data from Italy:
- increased incidence of arrest during COVID surges (greatest in provinces with highest COVID rate)
- more unwitnessed arrests, higher field mortality, lower rate of bystander CPR
- @FTeranMD at #HRreloaded
data from Paris:
- higher rate of arrest during COVID pandemic
- more arrests at home, lower bystander CPR, longer delays to intervention, fewer people alive at hospitalization
- @FTeranMD at #HRreloaded
do bystanders place themselves at risk by doing CPR?
- first link in the chain of survival = bystander CPR
- when you do the math, hands-only CPR should save lives
- @FTeranMD at #HRreloaded
AHA & ILCOR guidelines based on "best available evidence." unfortunately this is mostly expert-level opinion
- @FTeranMD at #HRreloaded
why more arrests?
- COVID causes vascular inflammation & myocarditis?
- excess Netflix?
- In France, most increase wasn't directly due to COVID. So arrests may be due largely to non-COVID patients delaying hospital admission in response to chest pain
- @FTeranMD at #HRreloaded
practical tips to improve codes in COVID:
- have a plan (donning PPE? when to call code?)
- define who is in room & how to *communicate* to support staff outside the room
- @FTeranMD at #HRreloaded
4-hand CPR technique:
- Two-hand mask seal reduces aerosolization (and it's preferred practice anyways to optimize mask seal)
- @FTeranMD at #HRreloaded
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how to place a consult: you MUST understand the five stages of consultant grief.
once you can understand this painful and natural process, requesting consults will make a LOT more sense
buckle up, it can be a little rough…
🧵 1/6…
stage 1: denial
- You dont need a consult.
- You called the wrong service.
- 18 years old? consult pediatrics
- I’m not actually on call now
- Everything’s fine, just walk it off…
stage 2: anger
- you should have consulted us earlier/later
- you should have checked this test before calling us
- you’re a terrible doctor/student/human being