Emergency Care
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38

Behind the metrics

If you don’t measure it, you can’t improve it.

Lincoln Fire-Rescue believes in the importance of metrics – especially considering they were able to more than double their witnessed VF-arrest survival rate from 23% to nearly 55%.

In this episode of resus10, Sean Graham interviews Scott Wiebe, EMS shift supervisor for Lincoln Fire-Rescue, member of the Nebraska Board of EMS, guest lecturer at the Union College Physician Assistant Program, and consultant for Stryker. Scott shares his department’s secret to improving their cardiac arrest survival rates. (Hint: It involved a system-of-care approach including actionable data, clear coordination and communication, and mechanical CPR.)

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37

Inside the innovation – LUCAS® chest compression system

As a Level 1 trauma center, UChicago Medicine sees its fair share of sudden cardiac arrest patients – including in the cath lab, where the challenge of providing high quality chest compressions can be difficult to say the least.

In this episode of resus10, Sean Graham interviews Dr. Atman Shah, the clinical director for the section of cardiology, co-director of the cardiac catheterization laboratory and associate professor of medicine at the University of Chicago Medicine. Dr. Shah discusses how his team uses mechanical CPR with the LUCAS chest compression system to provide high quality patient care, protect his resuscitators and how this technology has become implemented beyond his cath lab.

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36

ECG myth busting

How can your ECG reports be correct 98.5% of the time but still guide false cath lab activation 60% of the time? What’s the difference between specificity and positive predictive value and why does that matter? How can facts about ECGs be true and contradictory all at the same time?

In this episode, Sean Graham interviews Tim Phalen, paramedic clinical educator and author of The 12-Lead ECG in Acute Coronary Syndromes.   

Sean and Tim discuss common myths about ECGs, how ECGs can augment an emergency caregiver’s decision-making, and more insights on implementing ECG technology in the field.

This is part 2 of a two-part series on ECGs.

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35

The science of 12-leads

Let’s take an in-depth look at the clinical context surrounding ECGs.  

In this episode, Sean Graham interviews Blaine Krusor, who has spent the last 20 years focused on emergency medicine and the science that drives it. Currently one of Stryker’s clinical experts, Blaine began his career as a hospital cardiac RN and a CCU/ICU RN. He also holds multiple device patents in the areas of defibrillation and electrocardiography.  

Sean and Blaine discuss areas of 12-lead interpretation, including the Sgarbossa criteria and how clinicians can better utilize the 12-lead tool for improving diagnoses for acute coronary syndrome patients.

This is part 1 of a two-part series on ECGs.

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34

TEE: An emerging view into cardiac arrest

What would happen if personalized care was the standard of care?

In this episode, Nicole Kupchik interviews Dr. Ben Abella, director of the Center for Resuscitation Science, professor of emergency medicine for the University of Pennsylvania, and chair for the American Heart Association Resuscitation Science Symposium.

They discuss transesophageal echocardiography (TEE), including the emergent use of this technology to improve cardiac arrest care, its potential to provide clinicians the opportunity to tailor care to patients, and what needs to be done if this personalized care is to become a standard of care.

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33

Inside the innovation – cprINSIGHT® Analysis Technology

Until recently, pauses during CPR have been necessary when using an AED.1

We also know that it is critical to provide as much continuous CPR as possible throughout a resuscitation for the best chance of survival. Conventional AEDs must suspend chest compressions for at least 10 seconds in order to perform rhythm analysis free of ECG artifact.

So how can you get more CPR time if you are following the prompts of an AED?

In this episode of resus10, Sean Graham interviews Dr. Fred Chapman, director of research for Stryker's Emergency Care business, on how an innovative algorithm called cprINSIGHT Analysis Technology challenges the status quo and helps save lives.

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Learn more:

 

1 van Alem A, Sanou B, Koster R, et al. Interruption of Cardiopulmonary Resuscitation with the Use of the Automated External Defibrillator in Out-Of-Hospital Cardiac Arrest. Ann Emerg Med. 2003; 42(4):449-57.

32

Focus on airway management

Get ready for a master class in advanced airway management.

In this episode of resus10, Sean Graham interviews Dr. Mike Levy, medical director for Anchorage Fire and the state of Alaska, and chief medical advisor for Stryker. Sean and Dr. Levy discuss tools and techniques for airway management, and the evolving complexities and variabilities of providing advanced airway management in EMS.

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31

A shocking episode: Exploring cardiogenic shock

In this episode, Nicole Kupchik, MN, RN, CCNS, interviews Dr. Ali Haider on cardiogenic shock. Nicole and Dr. Haider, an interventional cardiologist, discuss managing cardiogenic shock, and the tools and resources needed to support these patients.

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  • Find Dr. Haider on Instagram and Twitter
  • resus10 episode 10: Saving the unsaveable, featuring Dr. Demetri Yannopoulos, professor of medicine and emergency medicine at the University of Minnesota and medical director of the Minnesota Resuscitation Consortium. Nicole and Dr. Yannopoulos discuss a promising new protocol for patients who are difficult to resuscitate, and the roles played by mechanical CPR, ECMO, and the cath lab in treating these patients.
30

Cath lab in the spotlight

From TAVR to STEMI, everything in the cath lab is on the table today.

In this episode, Nicole Kupchik, MN, RN, CCNS, interviews Dr. Ali Haider about current and emerging procedures in the cath lab. Nicole and Dr. Haider, an interventional cardiologist, discuss a range of practices representing the current state of the science in interventional cardiac care.  

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Interested in learning more?

  • Find Dr. Haider on Instagram and Twitter
  • resus10 episode 15: The transcatheter revolution, featuring 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. Dr. Shah and Nicole discuss TAVR and Dr. Shah’s experience with MitraClip, which some cardiologists say is one of the most technically challenging procedures to complete.
29

Behind the scenes with Instagram’s yourheartdoc

Also known as the popular "yourheartdoc" on Instagram, Dr. Ali Haider understands the importance of treating the patient – not just the labs. As an interventional cardiologist, he has used the latest technologies to navigate the most puzzling patients, from complicated cath lab cases to outliers lacking obvious risks.

In this episode, Nicole Kupchik, MN, RN, CCNS, and Dr. Haider discuss the power and potential of medical information in a social media world.

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28

Special edition: Resuscitation during a pandemic

During the COVID-19 pandemic, how can you resuscitate a patient in cardiac arrest while minimizing personal exposure and maximizing team effectiveness? Join Nicole Kupchik, MN, RN, CCNS, as she shares information to help emergency response teams during this unprecedented time, including logistical consideration of team response, safety during intubation and modifications to consider for resuscitation.

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27

Analyze this: Avoid analysis paralysis

Diving into data – Sean Graham meets with Jimmy Brothers, assistant chief of EMS for Howard County Fire and Rescue in Maryland. They discuss using data collection to drive decision-making, including how Howard County has developed a robust data collection methodology to impact clinical practice and training.

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26

EMS on the edge of Alaska

Emergency caregivers in the small town of Nikisiki, Alaska are using technology to face major challenges.

In this episode of resus10, Sean Graham interviews Harrison Deveer, senior captain at Nikiski Fire Department, vice president of Kenai Peninsula Emergency Services, and member of the board of directors for the Southern Region EMS Council.

They discuss the unique experience of EMS in Alaska, including Nikisiki’s use of point-of-care testing for the purpose of improving decision making.  

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25

A question of bias

Bias is a tricky thing – in order to address it, you must first recognize how and why it exists. When it comes to resuscitation time bias, these answers might be more challenging than you expect.

In this episode of resus10, Sean Graham joins the podcast and interviews Fred Chapman, director of research, Stryker Emergency Care. Fred explains how researchers studying certain aspects of resuscitation might not be gaining a full picture, and why their observations might be impacted by resuscitation time bias.  

What’s the fallout from being fooled by this bias? Listen now to find out.

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Resuscitation time bias: A unique challenge for observational cardiac arrest research

24

Between the lines – Interview with Mike McEvoy, PhD, NRP, RN, CCRN, JEMS executive editor

From working in law enforcement to EMS to the cardiac surgical ICU, Mike McEvoy’s career has spanned the gauntlet of emergency provider professions.

He sits down with Nicole Kupchik, MN, RN, CCNS, to discuss his experiences in critical care and the goals for his new role as executive editor of JEMS Magazine.    

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Interested in learning more? Visit these resources:

  • resus10 episode 23: Listen to Mike’s earlier interview with Nicole. In episode 23, they discuss the latest news for EMS and in-hospital resuscitation from clinical topics like airway management and emergency medicine to the importance of retaining high-quality providers.  
  • National Teaching Institute (NTI): Learn more about the event where this interview was recorded.
23

On the pulse of emergency medicine

Recorded live on the NTI show room floor, resus10 explores the hottest topics facing today’s EMS and hospital professionals.

In this episode, Nicole Kupchik, MN, RN, CCNS interviews Mike McEvoy, PhD, NRP, RN, CCRN, staff nurse at Albany Medical Center, EMS coordinator for Saratoga County, New York and a paramedic supervisor with Clifton Park and Halfmoon Ambulance. Mike is also the newly-appointed executive editor for JEMS magazine.

They discuss the latest news for EMS and in-hospital resuscitation, from clinical topics like airway management and emergency medicine to the importance of retaining high-quality providers. 

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22

All about emergency airway management

A recent hot topic in emergency medicine is the tube debate – should you pause CPR to place an endotracheal tube, or should you instead focus first on high-performance CPR and defibrillation?

In this episode, Nicole Kupchik, MN, RN, CCNS interviews Dr. Brian Clemency, associate professor of emergency medicine at the University at Buffalo and medical director of AMR Buffalo.

Nicole and Dr. Clemency discuss the results of three recent major studies on emergency airway management and they debate that one gold standard for cardiac arrest response traditionally has been the insertion of advanced airways – but is that still the case today?

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21

After the OD – cardiac arrest and opioid abuse

Opioid overdose leading to respiratory arrest is becoming more frequent in communities across the United States. These cardiac arrests present unique challenges with many variables – whether it’s the well-intentioned bystander administering an incorrect NARCAN® dose, or patients arriving at the ED with mysterious arrest experiences.

In today’s episode, Nicole Kupchik, MN, RN, CCNS, interviews Dr. Brian Clemency, associate professor of emergency medicine at the University at Buffalo and medical director for Buffalo AMR.

They discuss how critical care teams in Buffalo are responding to these unique patients and helping ensure they receive the best possible care.

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20

Scoop and Run vs. Stay and Play

Sometimes the most difficult question is the simplest: when do you leave?

For EMS teams responding to sudden cardiac arrest patients, this question is more nuanced than it looks. How long should first responders stay on scene and attempt resuscitation? Should you continue CPR and lifesaving efforts in the field, or should you transport to the nearest hospital as quickly as possible?

In today’s episode, Nicole Kupchik interviews Dr. Brian Clemency, associate professor of emergency medicine at the University at Buffalo and medical director for Buffalo AMR.

They discuss the great debate – do you scoop and run? Or do you stay and play?

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You might also be interested in:

19

The 2 a.m. advocate

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.

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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.

18

When a Life’s at Stake

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.

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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.

17

Going back to the tape

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.

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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. 
16

There's an App for That

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.

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15

The transcatheter revolution

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.

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Interested in learning more? Visit these resources:

14

The code whisperer

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.

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13

What's luck got to do with it

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.

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12

The lifelong learner

“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.

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11

Behind the big changes

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.

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10

Saving the unsaveable

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.

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9

Hot news about cold debriefings

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.

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8

A matter of degree

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.

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7

Small patients, big fighters – pediatric sudden cardiac arrest

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. 

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6

After the adrenaline rush

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.

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5

The numbers game: CPR quality & data-driven medicine

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.

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4

From collapse to cath lab: a new pathway for patients

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.

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3

Spotlight on Beth Israel Deaconess Medical Center

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. 

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2

Conducting the resuscitation orchestra

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.

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1

Resuscitation is a team sport

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.

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