EMS A to Z: 2020 AHA Guideline Updates

Show Notes:

From your hosts, Dr. Josh Gaither, Dr. Amber Rice, and Dr. Rachel Munn

Cardiac Arrest:

In 2015, 350,000 individuals had OHCA in the US. Less than 40% of adults receive layperson-initiated CPR, and fewer than 12% have an automated external defibrillator (AED) applied before EMS arrival.

EMS Highlights: 

Adults/Pediatrics: 

Importance of early CPR and defibrillation

CPR quality monitoring

Audio feedback if available

ETCO2 if available

IV may be preferred to IO if available

Early epinephrine in non-shockable rhythms

Prioritizing defibrillation over epinephrine in shockable rhythms

Shock x 3 prior to antiarrhythmic 

Early epinephrine in pediatrics

Neonates:

Neonatal warming, drying, stimulating, skin to skin with mom is priority

Neonatal suctioning only recommended if suspected airway obstruction due to meconium 

PPV for HR < 100

CPR for HR < 60

IO may be used for med admin

Epinephrine may be used if no response to CPR / PPV

Fluid bolus may be used 

Community Health:

Focus on debrief for providers and family members of patient suffering cardiac arrest

Focus on booster CPR training for layperson

Focus on naloxone admin by layperson