The World’s Okayest Medic Podcast More Cardiac Arrest with Josh Cooke
Dec 31, 2024
Josh Cooke, an EMS provider and the host of the Alert Medic One Podcast, dives deep into the world of cardiac arrest. He discusses the complexities of using epinephrine and its impact on patient outcomes, urging a focus on meaningful survival over immediate resuscitation. The conversation shifts to the role of Narcan in cardiac emergencies, revealing its challenges and potential benefits, especially in vulnerable patient populations. Through real-life scenarios, Cooke emphasizes teamwork and the nuances of emergency protocols in critical situations.
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Focus on Patient Benefit
- Focus on patient benefit and meaningful outcomes, not just ROSC.
- Consider the potential for worse neurological outcomes with repeated epinephrine doses.
Epinephrine's Double-Edged Sword
- Epinephrine may get ROSC, but can lead to worse neurological outcomes.
- This "backfires" by creating patients who survive but with severely diminished quality of life.
Esmolol and Catecholamine Surge
- Esmolol is used for refractory V-fib to block the sympathetic response and reduce catecholamine surge.
- This contradicts the practice of giving epinephrine, which increases catecholamines.