Kurt Bramer from Advanced CPR Solutions comes back on the show this week to continue the series on Head-Up CPR and other promising sudden cardiac arrest treatments. He and Dr. Joe Holley kicked off the discussion in a previous episode.

Elevated CPR Series Episode One

Elevated CPR Series Episode Three

Elevated CPR Series Episode Four

Elevated CPR Series Episode Five

In this second episode installment of the sudden cardiac arrest and CPR series Kurt and Dr. Joe Holley discuss some key flaws in approaching cardiac arrest research like other medical diseases and treatments. The large number of unknown and uncontrollable variables surrounding sudden cardiac arrest make it hard for randomized control trials to effectively pinpoint positive treatment modalities.

CARES Registry for Cardiac Arrest Stats

Follow up on more of these segments as we continue to look at the current research trends in future episodes and what is on the horizon for the future.

The episode was co-hosted by Sam Bradley and Jamie Davis.

Scroll down for Podcast Discussion Summary

Thank you as always to Paragon Medical Education Group for their long-term support of the Disaster Podcast. Dr. Joe Holley and the team at Paragon continue to provide excellent and customized disaster response training to jurisdictions around the U.S. and internationally as well.

Podcast Discussion Summary

Kurt discussed the paradox between resuscitation research and orphan drugs, highlighting how both lack funding despite their importance. He explained that orphan drugs target rare conditions, making research and development challenging due to limited market potential, similar to the situation in cardiac arrest resuscitation, which is a leading cause of death worldwide but receives limited research funding.

Joe agreed, noting that complacency and insufficient focus contribute to the lack of high-quality research and implementation of new techniques in cardiac arrest resuscitation. Sam questioned the reliance on randomized control trials as the gold standard for evaluating resuscitation therapies, suggesting a need to explore alternative research paradigms.

Kurt explained the concept of propensity score matching, a statistical analysis tool that allows for patient-to-patient comparisons using control groups not part of randomized trials, by matching variables such as age, downtime, and bystander CPR. Joe elaborated on the challenges of conducting cardiac arrest resuscitation research, highlighting the difficulty of patient participation in randomized trials and the need for large patient numbers to account for numerous impactful details. Jamie questioned the acceptance of different statistical analyses, to which Kurt responded that the issue is primarily one of unfamiliarity, as propensity score matching is widely used in other industries but not yet fully embraced in medicine.

Joe and Kurt discussed the challenges of conducting randomized controlled trials for cardiac arrest, noting the difficulty in controlling variables and the high cost associated with large-scale studies. They highlighted the importance of using large numbers of patients to account for variables and the need for funding, which is often scarce.

Sam brought up the discovery of the ITD and the plunger concept, leading to the suggestion of placing a thumb over the end of the ET tube to enhance pressure differentials and improve blood flow during CPR. Joe explained the hydrodynamic principles behind this technique, emphasizing the role of pressure differentials in creating flow and enhancing cardiac output.

The group discussed counterintuitive aspects of CPR physiology, including how preventing air from entering the lungs during chest compressions can actually improve blood flow. Kurt shared that many of these discoveries were made serendipitously while studying the body’s response to cardiac arrest.

The discussion touched on the challenges of rural emergency response and the importance of data collection in EMS agencies. The participants agreed to continue the series with future episodes focusing on heads-up CPR and various therapies, with Kurt promising to share survival stories in the next installment.

The group discussed the importance of disaster preparedness and the role of specialized training, with Jamie highlighting the sponsorship of the Disaster Podcast by Paragon Medical Education Group.

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