Impedance Threshold Device

A recent big development in the management of cardiac arrest. For years, our service has used an impedance threshold device. The science seems logical, the animal studies were promising and many of the long-term clinicians that I work with swear the device is the cause of increased patient survival. The problem is, the ROC study just decided to discontinue the portion assessing the ITD. They showed no improvement in patient outcomes after 11,500 cases.
www.nih.gov/news/health/nov2009/nhlbi-06.htm

We are yet to throw all of them away. As with any science in medicine, there is always more than one opinion and more research will come up supporting the device and it's use.

Certainly, this study is impressive. There are a lot of victims enrolled which sets it apart from many studies regarding cardiac arrest.

My opinion: I am going to continue to supports its use. There is no evidence is does harm and I am convinced it is improving our outcomes.

EMS Expo

As the first post of this blog, I am going to start with some things said in Orlando at the EMS Expo.
One subject that was brought up is the idea of paramedic treat and release. This is a subject that has a fair amount of research associated with it. As a medical director, the idea of patients being left at the scene seems to open the service up to a fair amount of liablilty. I have always argued that paramedic education never focuses on which patients can be left at the scene and therefor should not be part of the routine practice habit. Research also supports this and shows that it is possible to improve patient care and reduce bad outcomes by education of the crews.