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Rethinking CPR in Trauma: Insights from a Groundbreaking Study on Hemorrhagic Shock
For a pulseless trauma patient, starting CPR is an ingrained response. But in cases of pulseless electrical activity (PEA) from severe blood loss, could chest compressions do more harm than good? Host Bram Duffee, PhD, EMT-P, speaks with Dr. Patrick Greiffenstein, lead study author and Trauma ICU Director at LSU New Orleans, about new research that challenges a core tenet of resuscitation.
Dr. Greiffenstein’s study used a porcine model to simulate severe hemorrhagic shock. Researchers compared key outcomes between a group that received automated CPR during the shock phase and a group that did not, focusing on oxygen delivery to the brain and skin.
Key Findings:
• CPR provided no improvement in brain or skin oxygenation.
• Skin perfusion was significantly lower in the group receiving CPR.
• While systolic blood pressure increased, diastolic blood pressure—critical for organ perfusion—was significantly reduced.
• Intracranial pressure (ICP) showed a threefold increase with CPR, suggesting disruption of normal cerebral blood flow.
Disclaimer: This content is for educational and informational purposes only and does not constitute medical advice. Always follow your local protocols and medical direction.
Book announcement: Bram Duffee is a co-author of the latest book about how hypnosis has the potential to revolutionize medical care for those struggling with emergency / acute distress. Hypnotic Communication in Emergency Medical Settings: For Life-Saving and Therapeutic Outcomes demonstrates how hypnotic communication has the potential to improve patient outcomes in emergency care, integrating insights on the connection between mind and body for paramedics and other first responders. https://routledge.pub/Hypnotic-Communication-in-Emergency-Medical-Settings
Stay up to date: Review the most recent research in EMS through the monthly article reviews put out by the International PreHospital Medicine Institute https://iphmi.com/ems-articles-of-the-month
Connections: If you want to connect with the EMS Research Podcast staff check out our website at www.ProfessorBram.com If you enjoyed this episode please consider subscribing to EMS Research on YouTube: / @4emsresearch
Reference: Greiffenstein, P., Cavalea, A., Smith, A., Sharp, T., Warren, O., Dennis, J., Gatterer, M. C., Danos, D., Byrne, T. C., Scarborough, A., Deville, P., & VanMeter, K. (2025). Effect of cardiopulmonary resuscitation on perfusion in a porcine model of severe hemorrhagic shock. The Journal of Trauma and Acute Care Surgery, 98(2), 251–257.
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By Bram DuffeeFor a pulseless trauma patient, starting CPR is an ingrained response. But in cases of pulseless electrical activity (PEA) from severe blood loss, could chest compressions do more harm than good? Host Bram Duffee, PhD, EMT-P, speaks with Dr. Patrick Greiffenstein, lead study author and Trauma ICU Director at LSU New Orleans, about new research that challenges a core tenet of resuscitation.
Dr. Greiffenstein’s study used a porcine model to simulate severe hemorrhagic shock. Researchers compared key outcomes between a group that received automated CPR during the shock phase and a group that did not, focusing on oxygen delivery to the brain and skin.
Key Findings:
• CPR provided no improvement in brain or skin oxygenation.
• Skin perfusion was significantly lower in the group receiving CPR.
• While systolic blood pressure increased, diastolic blood pressure—critical for organ perfusion—was significantly reduced.
• Intracranial pressure (ICP) showed a threefold increase with CPR, suggesting disruption of normal cerebral blood flow.
Disclaimer: This content is for educational and informational purposes only and does not constitute medical advice. Always follow your local protocols and medical direction.
Book announcement: Bram Duffee is a co-author of the latest book about how hypnosis has the potential to revolutionize medical care for those struggling with emergency / acute distress. Hypnotic Communication in Emergency Medical Settings: For Life-Saving and Therapeutic Outcomes demonstrates how hypnotic communication has the potential to improve patient outcomes in emergency care, integrating insights on the connection between mind and body for paramedics and other first responders. https://routledge.pub/Hypnotic-Communication-in-Emergency-Medical-Settings
Stay up to date: Review the most recent research in EMS through the monthly article reviews put out by the International PreHospital Medicine Institute https://iphmi.com/ems-articles-of-the-month
Connections: If you want to connect with the EMS Research Podcast staff check out our website at www.ProfessorBram.com If you enjoyed this episode please consider subscribing to EMS Research on YouTube: / @4emsresearch
Reference: Greiffenstein, P., Cavalea, A., Smith, A., Sharp, T., Warren, O., Dennis, J., Gatterer, M. C., Danos, D., Byrne, T. C., Scarborough, A., Deville, P., & VanMeter, K. (2025). Effect of cardiopulmonary resuscitation on perfusion in a porcine model of severe hemorrhagic shock. The Journal of Trauma and Acute Care Surgery, 98(2), 251–257.