This podcast covers three interesting topics. They discuss improving outcomes in refractory VF by changing pad position, limiting adrenaline use, and using beta blockers. They also talk about the use of fentanyl lozenges for pre-hospital pain relief, showing significant decrease in pain levels. Finally, they explore the management of acute behavioral disturbance, emphasizing the use of sedation and de-escalation strategies.
Combining different approaches, such as limiting adrenaline and using beta blockers like Esmolol, can improve outcomes in managing refractory VF and VT in cardiac arrest.
Fentanyl lozenges show promise as a quick and effective alternative to intravenous pain medication for pain management in pre-hospital trauma care, with significant pain reduction and low side effects.
Deep dives
Managing refractory VF and VT in cardiac arrest
A paper explores combining different approaches to improve outcomes in managing refractory VF and VT, such as limiting adrenaline, using beta blockers like Esmolol, and changing pad positions during defibrillation.
Using fentanyl lozenges for pain relief
A study examines the use of fentanyl lozenges for pain management in pre-hospital trauma care. Results show a significant decrease in pain levels and low incidence of side effects, supporting the use of fentanyl lozenges as a quick and effective alternative to intravenous pain medication.
Managing acute behavioral disturbance in the pre-hospital setting
A retrospective study analyzes the management of acute behavioral disturbance by advanced paramedics in a pre-hospital setting. Findings demonstrate effective strategies such as communication and positioning that reduce the need for physical restraint. Selective use of sedation by appropriately trained paramedics also proves safe and effective in managing these patients.
Conclusion
This month's podcast episode covers papers on managing refractory VF and VT in cardiac arrest, using fentanyl lozenges for pain relief, and managing acute behavioral disturbance in the pre-hospital setting. The studies provide insights into effective strategies for improving outcomes in these critical scenarios.
Three more papers for you this month to inform and improve our care in acute and critical illness.
First up and following on from the recent DoseVF paper, we take a look at a study looking at the combined effect of vector change, esmolol and capping adrenaline administration in refractory VF with regards patient out ones. Could this be associated with even better patient outcomes?
Secondly we take a look at the utility of fentanyl lozenges in providing effective analgesia to patients in remote settings. Does this have potential for both prehospital and in-hospital patients prior to iv access.
Finally we cover a paper looking at prehospital management of acute behavioural disturbance; the need for restraint, the need for sedation and the subsequent effects on the patients.
Once again we’d love to hear any thoughts or feedback either on the website or via twitter @TheResusRoom.
Simon & Rob
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