EM:RAP 2018 September SNACK - AIRWAYS-2

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Ian L. -

In 1995 the late Dr Nancy Caroline (1944-2002) who with Dr Peter Safer formed Freedom House a Pioneer Emergency system provider for under serviced people in Pittsburg in 1974 .
She advocated in her ground breaking book for training paramedics :Emergency Care in the Streets 1995 rescuer use of Nasal Oxygen to increase the oxygen concentration of rescue breaths during CPR .
In Annals of Emergency Medicine Nov 2009 54(5) 656-662 Bobrow BJ et al trialed passive ventilation with an oxygen mask and oropharyngeal tube versus Bag Mask ventilation in Witnessed Vf/Vt cardiac arrest.
In 1019 adult out of hospital arrest patients between. Jan1 2005- September 28 2008
459 Patients receive passive oxygenated ventilation and 560 received Bag Valve Mask Ventilation .
Adjusted neurological intact survival in Witnessed aVf/Vt was higher for passive oxygenated ventilation 39/102 38.2 % versus Witnessed aVf/Vt cardiac arrest treated with Bag Valve Mask ventilation 31/120 25.8% .
The other 797 patients had UnWitnessed aVf/Vt arrest and non shockable rhthyms .
The was less survival advantage with passive oxygenation than bag mask but Survival Rates were far lower 13.8% Bag Mask unwitnessed aVf /Vt 1.3% passive mask oxygenation no shockable rhthyms.
Bobrow et al stated in witnessed aVf /Vt arrest passive oxygenation with mask and oropharyngeal airway in the context of Witnessed Vt /aVf cardiac arrest could be recommended.

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EM:RAP 2018 September SNACK Full episode audio for MD edition 4:52 min - 4 MB - M4A