Impedance Threshold Devices during cardiac arrest

[Smash]

Anyone using these?

I'm sorry if you are, they are a complete waste of time and money:

Aufderhide TP et al (The ROC Investigators) A trial of an impedance threshold device in out-of-hospital cardiac arrest. New England Journal of Medicine. 2011 Sep 1 ;365(9):798-806.

This was a blinded, prospective trial: 8718 patients were enrolled in ten centres throughout the US and Canada, 4345 using a sham ITD and 4373 using a real ITD.

No difference was found between either groups in terms of ROSC, survival to hospital, survival to home or neurological function post arrest.

Another example of manufacturers selling us rubbish with no science in order to turn a buck?

 

[BEorP]

I don't think it is fair to completely bash the concept as they were reported to improve ROSC rates before, which is all that was known before ROC PRIMED. That is more evidence than we have for a lot of things we do! That said, you're completely correct that no one should be using them now with the current evidence. Then again, people still use mechanical CPR so maybe ITDs will continue selling!

 

[JJR512]

As an EMT-B, I don't know much about ITDs. But I do recall seeing something favorable about them in the current issue of JEMS, so I looked it up online.

Next, we learned that creating a negative intrathoracic pressure with the ResQPod (ITD) increased blood return to the heart and improved both survival and neurological outcome.

...now it’s come back to good ol’ chest compressions along with a few other additions like the ITD and the advancement of ACD CPR.

Link to article: http://www.jems.com/article/patient-care/study-measures-sodium-nitroprusside-cpr

 

[MasterIntubator]

We stopped using them in 1997.

 

[VCEMT]

We use 'em. Probably for the same study. When the study started, back in '09, every EMT was authorized to drop Kingtubes with a ResQpod. Whatever...

 

[Melclin]

Those poor companies. They just can't catch a break can they. Go and pick on someone your own size, science.

 

[BEorP]

We use 'em. Probably for the same study. When the study started, back in '09, every EMT was authorized to drop Kingtubes with a ResQpod. Whatever...

If you're still using them and if half of them aren't shams then you were not part of ROC PRIMED (the study mentioned in the OP).

 

[VCEMT]

And...

 

[MasterIntubator]

Shoot... I got the year wrong.... 2007. End of 2005 is when we got them and played with them.

 

[jjesusfreak01]

We still use them, and we have very high ROSC and survival rates. I think the MD is waiting for the studies to stop contradicting each other before we take them off of the trucks.

 

[BEorP]

We still use them, and we have very high ROSC and survival rates. I think the MD is waiting for the studies to stop contradicting each other before we take them off of the trucks.

Your MD should probably stop waiting. ROC PRIMED was pretty definitive on the ITD.