The podcast discusses three interesting papers: the benefits of whole body CT in post-arrest patients, a pilot study on reduced dose systemic fibromyelysis in massive PE, and the use of post-mortem CT scans in trauma patients to determine cause of death. The speakers analyze the findings, address limitations, and explore potential implications for patient care.
Performing whole body CT scan after cardiac arrest can identify injuries and pathologies requiring rapid treatment.
Reduced-dose thrombolysis could be an effective and safe therapy for patients with massive PE, but further research is needed.
Deep dives
CT imaging after cardiac arrest: revealing potential injuries
A study explored the use of CT imaging after a cardiac arrest to detect potential injuries. The findings showed that performing a whole body CT scan after a cardiac arrest can identify injuries and pathologies that may require rapid treatment. The study emphasized the importance of considering CT imaging in cardiac arrest patients who do not have a clear cause of arrest, despite concerns about delaying treatment in certain cases.
Reduced-dose thrombolysis for massive pulmonary embolism
A pilot study investigated the use of reduced-dose thrombolysis for patients with massive pulmonary embolism (PE). The study administered a low-dose, prolonged infusion of TPA without a bolus to patients with massive PE. The findings showed promising results, including a return to normal blood pressure in all cases and significant improvement in pulmonary artery systolic pressure and right ventricular function. The study suggested that reduced-dose thrombolysis could be an effective and safe therapy for patients with massive PE, but further research is needed.
Post-mortem CT imaging for trauma patients
A retrospective cohort study analyzed the use of post-mortem computed tomography (CT) imaging to characterize fatal blunt injuries in trauma patients. The study aimed to challenge assumptions about the causes of death in trauma patients and identify potential injuries amenable to intervention. The findings showed that fatal blunt injury patterns did not vary between pre-hospital and in-hospital arrest deaths. The study emphasized the importance of detecting and treating potentially reversible causes of death, such as pneumothorax and misplaced airway devices, to improve care for trauma patients.
We're back with three really interesting papers after our summer break, with some great points to think about with regards to our practice and patient outcomes.
First up we take a look at the CT FIRST study which looks at the benefit of whole body CT in patients presenting with a ROSC after their out of hospital cardiac arrest with no obvious cause. Should we be more liberal in our imaging requests in this patient cohort?
Next up we have a think about thrombolysis for massive PEs. When it comes to these patients we have to consider the very real potential complications of thrombolysis and that can often dissuade us from treating them. This paper looks at an alternative dose in thrombolysis and describes some really interesting results.
Finally we take a look at a CT study which is scanning trauma patients after they have died. What injury patterns do they find, which injuries would have been amenable to treatment and are there any lessons on practice to be learnt?
Once again we’d love to hear any thoughts or feedback either on the website or via twitter @TheResusRoom and we'll see you back in September!
Simon & Rob
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