EMOttawa - By Renee Bradley - August 26, 2021
Take Home Points
In summary, review of the current literature surrounding three aspects of the new ILCOR 2020 Guidelines, has led us to draw the following conclusions:
- Dual Sequential Defibrillation (DSD): According to ILCOR, DSD is not recommended due to poor evidence on the subject. However, preliminary data from the DOSE-VF trial demonstrates that DSD is likely safe, and possibly more effective than standard defibrillation when used early in shock refractory VF.
- PoCUS during Cardiac Arrest: Although not recommended for use by ILCOR guidelines for prognostication during CPR, evidence suggests that POCUS is quite reliable in predicting likelihood of death. It could play a role as an additional data point to assist risk stratification during cardiac arrest.
- Epinephrine use in PEA/Asystole: Early epinephrine use is most beneficial in the non-shockable subgroup. Overall excessive use of epinephrine should be done with caution, as poor neurological outcomes may be encountered.