis)

Three-Phases of VF ShockCPR?

Analyze Later versus Analyze Early

Impedance Threshold Valve

ResQPOD

WHO? WHO? Inclusion Criteria: l Age >18yrs l Non-traumatic cardiac arrest l Receive defibrillation &/or CPR by EMS

Monitoring the Quality of CPR

Trauma

Hypertonic Saline and Dextran

Advantages l 250 ml ~ 3 litres of Ringer’s lactate l ↓ early systemic inflammatory response l ↓ incidence of sepsis

Goal l ↑Survival l ↑ Cognitive Performance l ↓ Multi Organ Dysfunction (MOD)

Who? Hypovolemic Cohort Inclusion Criteria: l Blunt or Penetrating Trauma l Prehospital SBP –< 70 or –SBP & HR > 108/min l Age >15yrs or >50kg

Who? TBI Cohort Inclusion Criteria: l Blunt trauma l Prehospital GCS 90 mmHg l Age >15yrs or >50kg

What is Being Asked of the You? l Registry: Identify Registry patients l CPR: Pads on patient; 50 or 300 compressions / analyze l ITV: Attach valve to mask or ET tube l Hypertonic Saline: Piggy back 250 ml bag / bolus l Common to all Studies: Data Collection Sheet

Keeping You in the Loop

The Research Wire

Username & Password

Paramedic Resources

Thank You!

Feedback: Privacy Policy Feedback
Do Not Sell My Personal Information
About project: SlidePlayer Terms of Service

© 2024 SlidePlayer.com Inc. All rights reserved.