OHCA literature review

Examining the evidence for managing intubation attempts, PEA and ETCO2 for out of hospital cardiac arrest

It’s time to review some recent cardiac arrest literature. In this episode of the MCHD Paramedic Podcast, we break down two articles from “Resuscitation” that address predictors of OHCA survival:

Murphy DL, Bulger NE, Harrington BM, et al. “Fewer tracheal intubation attempts are associated with improved neurologically intact survival following out-of-hospital cardiac arrest.” Resuscitation. 2021. – a retrospective, observational, cohort study of 1,205 non-trauma OHCA patients with a laryngoscopy attempt performed by Seattle Fire
Crickmer M, Drennan IR, Turner L, Cheskes S. The association between end-tidal CO2 and return of spontaneous circulation after out-of-hospital cardiac arrest with pulseless electrical activity. Resuscitation. 2021. – a retrospective, observational, cohort study of 208 non-trauma OHCA patients with presenting PEA conducted in two services in Ontario

We examine the literature and discuss:

Should we take a third attempt at intubating an OHCA patient?
What about PEA arrest; can ETCO2 help identify pseudo-PEA?

Listen to get some OHCA literature updates.

MCHD Paramedic Podcast · Episode 122 - OHCA Literature Update

About the author

The MCHD Paramedic Podcast was launched in early 2018 in an effort to provide easily consumable core-content EMS education and insights from prehospital care thought leaders. The Clinical Services Department of The Montgomery County Hospital District EMS service developed the podcast as a tool to better engage and disseminate continuing education to our MCHD medics as well as first responders and EMS professionals nationwide.

Dr. Casey Patrick is the assistant medical director for Montgomery County Hospital District EMS and is a practicing emergency physician in multiple community emergency departments across Greater Houston. His EMS educational focus is on innovative paramedic teaching via the MCHD Paramedic Podcast. Dr. Patrick’s prehospital clinical research involves the investigation of paramedic use of bolus dose intravenous nitroglycerin for acute pulmonary edema and the implementation of lung protective ventilation strategies for intubated EMS patients. Casey and his wife, Alyssa, work and live in Conroe, Texas, and Spokane, Washington. Together they have five children: Mia, Ainsley, Brock, Dean and Will.

Dr. Dickson graduated with honors from the University of Texas Health Science Center San Antonio in 2001 and completed emergency medicine training at Indiana University in 2004. He serves as the EMS medical director at Montgomery County Hospital District EMS and an assistant professor of emergency medicine at Baylor College of Medicine in Houston, Texas. His academic interests include systems of care in stroke and other time-sensitive emergencies, neurologic emergencies and education. He is board certified in emergency medicine in both the U.S. and Australasia, and has subspecialty board certification in EMS medicine. He has authored multiple professional articles and presented at regional, national and international conferences on emergency medicine and EMS topics.