Tackling Refractory Cardiac Arrest: New concepts for system-wide collaboration

This event was recorded on December 4, 2017 and is now available for on demand viewing.

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Event Description:

Refractory cardiac arrest presents a struggle for EMS systems. Providing excellent care in the field often doesn't guarantee a successful outcome. Innovative systems looking for better ways to improve their outcomes have started to examine taking these patients to the cath lab while using mechanical CPR support. Early evidence shows remarkable outcomes for these patients, with survival as high as 50% compared to the single digit survival of non-transported patients.

This webcast will highlight presentations from 3 leading researchers in the field of cardiac arrest care. Dr. Karl Kern, a Professor of Medicine a the University of Arizona, discusses the statistics associated with treatment of refractoroy v-fib patients. Dr. Demetri Yannopoulos, a Professor of Medicine at the University of Minnesota, discusses patient selection and management regarding transporting refractory v-fib patients. Dr. Brian Grunau, an Emergency Physician and Director ECPR program of St. Paul's Hospital in Vancouver, BC, will discuss the value of a load and go approach vs. a stay and play model for cardiac arrest and refractory v-fib patients.

Presented by:

Demetri Yannopoulos, MD
Professor of Medicine, University of Minnesota
Medical Director, Minnesota Resuscitation Consortium

A graduate of the University of Athens Medical School in Greece, Dr. Yannopoulos completed his residency and cardiology fellowship at the University of Minnesota, then went on to finish his Interventional Cardiology fellowship at the Johns Hopkins University. He joined the University of Minnesota faculty in 2008.

Dr. Yannopoulos is an Interventional Cardiologist at the University of Minnesota Medical Center (UMMC) with board certifications in Internal Medicine, Cardiovascular Medicine and Interventional Cardiology. He received the Robert Eddy Endowed Chair for Resuscitation Medicine and was appointed this past year as Professor of Medicine at the University of Minnesota.

Dr. Yannopoulos has conducted studies in the areas of cardiopulmonary resuscitation, hypovolemic shock and hypothermia and has investigated in depth cardiopulmonary and thoracic-cranial interactions focusing on optimization of blood flow and vital organ outcomes.

Karl Kern, MD
Professor of Medicine
University of Arizona

Dr. Kern is a Professor of Medicine at the University of Arizona, where he is the Gordon A. Ewy, MD Distinguished Endowed Chair of Cardiovascular Medicine.  Dr. Kern is also a Co-Director of the Sarver Heart Center at the University of Arizona.  Following his graduation from Brigham Young University (magna cum laude), he attended Hahnemann Medical College in Philadelphia, where he graduated with honors as Alpha Omega Alpha in 1980.  His postgraduate education and training, including his Cardiology Fellowship were at the University of Arizona.

Dr. Kern is a Fellow of the American College of Physicians, a Fellow of the American College of Cardiology, a Fellow of the Council of Clinical Cardiology and the Cardiopulmonary, Peri-Operative, and Critical Care Council of the American Heart Association, a Fellow of the American College of Chest Physicians, and a Fellow of the Society of Cardiovascular Angiography and Intervention.  

Dr. Kern is an active interventional cardiologist. He is a past Governor of Arizona for the American College of Cardiology as well as a Past Chairman of the Emergency Cardiac Care committee for that organization.  He was a member of the AHA National ACLS subcommittee from 1994 until 2002, and served as Chairman for three years, during which time the “Guidelines 2000 for CPR and ECC” were completed and published.  He served as the chair the Cardiopulmonary, Peri-Operative, and Critical Care Council (2011-13) and is now the current Vice-Chair of the AHA ECC Committee (2015-2017), having just been elected as the Chair-elect for 2018-2019. 

Dr. Kern’s research interests have centered on cardiopulmonary resuscitation and he has been an active investigator of CPR since 1983.  He is the Coordinator of the University of Arizona /Sarver Heart Center Resuscitation Research Group, which developed both “Chest Compression-Only Basic Life Support CPR” and “Cardiocerebral Resuscitation”.  He is currently the PI of the PEARL Study, a pilot RCT examining the utility of early coronary angiography versus not in post arrest patients without ST elevation on their ECGs.

Brian Grunau, MD
Emergency Physician
St Paul's Hospital

Dr. Grunau is an investigator at the British Columbia (BC) site of the Canadian Resuscitation Outcomes Consortium, a clinical trials network for the study of out-of-hospital (OHCA) cardiac arrest and trauma. His primary research interest is the management of OHCA patients with refractory arrest. He has developed regional protocols for cardiac arrest management, and sits on the region’s Cardiac Arrest Committee as well as on the Canadian Association of Emergency Physicians Critical Care Committee. He has an established publication record and was awarded an AHA Young Investigator Award in 2014. He has contributed to the American Heart Association / Heart and Stroke Foundation Heartsaver and ACLS Experienced Provider curricula.

Extracorporeal CPR is a key research interest of Dr. Grunau. He is the Director of the St. Paul’s Hospital ECPR Program and played the lead role in its development, the first ECPR program for OHCA in Canada. Dr. Grunau and the BC Ambulance Service then integrated ECPR services into the regional algorithm for OHCA management. He is specifically interested in how the addition of ECPR into an emergency medical system may improve the overall survival, and the cost effectiveness of such an intervention. 

Moderated by:  A.J. Heightman, MPA, EMT P
Editor in Chief


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  • - training manikins without feedback
  • - training manikins with feedback
  • - EtCO2
  • - video laryngoscope
  • - real time CPR feedback
  • - mechanical CPR
  • - training manikins without feedback
  • - training manikins with feedback
  • - EtCO2
  • - video laryngoscope
  • - real time CPR feedback
  • - mechanical CPR
  • - post event review and feedback to the team