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Physiology-Driven Resuscitation in Cardiac Arrest

Building Better Cardiac Arrest Care – Part 2


For many years the approach to patients in cardiac arrest has been held hostage by algorithmic care that stifled innovation and did nothing to improve overall survival. Now a combination of new technology, and a realization that one size does not fit all, has led to innovative approaches to the two goals of cardiac arrest care:

  1. To rapidly optimize cardio-cerebral perfusion.
  2. To find & treat reversible causes of cardiac arrest.

Like the previous post on the Lucas device & Cognitive Offloading, this is part of the “Building Better Cardiac Arrest Care” series that will highlight both new tools and new concepts that move us away from algorithmic care in favor of approaches designed to fit the needs of local environments – where decisions are driven by real-time feedback on the quality of our CPR, and a more rapid assessment of the patient’s pathophysiology.

Today, we’re going to introduce the Zoll-R defibrillator by sharing an incredibly useful resource by my friend Dr Jim Horowitz. This iBook is filled with useful tips and videos on how to use the device (neither of us have a financial interest in Zoll), and over the course of the series Jim will join us to highlight effective strategies for integrating the new features of this tool into cardiac arrest care.

What’s New

If you’re already familiar with the new Zoll-R, you know it provides all the same features and has the same “knobology” as older models but with three big changes:

  • An accelerometer that is placed on the chest with the pads
  • Integration of the monitor leads with the defibrillation pads into one unit
  • Filtering software that allows you to see the patient’s underlying cardiac rhythm.


Combined with a new dashboard, integrated ETCO2, and the standard features of a monitor/defibrillator the new machine can give you detailed real-time feedback on the quality of your resuscitation in ways not previously available.

Over the next few posts we will discuss how these new tools come into play in cardiac arrest care, and how to use them to optimize cardio-cerebral perfusion by: assessing quality of chest compressions, minimizing interruptions, and streamlining rhythm and pulse checks.

— Check this space…

Zoll-R Quick Reference Guide:  4-1da-r-series-quick-guide

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