Emergency Medical Minute17 Aug

Podcast 1017: CPR Hand Placement

Contributor: Taylor Lynch, MD

Educational Pearls:

CPR is an important life-saving measure designed for anyone to perform.

Chest compressions works by two mechanisms:

Cardiac pump: Direct squeezing of the heart
Thoracic pump: Increasing intrathoracic pressure, causing increased blood flow

Proper hand placement per current AHA guidelines:

Hands are placed in the center of the chest, on the lower half of the sternum

A recent study challenged this approach, using TEE during chest compressions to visualize the cardiac structures being compressed.

They found that when hands were placed ~1cm to the left of the sternum, this compressed the left ventricular outflow tract, potentially restricting forward blood flow.
Hand placement ~4cm to the left of the sternum resulted in more effective compression of the left ventricle.

While this is not yet reflected in AHA guidelines, the study presents an interesting finding that may influence how CPR is performed in the future.
Key takeaway: Always prioritize administering high quality compressions.

References:

American Heart Association. 2025 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2025;152(23_suppl_1). doi:10.1161/CIR.0000000000001378.
Chu S, Cheng C, Chang C, et al. Transesophageal echocardiography during CPR in patients with out-of-hospital cardiac arrest: the EXECT-CPR randomized clinical trial. JAMA Intern Med. 2026;186(5):557-566. doi:10.1001/jamainternmed.2026.0102.

Summarized by Ashley Lyons, OMS4 | Edited by Ashley Lyons & Ahmed Abdel-Hafiz, NREMT-P

Donate: https://emergencymedicalminute.org/donate/

Join our mailing list: http://eepurl.com/c9ouHf

Det här avsnittet är hämtat från ett öppet RSS-flöde och publiceras inte av Podme. Det kan innehålla reklam.

Avsnitt(1180)

Podcast 1025: Post intubation Sedation

Podcast 1025: Post intubation Sedation Contributor: Aaron Lessen, MD Educational Pearls: Experts suggest that anyone who is put on a ventilation should be given sedation. When acquiring Rapid Sequ...

12 Okt 2min

Podcast 1024: Caffeine Toxicity

Contributor: Taylor Lynch, MD Educational Pearls: Excessive caffeine intake can be dangerous. For normal adults, the toxicity level starts at 1000mg, which is equivalent to about 10 cups of coffe...

5 Okt 3min

Podcast 1023: Torsades de pointes

Contributor: Aaron Lessen, MD Educational Pearls: Case review of a patient with recurrent episodes of syncope and shortness of breath, during which she is found to have intermittent runs of polymorp...

28 Sep 5min

Podcast 1022: Emergent Dialysis

Contributor: Taylor Lynch, MD Educational Pearls: When a patient who missed dialysis presents to the emergency department, our clinical concern is who needs to be admitted to the hospital for emerge...

21 Sep 4min

Podcast 1021: Pulmonary Edema From Naloxone Administration

Contributor: Travis Barlock, MD Educational Pearls: What is pulmonary edema? Pulmonary edema is the accumulation of fluid initially in the interstitium of the lungs, that when severe enough can als...

14 Sep 4min

Podcast 1020: Benign Paroxysmal Positional Vertigo (BPPV)

Contributor: Alec Coston, MD Educational Pearls: Benign Paroxysmal Positional Vertigo (BPPV) Common inner ear condition that can cause dizziness Diagnosis of BPPV can help to avoid admissions and ...

7 Sep 6min

Podcast 1019: Trauma Blunt Cardiovascular Injuries (BCVI)

Contributor: Aaron Lessen, MD Educational Pearls: Blunt cerebrovascular injury (BCVI) BCVI is a traumatic injury to the carotid or vertebral arteries Patients may initially have no neurologic sy...

31 Aug 3min

Podcast 1018: Occult Ventricular Fibrillation on Echocardiography

Contributor: Aaron Lessen, MD Educational Pearls: Big question in cardiac arrest: is the rhythm shockable? Shockable: ventricular fibrillation (VF) and pulseless ventricular tachycardia Non-sho...

24 Aug 2min