Brendan Schultz

Paramedic / researcher / clinical guideline writer @QldAmbulance views my own

[Zachary Munn @ZacMunn]

Our team are incredibly excited to work with (and become part of) the vibrant and passionate MND community in Australia. With this guideline we aim to make a positive impact in care and outcomes for those with lived experience of MND.

[Peter Antevy @HandtevyMD]

"What's your Utstein?"

This is a phrase heard by agencies "flexing" their OHCA stat muscles.

First, for the definition:
Utstein survival is the term used for survival of patients who suffered a:
1. Witnessed arrest
2. With an initial shockable rhythm (VF/VT)

But......

That value includes ALL survivors (CPC 1-4).

A more clinically relevant value is the CPC 1-2 Utstein survivor percentage. To get that you need to do the math yourself (using the CARES flow sheet)

Take this example:
- Agency 1 has 20 Witnessed arrests with an initial shockable rhythm (Utstein). All 20 lived with CPCs of 4 (coma/vegetative state).

Their Utstein survival is 100%

- Agency 2 also has 20 Witnessed arrests with an initial shockable rhythm. 15 died, but the 5 who lived all had CPC 1-2 (normal or slightly disabled).

Their Utstein survival is 25%.

Agency 1 looks better on paper, but agency 2 has better clinical outcomes.

Using the Utstein Survival Report Below:
In the US in 2023, there were 14,033 witnessed arrests with an initial rhythm of VF/VT. Of those, 3,266 were discharged with a CPC of 1-2.

The neuro-intact Utstein survival for the US in 2023 was 23.3%.

This is the number that communities should be tracking yearly. Ask your CARES representative for your data to see how your community is doing.

[Brendan Schultz @bvschultz]

@armyemdoc @richardarmour99 ‘some dude from australia’ is 100% is right, 4mg is an massive dose…

we use 1.6 IM in our jurisdiction with good effect

https://t.co/a4EjAJiRLj

[Clinical Toxicology @Clin_Tox]

Is epinephrine harmful in volatile substance use-induced cardiac arrest? Editorial by @bobhoffmd https://t.co/YMPdb3SIIQ

[Clinical Toxicology @Clin_Tox]

In this study of 52,102 out-of-hospital cardiac arrests, 22 (0.04%) occurred after volatile substance use. Within this subset, administration of epinephrine was associated with a lower risk of survival to discharge. https://t.co/VxMX29rQZ6

[Adam Rolley @arolley]

Led by @bvschultz, we explored survival outcomes from #OHCA secondary to volatile substance use in Qld, Australia (2012-21). This is a rare event, predominately in adolescence, but with relatively favourable outcomes. Read more below:
https://t.co/GL9dxrfn7G

[Katherine Isoardi @KIsoardi]

Our experience of a thebaine poisoning cluster when non-food grade poppy seeds entered the Australian food supply is now published - free prints here @Clin_Tox @1darren1Dmr
https://t.co/DSwtrOerWh

[Brendan Schultz @bvschultz]

Unnecessary PIVC insertion exposes patients to potential harm.

In 2022, 32.2% of PIVCs inserted by QAS paramedics were not used before arriving at hospital and remained ‘idle’.

We’re addressing this by updating our clinical practice manual. https://t.co/TVCeAHi4Yf

[Brendan Schultz @bvschultz]

Massive congratulations to @QldAmbulance deputy medical directors Claire Bertenshaw & Daniel Bodnar who both received grants!

[EMFoundation @emfresearch]

We're very pleased to announce grant recipients for Round 39 of the EMF Queensland Research Program. Read about the diverse projects and collaborations being funded🔗https://t.co/pJabALrrUh
Congratulations to all involved and thanks to @qldhealth #emfresearch #emergencymedicine

[Amy Gomes (Craike) @AmesCraike]

Excited to announce the pre-order of my kid’s book about #Paramedics.
- Educational, incl practice 000 audio;
- Linked book reading with @GregPage_Yellow and Auslan component;
- Raising money for Heart of the Nation;
- AED/CPR awareness.
https://t.co/V94hvkNcTe

[Brendan Schultz @bvschultz]

@navid_zd absolute pleasure showing you around @navid_zd !

[Australian Resuscitation Council @ARC_resus]

📣 The Australian Resuscitation and NZ Councils have launched our revamped ANZCOR guidelines.
Check out our new user-friendly format, organised by sections and treatment recommendations.
Visit AU/NZ websites, click 'Guidelines' to explore the latest life-saving science.

[Brendan Schultz @bvschultz]

@Paul72309704 @real_michaelfox @BrianHaskinsPhd @ARC_resus @victoriauninews @LaTrobeRHS @VACAR_AV @Monash_SPHPM @AmbulanceVic @ACParamedicine @PEC_ANZ Hi Paul

That’s incorrect - we extended amiodarone to our ALS scope in QLD in 2022.

[Brendan Schultz @bvschultz]

@nathan_warner We’ve been using the corpus in QLD since ~2016. Has its pros & cons like most pieces of equipment.

[Brendan Schultz @bvschultz]

@Aidan_Baron @BrooksWalsh @DCollingsHughes We’ve been doing stacked shocks in special circumstances (adult, paramedic witnessed, cardiac aetiology) in QLD for a number of years.

Vast majority of this cohort are STEMIs that arrest that already have pads attached; anecdotally works well

https://t.co/2h8mjoiHlj

[Brendan Schultz @bvschultz]

@Aidan_Baron ambulance technician or out-of-hospital technician

[Brendan Schultz @bvschultz]

@StevenCBrooks @jab_doc 85j not sure…..

[Brendan Schultz @bvschultz]

@MatthewHumar @JamesOz1 @ben_meadley @happytegs @TobyStClair1 QAS registry is sound. It would be pragmatic if we could develop a collaborative AUS + NZ registry to quantify & progress practice

[Brendan Schultz @bvschultz]

@BronsGoated23 @PepiKostovski @NEfstathis

[Brendan Schultz @bvschultz]

@jcarlyon @IG_Bennett time will tell; it’s a nifty device & super practical - 85j is better than 0.. but is 85j noninferior to the 200j most other AEDs provide