When deciding whether to send a cardiac arrest patient to the cath lab, is it a question of the right timing or the right patient?

In today’s episode, Nicole interviews Dr. David Gaieski, Professor of Emergency Medicine at Sidney Kimmel Medical College at Thomas Jefferson University, Vice Chair for Resuscitation Services and Director of Emergency-Critical Care.

They discuss a recent study – the first of its kind – that focused on a randomized trial of immediate cardiac catheterization in post-arrest patients without ST elevation versus delayed cardiac catheterization during hospitalization.

You might also be interested in:

Coronary Angiography after Cardiac Arrest – The Right Timing or the Right Patients?: Read the editorial discussed by Nicole and Dr. Gaieski.

Cardiac resuscitation symposiums: Learn more about the event where this episode was recorded and see if we’re coming near you.

At 27 years old, Scott Nevers was already in a fight for his life after suffering sudden cardiac arrest.

It would take an entire system of care to save him – from bystanders calling for help and an EMS team who refused to give up, to more than 20 shocks from an AED and excellent post-arrest care at his local hospital.

Nicole Kupchik, MN, RN, recently spoke with Scott and the EMS team who helped save his life, which included Biddeford Fire Department deputy chief Kevin Duross, firefighter/paramedic Rob Mertz, and training educator Tim Sevigny.

You might also be interested in:

resus10 episode 13 – What’s luck got to do with it: From the cover of Newsweek to resus10, Brian Duffield shares his story of sudden cardiac arrest survival.

Cardiac resuscitation symposiums: Learn more about the event where this episode was recorded. Upcoming symposiums are coming soon to Seattle and Memphis.

Sometimes an outside view sees the biggest picture.

In this episode, Nicole Kupchik, MN, RN, interviews Dr. Dan Rolston and Dr. Timmy Li from Northwell Health, New York state’s largest healthcare provider. They discuss how their emergency department uses video recordings, data, and the LUCAS chest compression system to increase efficiencies and improve resuscitations at their facility.

Interested in learning more? Visit these resources:

• Episode 9 – Hot news about cold debriefings: Nicole interviews Dr. Heather Wolfe, Assistant Professor of Anesthesia and Critical Care Medicine at the Children's Hospital of Philadelphia. They discuss her team's study on post-event debriefings and how they have been able to sustain a successful debriefing program for more than seven years.
• LUCAS chest compression system: Learn how this mechanical chest compression device helps lifesaving teams deliver high-quality, guidelines-consistent chest compressions to sudden cardiac arrest patients.
• Improving in-hospital CPR performance: Go behind the scenes at EvergreenHealth, which uses CODE-STAT Data Review Software to improve CPR performance. 

We’ll admit it – documentation is rarely a caregiver’s favorite part of their job.

In this episode, Nicole Kupchik, MN, RN, interviews Bridgid Joseph, program director for the Emergency Cardiovascular Care Center at Beth Israel Deaconess Medical Center in Boston. Recorded live on the NTI 2018 exhibits show floor, they discuss how Bridgid’s team uses technology from the American Heart Association and CODE-STAT data review software to solve many common documentation challenges.

Interested in learning more? Visit these resources:

• American Heart Association: Download the American Heart Association Full Code Pro App (FCP 3.0), the free mobile application discussed in this episode. 
• Listen to Nicole and Bridgid’s earlier interview in resus10 episode 3 – Spotlight on Beth Israel Deaconess Medical Center.
• AACN National Teaching Institute: Learn more about the event where this episode was recorded. 

When it comes to scientific revolutions in valve technology, you might say this procedure is leading the charge: TAVR, a minimally invasive procedure that repairs the aortic valve without removing the old damaged valve. 

In this episode, Nicole Kupchik, MN, RN, interviews Dr. Atman Shah, clinical director for the section of cardiology, co-director of the cardiac catheterization laboratory, and associate professor of medicine at the University of Chicago. They discuss TAVR and also Dr. Shah’s experience with MitraClip, which some cardiologists say is one of the most technically challenging procedures to complete.

Interested in learning more? Visit these resources:

• Episode 4: Listen to Dr. Shah’s earlier resus10 interview – From collapse to cath lab.
• Dr. Shah is a frequent guest at our resuscitation symposiums. Find an event near you.

Recorded live on the NTI 2018 exhibits show  floor, Nicole discusses the anatomy of a resuscitation with clinical nurse specialist Chris Laux – and how planning, coordination and training can make all the difference.

Interested in learning more? Visit these resources:

• AACN National Teaching Institute: Learn more about the event where this episode was recorded.
• American Heart Association: A downloadable focused on resuscitation triangle and leadership roles as recommended by the AHA.
• Team communication patterns in emergency resuscitation: A mixed methods qualitative analysis on the importance of team communication.

From the cover of Newsweek to resus10, Brian Duffield is sharing his story of sudden cardiac arrest survival. Brian was only 40 when he suffered cardiac arrest, but is alive today thanks to a system of care that included bystander CPR, a nearby AED, and professional medical response.

Interested in learning more? Visit these resources:

• Back to Life: The Science of Reviving the Dead: Newsweek cover story featuring Brian and other cardiac arrest survivors
• Man Saved by a HeartSine AED Spreads Awareness: More about Brian’s journey from survivor to advocate
• Episode 11: Dr. Karl Kern, part of the chain of survival in Brian’s story, was recently featured on resus10 in Behind the Big Changes.

“Once you get out of nursing school, that’s just the beginning.” In this episode, Nicole Kupchik, MN, RN, interviews Dr. Beth Mancini, Senior Associate Dean for Education Innovation at The University of Texas at Arlington College of Nursing and Health Innovation.

They discussed the importance of education and simulation, and how shorter but more frequent trainings might help nurses keep their skills sharp. They also talked about the launch of the American Heart Association Resuscitation Quality Improvement (RQI) Program.

Interested in learning more? Visit these resources:

• American Heart Association
• Episode 1: Listen to Dr. Mancini’s earlier resus10 interview, Resuscitation is a Team Sport

In this episode, Nicole Kupchik, MN, RN, interviews Dr. Karl Kern, professor of medicine of the Division of Cardiology and co-director of the Sarver Heart Center at the University of Arizona, and Gordon A. Ewy, MD, Distinguished Endowed Chair of Cardiovascular Medicine. They discuss Dr. Kern’s leadership role with the American Heart Association and his personal goal to improve public mortality reporting for cardiac catheterization procedures. This interview was recorded at the most recent Physio-Control Refractory Cardiac Arrest Symposium in Raleigh in April 2018.

Shock…no response…shock…no response…shock…no response…then what? In this episode, Nicole Kupchik, MN, RN, interviews Dr. Demetri Yannopoulos, professor of medicine and emergency medicine at the University of Minnesota, the Robert Eddy endowed chair in cardiovascular resuscitation, and medical director of the Minnesota Resuscitation Consortium. 

They discuss a promising new protocol for patients who are difficult to resuscitate - such as those with refractory VF - and the roles played by mechanical CPR, ECMO, and the cath lab in treating these patients.

Interested in learning more? Visit these resources:

• Minnesota Resuscitation Consortium study: Advanced Perfusion and Reperfusion Cardiac Life Support Strategy for Out-of-Hospital Refractory Ventricular Fibrillation
  
• Minnesota Resuscitation Consortium Clinical Summary

Is it true that hindsight is 20/20? In this episode, Nicole Kupchik, MN, RN, interviews Dr. Heather Wolfe, Assistant Professor of Anesthesia and Critical Care Medicine at the Children's Hospital of Philadelphia. They discuss her team's study on post-event debriefings, how cold debriefings can make a lifesaving difference, and how her team has been able to sustain a successful debriefing program for more than seven years.

Interested in learning more? Visit these resources:

• Interdisciplinary ICU Cardiac Arrest Debriefing Improves Survival Outcomes

How cool is too cool? How fast is too fast? In this episode, Nicole Kupchik, MN, RN, interviews Dr. Ben Abella, Director of the Center for Resuscitation Science and Vice Chair of the Department of Emergency Medicine at the University of Pennsylvania.

Dr. Abella discusses post-cardiac arrest care, specifically how targeted temperature management can be deployed to help sudden cardiac arrest patients.

Interested in learning more? Visit these resources:

• University of Pennsylvania Center for Resuscitation Science

The smallest patients can be the biggest fighters. In this episode, Nicole Kupchik, MN, RN, interviews Dr. Vinay Nadkarni, a pediatric physician at Children’s Hospital of Philadelphia and endowed chair professor of the Department of Anesthesiology and Critical Care Medicine, medical director at CHOP for the Center of Simulation Advanced Education and Innovation, and associate director at the University of Pennsylvania Center for Resuscitation Science.  

They discuss some of the biggest puzzles of sudden cardiac arrest’s smallest victims, and Dr. Nadkarni shares his thoughts on the top five differences between treating pediatric sudden cardiac arrest patients versus adult patients. 

Interested in learning more? Visit these resources:

• Pediatric Cardiac Arrest Algorithm Reference Guide – AHA Update

Nicole Kupchik, MN, RN, interviews Janese Nichols, MSN, RN, clinical educator at Fort Washington Medical Center in Fort Washington, Maryland.

In this special interview held on the ENA 2017 exhibit floor, Janese discusses how her team uses data to analyze the entire patient story from collapse and resuscitation to the ultimate level of success - neurologically intact discharge.

Interested in learning more? Visit these resources:

• Improvements in the quality of advanced life support and patient outcome after implementation of a standardized real-life post-resuscitation feedback system
  Hubner P, Lobmeyr E, Wallmüller C, Poppe M, Datler P, Keferböck M, Zeiner S, Nürnberger A, Zajicek A, Laggner A, Sterz F, Sulzgruber P.
  Resuscitation. 2017 Aug 31;120:38-44. doi: 10.1016/j.resuscitation.2017.08.235.

• Sample CODE-STAT report
• CODE-STAT Data Review Software

Nicole Kupchik, MN, RN, interviews Dr. Dana Edelson who works with the University of Chicago as a hospitalist and is the founder and CEO of Quant HC.

Dr. Edelson discusses the importance of patient-driven and data-driven medicine and her work regarding CPR quality – including how her team addressed the “pause problem” and lowered their median CPR pause to less than 2 seconds.

Interested in learning more? Visit these resources:

• Improving In-Hospital Cardiac Arrest Process and Outcomes with Performance Debriefing

  Edelson DP, Litzinger B, Arora V, Walsh D, Kim S, Lauderdale DS, Vanden Hoek TL, Becker LB, Abella BS.

  Arch Intern Med. 2008 May 26;168(10):1063-9. doi: 10.1001/archinte.168.10.1063. 

• The Longest Pause - Clinical Summary

  Brouwer T, Walker R, Chapman F, Koster, R. Association Between Chest Compression Interruptions and Clinical Outcomes of Ventricular Fibrillation Out-of-Hospital Cardiac Arrest. Circulation. 2015;132:1030-1037.

In this episode, Nicole Kupchik, MN, RN, interviews Dr. Atman Shah, Clinical Director of the Section of Cardiology at the University of Chicago Medicine (UCM). 

Dr. Shah shares how his organization is utilizing mechanical CPR and ECMO to support patients during cardiac arrest, with the intention to preserve the myocardium while PCI is being performed. He also discusses what factors guide his team in making critical decisions when delivering lifesaving care.

Interested in learning more? Visit these resources:

• Prolonging CPR with Mechanical Chest Compression: Buying Time to Improve Survival
• Minnesota Resuscitation Consortium Study: Advanced Perfusion and Reperfusion Cardiac Life Support Strategy for Out-of-Hospital Refractory Ventricular Fibrillation
• Minnesota Resuscitation Consortium Clinical Summary

In this episode, Nicole Kupchik, MN, RN, interviews Bridgid Joseph, Clinical Nurse Specialist and Program Director for the Emergency Cardiovascular Care Center at Beth Israel Deaconess Medical Center in Boston.

Bridgid shares how her medical center tackled the challenge of implementing the latest American Heart Association ACLS and BLS guidelines in an organization with multiple campuses, satellite campuses, and more than 3,000 team members. 

Interested in learning more? Visit these resources:

• Adult Cardiac Arrest Algorithm Reference Guide – AHA 2015 Update 
• Pediatric Cardiac Arrest Algorithm Reference Guide – AHA 2015 Update

In this episode, Nicole Kupchik, MN, RN, interviews Dr. Chuck Pozner, who is Medical Director at the STRATUS Center for Medical Simulation at Brigham and Women's Hospital.

Dr. Pozner shares how his team has used mock codes to identify and change potentially lifesaving processes - and how a resuscitation team is more similar to a symphony orchestra than you might think.

Interested in learning more? Visit these resources:

• BWH Clinical & Research News: Pozner Reflects on a Decade of Education through Simulation
• Finding the Key to a Better Code: Code Team Restructure to Improve Performance and Outcomes
• Simulating Emergencies to Prevent Errors

In this episode, Nicole Kupchik interviews Dr. Beth Mancini, Professor and Associate Dean and Chair for the Undergraduate Nursing Programs at the University of Texas.

Beth shares her perspective on how training in teams with simulations and debriefings is impacting how her organization manages an environment of constant change.

Interested in learning more? Visit these resources:

• Defining Excellence in Simulation Programs (by Dr. Beth Mancini, et al) 
• Interdisciplinary ICU Cardiac Arrest Debriefing Improves Survival Outcomes
• The System-Wide Effect of Real-Time Audiovisual Feedback and Post-Event Debriefing for In-Hospital Cardiac Arrest: The Cardiopulmonary Resuscitation Quality Improvement Initiative 
• Clinical Simulation in Nursing
• Simulation in Nursing Practice: The Impact on Patient Care