The Resus Room August 2025; papers of the month
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Aug 1, 2025 This discussion kicks off with a groundbreaking study on occult ventricular fibrillation in cardiac arrest, suggesting it might be a hidden key to better survival rates. The hosts delve into the misdiagnosis of cardiac conditions and the complex challenges of ruling out acute coronary syndrome effectively in emergency settings. They also tackle the role of hypertonic saline in treating traumatic brain injury, weighing its potential benefits against limitations. Tune in for a mix of serious insights and engaging banter!
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Occult VF in Cardiac Arrest
- Occult VF occurs in about 5.3% of out-of-hospital cardiac arrest cases and is missed by ECG defibrillator rhythm detection.
- Recognizing occult VF via echo could allow earlier shock delivery and improved outcomes similar to recognized VF.
Echo Reveals Hidden VF
- Many cardiac arrests labeled as PEA on ECG may actually have occult VF detectable by echo.
- Real-time echo identification is challenging, but has potential to tailor resuscitation treatments and improve survival.
ACS Rule-Out Strategies Equalize
- In the UK, different ACS rule-out strategies yield similar emergency department lengths of stay despite theoretical timing differences.
- System pressures like crowding likely negate potential time savings of rapid rule-out protocols.