- Push continuous chest compressions to new levels. Seattle Medic One showed us station-level training, highlighting doing compressions while the AED was charging. Note: not while discharging/delivering shock. Kansas City, Mo., and many Arizona systems have reported on the benefits of passive oxygenation—benefits easily appreciated if the initial resuscitation team comprises only two EMS professionals
- Move from 100 compressions per minute to 120 compressions per minute. This is based on Resuscitation Outcome Consortium (ROC) study data (see further discussion below), and this compression rate goes hand in hand with instituting system-wide use of compression metronomes.
- Build on the concept of tightly defined resuscitation roles for all levels of EMS professionals. Credit is due to a lot of systems but directly to Austin/Travis County, Texas, and their “CPR triangle” model.
- Incorporate hands-on, station-level training taught directly by medical oversight officers and the medical director (e.g., Seattle Medic One).
- Stay the course with the impedance threshold device. This idea is supported in post-hoc analysis of the ROC PRIMED data by ROC investigators and their EMS systems, which are too numerous to mention.
- Get more aggressive in initiating post-arrest therapeutic hypothermia (e.g., Wake County (N.C.) EMS and other innovative systems).
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