Ep 216 Cardiac Arrest Update: Beyond the 2025 ACLS Guidelines Part 2 – Medications, Airway, Termination and Post-ROSC Care

Emergency Medicine Cases

Dr. Anton Helman

Education, Health & Fitness, Courses, Medicine, Science

4.7 • 602 Ratings

🗓️ 7 April 2026

⏱️ 102 minutes

🔗️ Recording | iTunes | RSS

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Summary

In this Part 2 or our 2-part EM Cases podcast series on Cardiac Arrest Update, Dr. Sheldon Cheskes and Dr. Rob Simard take us beyond the algorithms and into the real-world decision-making of cardiac arrest care. We answer questions like: Do vasopressin and steroids improve survival or just ROSC? Should we be giving amiodarone earlier—and is lidocaine just as good? When should we use calcium, bicarbonate, or magnesium, and when should we avoid them? What role does ketamine play in CPR-induced consciousness? How should we choose between supraglottic airways and endotracheal intubation? What are the pitfalls of waveform capnography (ETCO2) to help guide CPR quality, detect ROSC, and inform prognosis? What is the role of PoCUS and TEE during cardiac arrest? When should we terminate resuscitation—and how do ETCO2 and POCUS factor into that decision? Should we widen the criteria to consider thrombolytics and who should go to the cath lab, and should we be ordering whole-body CT after ROSC for everyone who isn't going to the cath lab or getting ECMO? And finally, what are the key post-ROSC targets that actually impact neurologic outcomes in cardiac arrest patients? and many more...Please consider a donation to EM Cases to support ongoing high quality Free Open Access Medical Education https://emergencymedicinecases.com/donation/

Transcript

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0:00.0	Emergency medicine is more than just ordered chaos.
0:04.5	From the recess room to the bedside, we are witness to it all.
0:07.9	And we're here to help you prepare for it.
0:10.3	Bringing you the brightest minds in emergency medicine from around the world for trusted,
0:14.8	tried, and true free open access medical education.
0:18.0	I'm Dr. Anton Hellman.
0:19.6	And I'm Dr. Katie Lynn. Katie, let's welcome the listeners
0:22.7	from our amazing EM community to the Emergency Medicine Cases podcast, shall we? Yeah. Or let's simply call it
0:28.7	EM cases. Okay, EM Cases. EM cases is brought to you by Shremi, the Schwartz-Rizman Emergency Medicine
0:35.6	Institute. That's a non-profit organization dedicated to improving EM care through high-quality research and education. The opinions expressed on this podcast are intended for information and education purposes only and should not be used to diagnose, treat, or prevent any medical condition, nor should they be used as a substitute for medical advice from qualified practicing physicians. First, just a quick word from our sponsor, Metricade, the experts in complex physician scheduling since 2012. I've been using
0:55.8	Metricade's incredible scheduling system for more than a decade, and it's been a game changer
0:59.9	for me and my colleagues. Shift work comes with its challenges, but Metricade helps minimize
1:05.0	the drawbacks by ensuring fair distribution of shifts while integrating circadian rhythm-friendly recovery time into its methodology,
1:13.1	preserving your precious sleep so that you can perform at your best. Go to metricade.com slash
1:18.8	EM cases to see how Metricade can make your scheduling fair, improve your sleep, and your performance.
1:25.5	That's metricade.com slash EMC-A-S-E-com slash emcases. This is part two of our update
1:32.0	in cardiac arrest management beyond the guidelines. In part one, we went deep into the fundamentals
1:37.2	and the nuances behind them. We reminded ourselves that CPR and defibrillation still reigns
1:43.1	supreme, but that excellence
1:45.0	lives in the details. Compression fraction, recoil, ventilation discipline, shock strategy, pad
1:51.4	position, distinguishing refractory versus recurrent VF, Pocus integration and the physiology behind
1:57.6	every decision we make during a code. If part one was about mastering the mechanics of resuscitation, part two is about confronting
	...

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