Episode 12 Part 1: ACLS Guidelines – What’s New & Controversial

Emergency Medicine Cases

Dr. Anton Helman

Science, Courses, Medicine, Health & Fitness, Education

4.7 • 602 Ratings

🗓️ 10 March 2011

⏱️ 50 minutes

🔗️ Recording | iTunes | RSS

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Summary

In Part 1 of this episode on the latest ACLS Guidelines, Dr. Steven Brooks and Dr. Michael Feldman review and debate what's new and what's controversial in the the 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Within the frameworks of Cardiocerebral Rescusitation and the 3 phase model of rescucitation (electrical, circulatory and metabolic), they discuss the importance of high quality CPR, the de-emphasis on early ventilation and the utility of continuous quantitative waveform capnography. Dr. Brooks and Dr. Feldman answer questions such as: of all the therapeutic manoeuvres we do for the cardiac arrest patient, which ones have been shown to improve survival to hospital discharge? What is the evidence for chest compression machines? What is the utility of bedside ultrasound in the cardiac arrest patient? Why is cardiac arrest survival to discharge in Seattle the best in the world? Should we be performing 'hands-on defibrillation'? and many more.....

Transcript

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0:00.0	Welcome to Emergency Medicine Cases.com.
0:07.8	I'm your host, Dr. Anton Hellman, bringing you Canada's brightest minds in emergency medicine
0:12.6	from EMC Studios in Toronto.
0:17.1	In this episode on What's New in ACLS, we have with us Dr. Stephen Brooks and Dr. Michael Feldman.
0:24.9	Dr. Brooks is an emergency physician at Sunnybrook Health Sciences Center in Toronto and an assistant professor at the University of Toronto.
0:30.8	He recently completed a clinical research fellowship within the pre-hospital and transport medicine research program at the University of Toronto and a Master's of Health Sciences from the University of British Columbia.
0:40.4	He is currently a member of the Advanced Cardiac Life Support Subcommittee of the American Heart
0:44.2	Association and the ACSMI Task Force for the International Liaison Committee for Resuscitation.
0:50.9	Dr. Michael Feldman is an emergency physician at Sunnybrook Health Science Center in Toronto and is the medical director of the EMS Special Operations Program as well as the medical director of the firefighter pre-hospital care program.
1:02.9	In the most recent American Heart Association Guidelines for Cardopulmonary Resuscitation and Emergency Cardiovascular Care published in circulation in November, the authors ask,
1:12.8	how good can ACLS be? Which is a really good question, since there's not much use in performing
1:18.0	some particular therapeutic maneuver unless there's good outcome data showing that it's helpful.
1:23.3	There are a few really important things that we can do in resuscitating our cardiac arrest patients
1:28.1	that really does make a difference. The guidelines call these life-saving things links in the
1:33.3	chain of survival, and they are, one, immediate recognition of cardiac arrest and activation
1:39.3	of the emergency response system, two, early CPR with an emphasis on chest compressions.
1:45.3	Three, rapid defibrillation.
1:48.0	Four, effective advanced life support.
1:51.2	And five, integrated post-cardiac arrest care.
1:55.4	Now, some of these steps we already knew helped save lives based on previous guidelines,
1:59.2	but others like the Fifth Link,
2:01.5	integrated post-cardiac arrest care, is all pretty much new and really exciting too.
	...

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