RIALTO’S RESUSCITATION TOOLKIT
we have always done. We need to ask, in no
uncertain terms, does every single thing I do
in the cardiac arrest setting improve neurologically intact survival. If not, why do we do it?
The RFD is hopeful that you’ve unlearned
some of the things you were previously taught
and are motivated to evaluate this new paradigm and how it could increase cardiac survivability in your community. JEMS
Joe Powell, EMT-P is the EMS coordinator for the Rialto
(Calif.) Fire Department.
Kevin Dearden, BS, EM T-P, is the EMS quality improvement
coordinator for the Rialto (Calif.) Fire Department.
Sean Grayson, MS, EMT-P, is the fire chief for the Rialto
(Calif.) Fire Department.
1. American Heart Association. (2017.) CPR facts and stats. Retrieved
Oct. 27, 2017, from http://cpr.heart.org/AHAECC/CPRAndECC/
2. Rialto Fire Department. (2017.) Rialto Fire Department operations
manual. [Internal document.]
3. Duchateau FX, Gueye P, Curac S, et al. Effect of the AutoPulse automated band chest compression device on hemodynamics in
out-of-hospital cardiac arrest resuscitation. Intensive Care Med.
2010; 36( 7):1256–1260.
4. Farkus J. (July 2, 2014.) Preoxygenation and apneic oxygenation using a nasal cannula. PulmCrit (EMCrit). Retrieved Oct. 27,
2017, from www.pulmcrit.org/2014/07/preoxygenation-apneic-
5. Langhelle A, Strømme T, Sunde K, et al. Inspiratory impedance
threshold valve during CPR. Resuscitation. 2002; 52( 1): 39-48.
6. Lurie KG, Mulligan KA, McKnite S, et al. Optimizing standard cardiopulmonary resuscitation with an inspiratory impedance threshold
valve. Chest. 1998;113( 4):1084–1090.
7. Yannopoulos D, Aufderheide TP, Abella BS, et al. Quality of CPR: An
important effect modifier in cardiac arrest clinical outcomes and
intervention effectiveness trials. Resuscitation. 2015;94:106–113.
8. Frascone RJ. And the dead shall rise: Head up CPR & the revolutionary research model used to develop it. JEMS. 2017; 42( 1): 33–37.
9. Debaty G, Shin SD, Metzger A, et al. Tilting for perfusion: Head-up
position during cardiopulmonary resuscitation improves brain flow
in a porcine model of cardiac arrest. Resuscitation. 2015;87: 38–34.
10. Soar J, Nolan JP, Böttiger BW, et al. European Resuscitation Council
Guidelines for Resuscitation 2015: Section 3. Adult advanced life
support. Resuscitation. 2015;95:100–147.
11. UCSD Center for Resuscitation Science. (2014.) 2014 UCSD
Medical Center Advanced Resuscitation Training Manual. UC San Diego Health. Retrieved Oct. 27, 2017, from
12. Hagihara A, Hasegawa M, Abe T, et al. Prehospital epinephrine
use and survival among patients with out-of-hospital cardiac
arrest. JAMA. 2012;307( 11):1161–1168.
The ResQPOD ITD acts as a one-way valve which lowers thoracic pressure, creating a vacuum that pulls more
blood back to the heart, increasing preload while decreasing intracranial pressure to allow for quality cerebral perfusion.
From an ergonomic and effectiveness perspective, heads-up CPR can only be performed with an automated
CPR device and should only be performed with an ITD in place to maximize the pressure variant and cerebral perfusion.