Episode 109: Dr. Ken Milne, Small BVMs, and Nitroglycerine

The Overrun

Summary

In this episode, Dr. Ken Milne discusses two studies related to emergency medicine. The first study examines the use of small adult ventilation bags in out-of-hospital cardiac arrest. The study found that small bags were associated with a lower rate of return of spontaneous circulation (ROSC) compared to standard bags. However, this was an observational study and more research is needed to draw definitive conclusions. The second study explores the use of nitroglycerin in right ventricular myocardial infarctions (MIs). Traditionally, nitroglycerin has been contraindicated in these cases, but the study found no significant difference in adverse events when nitroglycerin was used. Again, more research is needed to confirm these findings. Overall, these studies highlight the importance of evidence-based practice and the need for further research in emergency medicine.

Takeaways

Small adult ventilation bags may be associated with a lower rate of return of spontaneous circulation (ROSC) in out-of-hospital cardiac arrest, but more research is needed to confirm this finding. The use of nitroglycerin in right ventricular myocardial infarctions (MIs) may not be as contraindicated as previously thought, but further research is needed to determine its safety and efficacy. These studies highlight the importance of evidence-based practice and the need for more high-quality research in emergency medicine. Clinicians should consider the limitations of observational studies and use their clinical judgment when interpreting and applying the findings. Discussion and collaboration among healthcare professionals are crucial for updating protocols and guidelines based on emerging evidence.

Then, Ed and Dan discuss two recent studies. The first study examines the use of small bags in cardiac arrest resuscitation, while the second study explores the use of nitroglycerin in right ventricular myocardial infarction (RVMI). The hosts analyze the findings of these studies and discuss their implications for clinical practice. They emphasize the importance of conducting further research and encourage EMS providers to get involved in research projects. The hosts also highlight the need for open communication with medical directors and other healthcare professionals to drive positive change in protocols and treatment approaches.

Chapters

Introduction and Overview Reevaluating the Use of Nitroglycerin in Right Ventricular Myocardial Infarctions

Introduction and Discussion of Small Bags in Cardiac Arrest Resuscitation

The Importance of Research and Collaboration in EMS

Keywords small bags, cardiac arrest resuscitation, nitroglycerin, right ventricular myocardial infarction, RVMI, research, clinical practice, EMS providers, medical directors, protocols, treatment approaches, emergency medicine, cardiac arrest, ventilation bags, nitroglycerin, observational study, myocardial infarction, evidence-based practice

thesgem.com

SGEM#428: Don’t Worry, Be Happy – The Safety of Nitroglycerin Administration in RVMI

SGEM#426: All the Small Things – Small Bag Ventilation Masks in Out of Hospital Cardiac Arrest

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7234703/

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