September 2025; papers of the month
The Resus Room
Simon Laing
4.9 • 708 Ratings
🗓️ 1 September 2025
⏱️ 35 minutes
🧾️ Download transcript
Summary
Welcome back to September's Papers of the Month. We've got three cracking studies for you this time, each tackling really core questions in pre-hospital and emergency care and each giving us plenty to chew over when it comes to the evidence base and what it means for our practice.
First up, we're heading down under to Sydney with the PRECARE pilot feasibility study on pre-hospital extracorporeal CPR for refractory cardiac arrest. Now, we all know survival from refractory OHCA is pretty dismal with conventional CPR alone, and that the big limiting factor with ECPR is time to flow. So could we meaningfully shorten that window by bringing ECMO to the roadside rather than the hospital? This study tested whether pre-hospital physicians could safely and effectively deliver ECPR on scene and the results are some of the fastest low-flow times yet reported. But of course, feasibility is only one piece of the puzzle…
Next, we're back in the UK with a service evaluation from Devon Air Ambulance looking at endotracheal intubation by critical care paramedics during cardiac arrest. Airway management in OHCA has always been a hot topic, with long-running debates over supraglottic devices versus intubation, and questions about who should be putting a tube in. This six-year dataset explores how structured education, theatre placements, and the introduction of video laryngoscopy have changed practice and whether CCPs can consistently meet the ERC's benchmark of 95% success, or more, within two attempts.
And finally, we're heading to Switzerland with a study on the HOPE score in hypothermic cardiac arrest. Hypothermia remains one of those rare but high-stakes presentations where patients in cardiac arrest can sometimes make remarkable recoveries if we select the right ones for extracorporeal rewarming. The HOPE score is designed to guide those decisions by predicting survival. This study takes a retrospective cohort across two hospitals and asks: does the score actually deliver in real-world practice, and can it help avoid futile attempts at ECLS?
So, three papers, ECMO on the roadside, paramedic-led intubation in cardiac arrest, and the precision of the HOPE score. As ever, plenty to think about for both the evidence and our day-to-day practice.
Once again we'd love to hear any thoughts or feedback either on the website or via X @TheResusRoom!
Simon & Rob
Transcript
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| 0:00.0 | Welcome to the recess room podcast. |
| 0:03.5 | Five, four, three, two, one, fire. |
| 0:12.1 | So hi, and welcome back to the recess room podcast. |
| 0:15.3 | I'm Simon Lang, and I'm Rob Fenwick. |
| 0:18.0 | And we're back with September 2025's Papers of the month refreshed after some fantastic summer holidays. |
| 0:26.5 | Wow, what a shock to the system back after that summer break. It's like going back to school. I bet you've got yourself a new uniform and some new shoes, aren't your langa, I've definitely forgotten how all this microphone, |
| 0:37.8 | etc. jazz works, so let's hope we can make it through. I think we've got enough muscle memory |
| 0:42.0 | in there to make it work. So we've actually gotten incredibly and extremely invasive |
| 0:47.5 | papers of the months for you this month. So first up, we are looking at pre-hospital |
| 0:51.8 | ECPR and the results of a feasibility trial. |
| 0:55.4 | Then we're on to endotracheal intubation and we're going to finish off with an ice cold look |
| 1:00.9 | at hypothermic cardiac arrest to specifically the Hope score. |
| 1:05.5 | That was quite a good link there. You must have written that one down. That sounds far too polished |
| 1:09.1 | as a delivery. No, no. I was just trying to think of a reference to hypothermia, too many ice lollies, something like that in the summer, but didn't think that was appropriate. |
| 1:17.5 | So let's go with an ice cold look at it, shall we? |
| 1:20.3 | Well, before we get into it and before you start sharpening your HB pencils for that school return, A huge thanks to Zol Medical Corporation for collaborating |
| 1:29.4 | with us on the podcast and making this all free and open access in their pursuit of excellent |
| 1:35.5 | patient care and also providing the CPD portal. So make sure you go over to that after you've |
| 1:41.0 | listened to this and get your free certificate of listening. So without further ado, let's crack in to paper number one. |
| 1:52.0 | Okay, well, in our Spear episode, we talked about the possibilities that exist out there in terms of endovascular resuscitation in cardiac arrest, including the use of |
| 2:02.9 | ECMO CPR, which we know currently, and this is probably an understatement, there is a limited |
| 2:09.1 | availability and access to. It requires a whole load of kit, a whole load of expertise, |
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