People should not die before they are done living Introduction to Advanced Resuscitation Techniques ART The ART of improving outcomes in cardiac arrest Novel resuscitation techniques and high performance ID: 1044143
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1. Advanced Resuscitation Training People should not die before they are done living. Introduction to Advanced Resuscitation Techniques (ART)- The ART of improving outcomes in cardiac arrestNovel resuscitation techniques and high performance CPRImproving outcomes with advanced techniques and technologyA paradigm shift in the way we approach cardiac arrest
2. Introduction to ARTART has three main goals: Improving the resuscitation response to drive greater survival.Preventing arrests via analysis of the root causes of arrests.Continuous Quality Improvement via use of data collection and analytics.
3. Current Resuscitation ModelInfrequent exposure to a standardized model of care for all patients and all care providersRigid and inflexibleHas not drastically changed outcomesDoes not take into account available technology and institutional needs
4. Optimizing CPRInterruptionsCPR Quality
5. Perfect CPR – Real time feedbackRate , depth, compression rate AND recoil for each compression.Seamless continuous CPR achieved with filtered ECG. NO interruptions for rhythm check – Filtered ECG
6. Ventilations?NO interruptions for ventilation – synchronous ventilationSingle ventilation inserted on the upstroke of every 10th compression. Although < 0.4 sec, animal studies have shown adequate TV and minimal gastric insufflation due to negative intrathoracic pressure during upstroke
7. Upstroke VentilationBreathBreath12345678910
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9. ETCO2 – information gainedConfirmation of optimal CPR parameters – better CPR will produce better ETCO2 valuesPrognostication – low ETCO2 < 12mmhg a/w poor prognosisPredict success at defibrillation – Higher ETCO2 (>25mmhg) a/w significantly better shock success.Detect ROSC – sharp and sustained rise in ETCO2
10. The following chart shows the progress made in some hospitals and emergency response systems following implementation of ART Resuscitation.
11. Before and after study. Improved survival to hospital discharge, improved neurological outcomes.
12. NTFGH & JCH Cardiac Activation (Reactive) –AUTOMATED CODE BLUE
13. NTFGH & JCH Cardiac & Peri-Arrest Alert & Activation (Predictive)
14. Cardiac Arrest Rate per 1000 patient admissions