Kurt Bramer from Advanced CPR Solutions comes on the show this week with Dr. Joe Holley. Kurt has a background in EMS since 1979 and worked as an emergency manager in Minneapolis. He currently works for Advanced CPR Solutions as a clinical educator.

Sudden cardiac arrest is a global disaster that rivals the recent viral pandemic in scope. Cardiac arrest is by far the number one killer worldwide according to every public health agency of note. Over the years, treatment of this problem has a less than 4 or 5 percent survival rate with only minor incremental changes to treatment modalities.

The regular treatment updates that go out every five years feature only relatively minor adjustments to treatments that aren’t all that effective. Part of the problem is that it’s nearly impossible to accurately study the effects of various treatments on cardiac arrest victims due to the wide variety of variables present.

Follow up on more of these segments as we continue to look at the current research trends in future episodes and what is on the horizon for the future.

The episode was co-hosted by Sam Bradley and Jamie Davis.

Scroll down for Podcast Discussion Summary

Thank you as always to Paragon Medical Education Group for their long-term support of the Disaster Podcast. Dr. Joe Holley and the team at Paragon continue to provide excellent and customized disaster response training to jurisdictions around the U.S. and internationally as well.

Podcast Discussion Summary

Advancing Cardiac Arrest Survival Strategies

Jamie, Sam, and Kurt discussed the global disaster of sudden cardiac arrest, highlighting its prevalence and the low survival rate despite advancements in CPR. Kurt explained the distinction between evolutionary and revolutionary changes in resuscitation, emphasizing the need for significant innovations like public access defibrillation and rescue CPR.

The group planned to explore these topics further in upcoming episodes, aiming to engage both EMS professionals and emergency managers in addressing this critical issue.

CPR Practices and Research Evolution

The group discussed the evolution of CPR practices and the impact of scientific research on patient outcomes. Kurt and Jamie shared their experiences with skepticism and complacency among emergency responders regarding cardiac arrest cases, noting that previous protocol changes often had limited effectiveness.

The conversation highlighted the importance of evidence-based practices and the potential for new techniques, like active compression and decompression, to improve survival rates.

Cardiac Arrest Survival Rates Challenges

The group discussed the challenges and limited success rates in resuscitating cardiac arrest patients, with Joe noting that despite advancements, survival rates remain around 10-11%, equivalent to a 90% failure rate. Kurt explained that while the Cardiac Arrest Registry for Enhanced Survival (CARES) data shows a 10% overall survival rate, the rate for neurologically intact survival has remained below 9% since 2013.

The discussion highlighted the difficulties in conducting research on cardiac arrest due to variables like CPR quality, EMS response models, and patient characteristics, leading Kurt to suggest that randomized control trials may not be the most effective research paradigm for this field.

Challenges in Pre-Hospital RCTs

The group discussed challenges in conducting randomized controlled trials (RCTs) for pre-hospital resuscitation, with Joe highlighting significant variability in CPR quality and ventilation techniques. Kurt mentioned Peter Safar’s work and his belief that high-quality animal studies are needed before deploying therapies in uncontrolled EMS environments.

The discussion also touched on the American Heart Association’s guidelines, with Joe noting that while these represent the state of science, local factors and resource constraints must be considered when implementing recommendations.

Advancing CPR Techniques for Survival

The meeting focused on a series discussing cardiac arrest as a global disaster, with a particular emphasis on improving CPR techniques. Kurt Bramer shared a case study from a ski slope where a patient’s recovery was attributed to the use of a rescue pump and the gravitational effect of being in an inclined position.

The group discussed the potential of “head-up CPR” as a promising technique, and Jamie Davis announced upcoming episodes in the series. The participants agreed to continue exploring these topics in future discussions.

The group discussed the importance of disaster preparedness and the role of specialized training, with Jamie highlighting the sponsorship of the Disaster Podcast by Paragon Medical Education Group.

Catch the full episode using the player above or on your favorite podcast platform, and don’t forget to subscribe to the Disaster Podcast for weekly insights from leaders in disaster response and research!

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