Advanced Cardiac Life Support with Prof. Jerry Nolan.
Oct 10, 2023
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Join us as we dive deep into the world of ACLS guidelines and resuscitation science with Professor Jerry Nolan, an expert in the field. Discover the challenges of managing multiple roles and the bias towards high-income countries in ACLS guidelines. Explore ongoing studies on drugs for cardiac arrest and the future of medical journals. A must-listen for healthcare professionals and anyone interested in saving lives.
ACLS guidelines provide broad recommendations internationally but need to be adapted locally to suit regional healthcare systems.
Adrenaline has a role in resuscitation, but the ideal dose and patient group remain uncertain, with ongoing research exploring different dosing strategies.
Deep dives
Advanced Life Support Guidelines and International Collaboration
The podcast discusses the process behind advancing life support guidelines, emphasizing that they are not standards but guidance for medical professionals. The International Liaison Committee on Resuscitation conducts extensive reviews of resuscitation science, providing broad recommendations internationally. However, regional resuscitation organizations, such as the American Heart Association and the European Resuscitation Council, provide practical recommendations tailored to local conditions. Efforts are being made to include low and middle-income countries in guideline development. Local adaptation is necessary due to variations in healthcare systems. Overall, guidelines aim to strike a balance between standardization and flexibility in resuscitation practices.
Adrenaline (Epinephrine) and High Dose Epinephrine in Resuscitation
The podcast explores the use of adrenaline in resuscitation, highlighting its ability to restart more hearts compared to a placebo. However, the long-term benefits diminish, and questions remain regarding the appropriate dose. High-dose epinephrine, studied extensively in the past, also showed limited long-term benefits. Ongoing research is investigating different dosing strategies, such as smaller doses and infusions, particularly in highly monitored environments like the operating room or intensive care. Finding the ideal dose and patient group is crucial, as while adrenaline has a role in resuscitation, its relative effects are outweighed by interventions earlier in the chain of survival.
Controversial Interventions and Challenges in Resuscitation
The podcast highlights controversial interventions in resuscitation, including the use of adult calcium administration, bicarbonate, extracorporeal CPR (ECR), and point-of-care ultrasound (POCUS). Recent studies suggest that calcium administration may be harmful, leading to changes in guidelines. The role of bicarbonate remains uncertain, as more data is needed to determine its usefulness in cardiac arrest. ECR has shown benefits in select patients, but its implementation is challenging. The role of POCUS in pulse checks is debated, as it requires highly skilled practitioners and minimal interruption to chest compressions. Future studies are anticipated to shed light on these interventions and provide more conclusive evidence.
The Future of Journals and Open Access
The podcast touches on challenges facing medical journals, including the push toward open access publishing. Funders, like the World Health Trust, require research to be published as open access, heightening the need for sustainable funding models. The transition to online-only journals has reduced costs but not eliminated them. Advertising is emerging as a potential source of revenue for open access publications, with some journals already implementing advertisement placements. Publishers are actively exploring ways to strike a balance between making research freely accessible and generating income to support the publication process.
Welcome back to the Critical Care Commute as we continue our “State of the Art 2023” series. In today's episode, we have a distinguished guest who needs no introduction in the field of Advanced Cardiac Life Support (ACLS).
Joining us today is Professor Jerry Nolan, a renowned expert and thought leader in resuscitation science and ACLS guidelines. Join us for an insightful and informative conversation with Professor Jerry Nolan as we delve deep into the world of ACLS guidelines, resuscitation science, and the critical role they play in saving lives.
Whether you're a healthcare professional or simply interested in the field, this episode is a must-listen.
Thank you for tuning in to the Critical Care Commute. If you enjoyed this episode, please consider leaving a review and sharing it with your colleagues and friends. Stay tuned for more fascinating discussions in the
world of healthcare and medicine.
[Disclaimer: The information provided in this podcast is for educational and informational purposes only and should not be considered as medical advice. Consult with a qualified healthcare professional for any
medical concerns or questions.]
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