Defibrillation Strategies for Refractory Ventricular Fibrillation

Stu Berger, MD, Citizen CPR Foundation President, shares the following summary of “Defibrillation Strategies for Refractory Ventricular Fibrillation,” recently published in the New England Journal of Medicine:

Outcomes from sudden cardiac arrest have improved over the years as a result of technological advances in defibrillation techniques and technology. Other interventions that have included community CPR-AED education have also proved to be beneficial. However, shock-refractory ventricular fibrillation (VF) is not uncommon during out-of-hospital-cardiac-arrest (OHCA). This study offers an important discussion of exciting alternatives to shock strategies when conventional approaches fail.

In a randomized-controlled study reported by Cheskes et al. in the New England Journal of Medicine in November 2022, double sequential external defibrillation (rapid sequential shocks from two defibrillators) and vector-change defibrillation (switching defibrillator pads to the anterior-posterior position) have been proposed as techniques to improve outcomes.

In this study, 405 patients were enrolled with a total of 136 (33.6%) receiving standard defibrillation, 144 (35.6%) receiving vector-change defibrillation, and 125 (30.9%) receiving double-sequential external defibrillation. Of importance is the fact that survival to hospital discharge was more common in the double-sequential external defibrillation group than in the standard group (30.4% vs. 13.3%) and more common in the vector-change group than in the standard group (21.7% vs. 13.3%). Double-sequential external defibrillation was associated with a higher recovery of patients having a good neurologic outcome than standard defibrillation.

This paper offers an exciting possibility for improved outcomes by the employment of alternative methods for defibrillation in heretofore shock-refractory VF. Although the logistics of having a second defibrillator present and available might be challenging, the use of vector-change defibrillation with single defibrillator systems might be an alternative strategy when a second defibrillator is not available.

Although this trial was accompanied by/associated with some limitations, particularly with its institution around the time of the COVID-19 pandemic, and the operational challenges associated with that, this trial is indeed significant in that it does show that survival to hospital discharge was significantly improved with double-sequential external defibrillation and vector-change defibrillation compared to standard defibrillation in patients with shock-refractory VF during OHCA. We look forward to more data on these techniques, as well strategies for implementation. Although this is but one study, it is indeed a report of some exciting alternatives to conventional approaches and we look forward to additional studies and education with regard to implementation, if appropriate.

Read the full article on the NLM website >>

 

 

 

 

 

 

 

Got it! TY.

Summit 2023 Exhibitor and Sponsor Opportunities Available Now!

The exciting Summit 2023 news keeps coming! Opportunities to secure your spot as an exhibitor and sponsor are now available. We’ve added several features to help maximize your visibility, interactivity and investment, delivering an outstanding and valuable Summit experience.

Reach out to Ginna Gutierrez at CCPRFSummitSponsors@citizencpr.org for more information. Or visit our Summit 2023 webpage and download our full exhibitor and sponsor prospectus.

Summit 2023 Call for Presentations Opens Jan. 2, 2023

We’ll open Summit 2023’s Call for Presentations on Jan. 2, 2023. In the meantime, be thinking about how you can help us challenge the status quo in sudden cardiac arrest. With a bias for action, we want presenters to stimulate attendees to think differently about the information presented. We also want to hear what presenters are doing to strengthen connections, communities and commitments to truly make an impact on SCA survival and survivorship.

Deadline for submissions is March 3, 2023.

Join Us Next Year in San Diego!

Planning for the Cardiac Arrest Survival Summit 2023 is officially underway! We’re excited to return to the Town and Country Resort in San Diego, Calif., Nov. 29 – Dec. 2, 2023.

Citizen CPR Foundation’s Cardiac Arrest Survival Summit is the central hub for resuscitation professionals, educators, experts, influencers and advocates, as well as the top decision-makers for resuscitation products, services and information.

We need your help in 2023 to inspire and enable action. Our conference theme is Respond. Revive. SURVIVE: Challenging the Status Quo in SCA. Every two years, the Summit brings together the widest array of resuscitation professionals and advocates in one place. In 2023, that collaboration will help inspire action, giving all attendees tips, insights and next steps that they can take home to their communities. That’s how we’ll continue to work toward our primary goal: improve SCA outcomes, which means more lives saved.

We’ll continue to provide Summit updates here in Currents, other email updates and through our social channels. Connect with us on Twitter, Facebook, LinkedIn and Instagram and stay in the loop as we count down to Summit 2023!

 

Happy Holidays From Citizen CPR Foundation!

We want to send our holiday wishes to each and every one of you.  All the best to you and your families for a happy, healthy, peaceful and safe holiday season.  And we send our best wishes for an amazing 2023 of continued advocacy and hard work to do all that we can do to save lives from sudden cardiac arrest.  The Citizen CPR Foundation will continue our collaboration with citizens, professionals, communities, survivors and organizations in order to save lives from sudden cardiac arrest.  Thank you for joining us in this endeavor and once again, Happy Holidays!

Stu Berger, MD

President, Citizen CPR Foundation

Paula Lank, BSN, RN

Chair, Citizen CPR Foundation

Bystanders Save Lives in Neighboring California Cities

In two Sonoma County, Calif. cities just 40 minutes apart, the quick-thinking actions of bystanders helped save two lives in a span of less than three months.

Three friends — Mason Matulaitis, Toby Ford-Monroe and Nate Jordan — jumped to their friend Mikey Serbicki’s aid when he collapsed while the four were playing two-on-two basketball in their home city of Sonoma in June. When Toby called 911, the dispatcher said Mikey was likely in cardiac arrest. Mason immediately began applying chest compressions, a skill he’d learned in gym class. Nate spotted a recently installed AED and, despite his nervousness about the device, used it to deliver lifesaving shocks to Mikey’s heart. Read more about Nate overcoming his hesitation to use the AED and Mikey’s full recovery in the Sonoma Index-Tribune >>

Nearly two months to the day in neighboring Santa Rosa, Calif., Mark Hays collapsed while playing indoor soccer. Meredith Freed, an intensive care nurse, was playing nearby when she heard commotion. She, along with a second medical professional, quickly assessed the situation and began delivering CPR while a third player, also a nurse, searched for an AED. After the AED administered a shock and compressions continued, Hays not only regained consciousness; he was able to walk around in the facility. Read more about what Jenny Ogston, manager of the Epicenter sports facility, called “the best possible outcome” in The Press Democrat >>

Do you have an inspiring sudden cardiac arrest save story that you’d like to share for consideration in an upcoming issue of Currents? Please email information to Katy Schamberger at kschamberger@augeomarketing.com.

Meet the 2021 Class of 40 Under 40 Honorees! – Part 3

In this Q3 issue of Currents, we’re continuing our spotlight on the 2021 Class of 40 Under 40, first announced and recognized at the Cardiac Arrest Survival Summit.

This is a dynamic group of young leaders, professionals, advocates and survivors who share a common passion: working to improve SCA outcomes.

Introducing the 40 Under 40 honorees recognized this quarter:

  • Michael Herbert, B.S., NRP
  • Thomas Jenkins, Fire Chief, City of Rogers FD
  • Aaron Johnson, Advocate, Dynamic Cardio Care, Arizona Cardiac Arrest Survivors
  • Bethany Keime, Founder and CEO, HeartCharged
  • Hannah Keime, Founder and Creative Director, HeartCharged
  • Kacey Kronenfeld, MD, FAEMS, Director of Prehospital Services, Madison Emergency Physicians, Wisconsin Regional EMS Director
  • Melissa Lederer, Heart & Vascular Quality & Accreditation Manager, MBA, BSN, RN
  • Brian Leonard, Director of Sales, Cardio Partners
  • Emily Lewis, EMT; CPR, First Aid and Personal Safety Instructor
  • MIchael Mancera, MD, EMS Medical Director, University of Wisconsin

Visit our website to read more about these honorees and meet the rest of the 2021 Class of 40 Under 40. We’ll be back to introduce you to more winners in our final issue of the year!

Partner News: WorldPoint Introduces Tools to Expand CPR Training Inclusivity, Delivery

Data from the American Heart Association shows that not only are women less likely than men to receive bystander CPR when experiencing sudden cardiac arrest; people of color are also less likely to receive life-saving bystander intervention.

To help improve these troubling disparities, WorldPoint Inc. (a member of Citizen CPR Foundation’s Partner Council) recently unveiled two new training tools: CPR Taylor and Baby Tyler. With CPR Taylor’s 3-in-1 design, CPR instructors and students can easily change their manikins to practice CPR delivery on an adult male, adult female and child. CPR Taylor is also available in varying skin tones, a more inclusive reflection of our collective population.

“Cardiac arrest doesn’t discriminate, and neither should your CPR equipment,” says Maggie Hart, Director of Global Marketing, WorldPoint.

WorldPoint’s Baby Tyler, a realistic infant manikin, is also available in a diverse range of skin tones and includes fully movable limbs so that instructors can practice different and realistic CPR and choking scenarios with their students.

See Taylor in action on a recent episode of Good Morning America >>

In Remembrance: George Murphy

Thank you to David Hiltz for writing and contributing this article to Currents.

A dear friend of the resuscitation community and celebrated advocate-champion, George Murphy, NRP, died on June 17, 2022 at the Massachusetts General Hospital.

George Murphy attended the Northeastern University paramedic program where he later earned his degree and worked for Boston EMS for 33 years from 1978 to 2011, retiring as a Captain in the agency’s division of Research, Training and Quality Improvement.

As a member of the Research, Training, and Quality Improvement (RTQI) team at Boston EMS, George was involved in the training and continuing education of Boston EMS’ EMTs and Paramedics. George was a consummate champion of superior care for the people of Boston and integral part of critical strategies designed to introduce new treatment protocols and technologies with the goal of advancing pre-hospital emergency medical care. In George’s case, the focus was clearly on improving outcomes from sudden cardiac arrest.

George was also widely known for his longstanding role as Santa Claus for the City of Boston. Over the years, George became very close to former Mayor Thomas Menino and his wife Angela, appearing as Santa on hundreds of occasions during Menino’s 20-years in office. Anyone who knew George knew of his passion for being Santa.

George was equally well known for dedicating his life to serving others through EMS. He embodied the Latin phrase non-nobis solem as a devoted prehospital care provider, an EMS instructor, a chief EMS examiner and a tireless advocate for patients. His dedication to others was evident in all that he did.

George was also a founding board member and past president of the National EMS Memorial Service, an organization that aims to remember and honor those emergency medical services personnel who have died in the line-of-duty and to recognize the ultimate sacrifice each made for his fellow man.

He was an avid volunteer and served as AHA BLS National Faculty, the Chair of the Massachusetts Emergency Cardiovascular Care Committee and on the American Heart Association New England Affiliate Board of Directors. He actively sought out opportunities to raise awareness of cardiac risk factors, promoting community responsibility, and providing education and training for use of CPR and AED‘s not only in Boston but throughout the United States and beyond. He demonstrated commitment, a culture of action and collaborative spirit at all times, which made him an effective leader.

George thrived on being around people, learning, swapping stories and always encouraging others with his infectious laugh and personality. George is and will be deeply missed by all those whose lives he touched both in-person and through his tireless support of CPR, AEDs and Emergency Cardiac Care.

Remembrances:

It has been said that “the heart has a language all its own meaning, which mind alone cannot fully comprehend.” George spoke volumes with his heart and gave of himself with his expertise to anyone. He never turned down a request and instead would commit himself to helping. Rest in peace, George.

—Janet M. Spellman, RN, EMT-P

Paramedic Program Director, Northeastern University (Ret.)

 

George was a cardiac resuscitation champion nationally, regionally and locally. Gregarious, he knew and worked closely with leadership from the American Heart Association and would bring new ideas and innovations in cardiac and stroke care back to Boston EMS for implementation. George led Boston EMS’s community CPR campaign. In 2005 and the few years thereafter, he organized and coordinated CPR training for all of Boston’s 9,000 public school freshmen. I remember a course for “court-involved youth” that George taught. At their graduation ceremony, the keynote speaker told the graduates that often they had been viewed by themselves and others as problems. CPR had given them a chance to be a part of a solution.

—Peter Moyer, MD, MPH

Professor and Chair Emeritus — Boston University Medicine

Medical Director for Boston EMS, Fire and Police (Ret.)

 

George Murphy was a larger than life teacher, champion and friend. His big Irish laugh and easy smile filled the room. Everyone enjoyed him and his teaching immensely. His work has and will continue to save lives.

Rest easy.

—Mark Forgues, MEd., NRP

MIT EMS Technical Director (Ret.)

Clinical Training Center at Boston Medical Center

 

Although George is no longer with us physically, many of us remain standing on his strong shoulders. Thank you, George. You were an incredible mentor and dear friend. Rest easy — we will carry on with you in our hearts.

—David B. Hiltz

Citizen CPR Foundation