The Resus Room May 2024; papers of the month
7 snips
May 1, 2024 Delve into refractory VF, predicting serious abdominal conditions in elderly patients, and the impact of facemask pressure on neonatal resuscitation. Learn about dual sequential defibrillation, factors influencing abdominal conditions, and the risks of mask pressure during critical care. What strategies should we adopt for recurrent VF and how can we improve outcomes for older patients with abdominal pain and neonatal resuscitation?
AI Snips
Chapters
Transcript
Episode notes
Refractory Versus Recurrent VF Reconsidered
- Many arrests labelled 'refractory VF' may actually be transiently terminated then recur, changing management implications.
- Secondary analysis of DOSE-VF interrogated defibrillator ECGs to separate true refractory from recurrent VF.
Use Defibrillator ECGs To Classify VF
- When assessing VF after shocks, inspect defibrillator ECG logs to distinguish true refractory from recurrent VF.
- Use a ≥5 second VF‑free interval post‑shock to classify recurrence rather than assuming persistent VF at pulse checks.
Most 'Refractory' VF Is Actually Recurrent
- In the DOSE-VF secondary analysis only 17% met the stricter shock-refractory definition while 83% were recurrent.
- Recurrent VF patients had higher survival (OR 2.76) than true shock-refractory cases.