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Article: And the Dead Shall Rise: Head-up CPR and the revolutionary research model used to develop it.

Frascone, Ralph J

JEMS : a journal of emergency medical services

2017 Volume 42, Issue 1, Page(s) 33–37

MeSH term(s)	Animals ; Cadaver ; Cardiopulmonary Resuscitation/methods ; Cerebrovascular Circulation/physiology ; Emergency Medical Services ; Emergency Treatment/methods ; Hemodynamics/physiology ; Humans ; Out-of-Hospital Cardiac Arrest/therapy ; Patient Positioning ; Research Design ; Swine
Language	English
Publishing date	2017
Publishing country	United States
Document type	Journal Article
ZDB-ID	1292428-3
ISSN	0197-2510
ISSN	0197-2510
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Article ; Online: The risk versus benefit of LUCAS: is it worth it?

Frascone, Ralph J

Anesthesiology

2014 Volume 120, Issue 4, Page(s) 797–798

MeSH term(s)	Cardiopulmonary Resuscitation/adverse effects ; Cardiopulmonary Resuscitation/methods ; Heart Arrest/therapy ; Heart Massage/adverse effects ; Heart Massage/methods ; Humans ; Male ; Pancreas/injuries ; Wounds, Nonpenetrating/etiology
Language	English
Publishing date	2014-04
Publishing country	United States
Document type	Comment ; Editorial
ZDB-ID	269-0
ISSN	1528-1175 ; 0003-3022
ISSN (online)	1528-1175
ISSN	0003-3022
DOI	10.1097/ALN.0000000000000146
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Article: Resuscitation outcomes consortium (ROC) studies dig deep into the science of CPR.

Lurie, Keith / Frascone, Ralph J / Goodloe, Jeffrey M

JEMS : a journal of emergency medical services

2017 Volume 42, Issue 1, Page(s) 29–32

MeSH term(s)	Cardiopulmonary Resuscitation/standards ; Emergency Medical Services/standards ; Emergency Treatment/standards ; Humans ; Out-of-Hospital Cardiac Arrest/diagnosis ; Out-of-Hospital Cardiac Arrest/therapy ; Quality Assurance, Health Care ; United States
Language	English
Publishing date	2017
Publishing country	United States
Document type	Journal Article
ZDB-ID	1292428-3
ISSN	0197-2510
ISSN	0197-2510
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Article ; Online: A Case of Neurologically Intact Survival after 2 hours and 50 minutes of Euthermic Cardiac Arrest Treated with Mechanical CPR and Intra-arrest Percutaneous Coronary Intervention.

Burnett, Aaron Michael / Frascone, Ralph J / Brechtken, Johannes / Warren, David / Roach, Brian / Zinkel, Andrew R

Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors

2018 Volume 23, Issue 3, Page(s) 430–433

Abstract: We report a case of a 56 year old male in ventricular fibrillation (VF) cardiac arrest for a total of 2 hours and 50 minutes who was diagnosed with ST elevation myocardial infarction (STEMI) during a brief 10 min period of return of spontaneous ... ...

Abstract	We report a case of a 56 year old male in ventricular fibrillation (VF) cardiac arrest for a total of 2 hours and 50 minutes who was diagnosed with ST elevation myocardial infarction (STEMI) during a brief 10 min period of return of spontaneous circulation (ROSC). The patient underwent successful percutaneous coronary intervention (PCI) while receiving mechanical chest compressions for ongoing VF. Our case demonstrates the potential for neurologically intact survival in VF cardiac arrest patients despite prolonged periods of VF who are treated with mechanical CPR and intra-arrest PCI.
MeSH term(s)	Cardiopulmonary Resuscitation/instrumentation ; Defibrillators ; Emergency Medical Services ; Heart Arrest/therapy ; Humans ; Male ; Middle Aged ; Percutaneous Coronary Intervention ; ST Elevation Myocardial Infarction ; Survival ; Time Factors ; Treatment Outcome ; Ventricular Fibrillation/therapy
Language	English
Publishing date	2018-09-10
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	1461751-1
ISSN	1545-0066 ; 1090-3127
ISSN (online)	1545-0066
ISSN	1090-3127
DOI	10.1080/10903127.2018.1506842
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Article ; Online: Use of an intraosseous device for invasive pressure monitoring in the ED.

Frascone, Ralph J / Salzman, Joshua G / Ernest, Eric V / Burnett, Aaron M

The American journal of emergency medicine

2014 Volume 32, Issue 6, Page(s) 692.e3–4

Abstract: Venous access is essential to providing emergency care for critically ill or injured patients. Obtaining peripheral or central access can be problematic and time consuming. Intraosseous (IO) fluid administration provides similar flow rates and central ... ...

Abstract	Venous access is essential to providing emergency care for critically ill or injured patients. Obtaining peripheral or central access can be problematic and time consuming. Intraosseous (IO) fluid administration provides similar flow rates and central circulation times compared to central lines, but use of these devices to monitor blood pressure has not been explored. We report a case of successful IO pressure (IOP) monitoring through an IO during the resuscitation of a 31-year-old male. This is the first report of monitoring IOP in a clinical setting and comparing it to traditional measures of central pressure.
MeSH term(s)	Adult ; Blood Pressure ; Blood Pressure Monitors ; Emergency Service, Hospital ; Fatal Outcome ; Humans ; Infusions, Intraosseous/methods ; Male ; Monitoring, Physiologic/instrumentation ; Monitoring, Physiologic/methods ; Out-of-Hospital Cardiac Arrest/physiopathology ; Out-of-Hospital Cardiac Arrest/therapy
Language	English
Publishing date	2014-06
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	605890-5
ISSN	1532-8171 ; 0735-6757
ISSN (online)	1532-8171
ISSN	0735-6757
DOI	10.1016/j.ajem.2013.12.029
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Article ; Online: Improved Survival With Extracorporeal Cardiopulmonary Resuscitation Despite Progressive Metabolic Derangement Associated With Prolonged Resuscitation.

Bartos, Jason A / Grunau, Brian / Carlson, Claire / Duval, Sue / Ripeckyj, Adrian / Kalra, Rajat / Raveendran, Ganesh / John, Ranjit / Conterato, Marc / Frascone, Ralph J / Trembley, Alexander / Aufderheide, Tom P / Yannopoulos, Demetris

Circulation

2020 Volume 141, Issue 11, Page(s) 877–886

Abstract: Background: The likelihood of neurologically favorable survival declines with prolonged resuscitation. However, the ability of extracorporeal cardiopulmonary resuscitation (ECPR) to modulate this decline is unknown. Our aim was to examine the effects of ...

Abstract	Background: The likelihood of neurologically favorable survival declines with prolonged resuscitation. However, the ability of extracorporeal cardiopulmonary resuscitation (ECPR) to modulate this decline is unknown. Our aim was to examine the effects of resuscitation duration on survival and metabolic profile in patients who undergo ECPR for refractory ventricular fibrillation/ventricular tachycardia out-of-hospital cardiac arrest. Methods: We retrospectively evaluated survival in 160 consecutive adults with refractory ventricular fibrillation/ventricular tachycardia out-of-hospital cardiac arrest treated with the University of Minnesota (UMN) ECPR protocol (transport with ongoing cardiopulmonary resuscitation [CPR] to the cardiac catheterization laboratory for ECPR) compared with 654 adults who had received standard CPR in the amiodarone arm of the ALPS trial (Amiodarone, Lidocaine, or Placebo Study). We evaluated the metabolic changes and rate of survival in relation to duration of CPR in UMN-ECPR patients. Results: Neurologically favorable survival was significantly higher in UMN-ECPR patients versus ALPS patients (33% versus 23%; Conclusions: ECPR was associated with improved neurologically favorable survival at all CPR durations <60 minutes despite severe progressive metabolic derangement. However, CPR duration remains a critical determinate of survival.
MeSH term(s)	Acidosis, Lactic/etiology ; Advanced Cardiac Life Support ; Amiodarone/therapeutic use ; Brain Damage, Chronic/etiology ; Brain Damage, Chronic/prevention & control ; Cardiopulmonary Resuscitation/adverse effects ; Cardiopulmonary Resuscitation/methods ; Cohort Studies ; Double-Blind Method ; Electric Countershock ; Extracorporeal Membrane Oxygenation ; Female ; Humans ; Hypercapnia/etiology ; Hypoxia/etiology ; Male ; Middle Aged ; Multicenter Studies as Topic/statistics & numerical data ; Out-of-Hospital Cardiac Arrest/complications ; Out-of-Hospital Cardiac Arrest/mortality ; Out-of-Hospital Cardiac Arrest/therapy ; Randomized Controlled Trials as Topic/statistics & numerical data ; Retrospective Studies ; Survival Rate ; Tachycardia, Ventricular/complications ; Tachycardia, Ventricular/therapy ; Time Factors ; Treatment Outcome ; Ventricular Fibrillation/complications ; Ventricular Fibrillation/therapy
Chemical Substances	Amiodarone (N3RQ532IUT)
Language	English
Publishing date	2020-01-03
Publishing country	United States
Document type	Comparative Study ; Journal Article
ZDB-ID	80099-5
ISSN	1524-4539 ; 0009-7322 ; 0069-4193 ; 0065-8499
ISSN (online)	1524-4539
ISSN	0009-7322 ; 0069-4193 ; 0065-8499
DOI	10.1161/CIRCULATIONAHA.119.042173
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Article ; Online: Supraglottic airway devices variably develop negative intrathoracic pressures: A prospective cross-over study of cardiopulmonary resuscitation in human cadavers.

Holley, Joe / Moore, Johanna C / Jacobs, Michael / Rojas-Salvador, Carolina / Lick, Charles / Salverda, Bayert J / Lick, Michael C / Frascone, Ralph J / Youngquist, Scott T / Lurie, Keith G

Resuscitation

2020 Volume 148, Page(s) 32–38

Abstract: Aim of the study: Negative intrathoracic pressure (ITP) during the decompression phase of cardiopulmonary resuscitation (CPR) is essential to refill the heart, increase cardiac output, maintain cerebral and coronary perfusion pressures, and improve ... ...

Abstract	Aim of the study: Negative intrathoracic pressure (ITP) during the decompression phase of cardiopulmonary resuscitation (CPR) is essential to refill the heart, increase cardiac output, maintain cerebral and coronary perfusion pressures, and improve survival. In order to generate negative ITP, an airway seal is necessary. We tested the hypothesis that some supraglottic airway (SGA) devices do not seal the airway as well the standard endotracheal tube (ETT). Methods: Airway pressures (AP) were measured as a surrogate for ITP in seven recently deceased human cadavers of varying body habitus. Conventional manual, automated, and active compression-decompression CPR were performed with and without an impedance threshold device (ITD) in supine and Head Up positions. Positive pressure ventilation was delivered by an ETT and 5 SGA devices tested in a randomized order in this prospective cross-over designed study. The primary outcome was comparisons of decompression AP between all groups. Results: An ITD was required to generate significantly lower negative ITP during the decompression phase of all methods of CPR. SGAs varied in their ability to support negative ITP. Conclusion: In a human cadaver model, the ability to generate negative intrathoracic pressures varied with different SGAs and an ITD regardless of the body position or CPR method. Differences in SGAs devices should be strongly considered when trying to optimize cardiac arrest outcomes, as some SGAs do not consistently develop a seal or negative intrathoracic pressure with multiple different CPR methods and devices.
MeSH term(s)	Cadaver ; Cardiopulmonary Resuscitation ; Cross-Over Studies ; Heart Arrest/therapy ; Humans ; Prospective Studies
Language	English
Publishing date	2020-01-18
Publishing country	Ireland
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	189901-6
ISSN	1873-1570 ; 0300-9572
ISSN (online)	1873-1570
ISSN	0300-9572
DOI	10.1016/j.resuscitation.2019.12.022
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Article ; Online: Medical preparation for the 2008 Republican National Convention: a practical guide.

Dries, David J / Frascone, Ralph J / Hick, John L / Salzman, Josh

The journal of trauma and acute care surgery

2012 Volume 73, Issue 6, Page(s) 1614–1623

MeSH term(s)	Civil Defense/manpower ; Civil Defense/methods ; Civil Defense/organization & administration ; Congresses as Topic/organization & administration ; Emergency Medical Services/manpower ; Emergency Medical Services/organization & administration ; Humans ; Minnesota ; Politics ; Security Measures ; Terrorism
Language	English
Publishing date	2012-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	2651070-4
ISSN	2163-0763 ; 2163-0755
ISSN (online)	2163-0763
ISSN	2163-0755
DOI	10.1097/TA.0b013e3182769f48
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Article: 12-lead electrocardiograms during basic life support care.

Provo, Terry A / Frascone, Ralph J

Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors

2004 Volume 8, Issue 2, Page(s) 212–216

Abstract: Objectives: Prehospital 12-lead electrocardiograms (PTLs) decrease time to thrombolytics. Paramedics have performed them successfully for years, but emergency medical technicians (EMTs) have not typically performed them. To determine whether PTLs could ... ...

Abstract	Objectives: Prehospital 12-lead electrocardiograms (PTLs) decrease time to thrombolytics. Paramedics have performed them successfully for years, but emergency medical technicians (EMTs) have not typically performed them. To determine whether PTLs could be considered a basic life support (BLS) skill, the authors conducted a pilot study to determine whether scene times are lengthened when EMTs obtain PTLs, whether EMTs can appropriately select patients for PTLs, and what value physicians place on prehospital PTLs. Methods: The authors prospectively evaluated PTL performance in four BLS agencies. EMTs provided standard cardiac care to patients on even days. On odd days, they additionally performed a PTL. Scene times of patients receiving a PTL (n=77) were compared with scene times of similar patients not receiving one (n=100). Results: EMTs attempted to perform 101 PTLs, of which 77 were eligible for inclusion. The mean scene time [95% confidence interval] of patients on even days (no 12-lead) was 11.9 [11.0, 12.8] minutes, compared with 16.9 [15.8, 18.0] minutes for patients who received a PTL. Scene times increased by 5.0 [3.6, 6.4] minutes when a PTL was added to the evaluation. Physician feedback was received on 63 of 77 PTLs. Receiving physicians agreed that 59 of 63 (93.6%) patients needed the PTL and found them moderately helpful (3.56 on a 1 to 5 scale). Conclusion: When EMTs performed PTLs, scene times increased approximately 5 minutes. Most physicians agreed that the PTL was indicated. PTL acquisition by EMTs appears feasible with slightly lengthened scene times, but evaluation in other BLS agencies is necessary to validate this conclusion.
MeSH term(s)	Adult ; Aged ; Cardiopulmonary Resuscitation/methods ; Case-Control Studies ; Decision Making ; Electrocardiography/methods ; Emergency Medical Services/methods ; Emergency Medical Technicians/education ; Emergency Medical Technicians/psychology ; Female ; Humans ; Male ; Middle Aged ; Myocardial Ischemia/diagnosis ; Patient Selection ; Pilot Projects ; Prospective Studies ; Time Factors
Language	English
Publishing date	2004-01-01
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1461751-1
ISSN	1545-0066 ; 1090-3127
ISSN (online)	1545-0066
ISSN	1090-3127
DOI	10.1016/s1090-3127(03)00222-3
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Article ; Online: Marathon runner prolonged normothermic cardiopulmonary arrest and neurologically intact survival.

Tanghe, Peter / Frascone, Ralph J / Russi, Christopher / Salzman, Joshua G / Kaye, Koren / Roberts, William O

Current sports medicine reports

2013 Volume 12, Issue 3, Page(s) 141–142

MeSH term(s)	Adult ; Anaerobic Threshold ; Cardiopulmonary Resuscitation ; Heart Arrest/diagnosis ; Heart Arrest/etiology ; Heart Arrest/therapy ; Humans ; Male ; Nervous System Diseases/diagnosis ; Nervous System Diseases/etiology ; Nervous System Diseases/therapy ; Running ; Ventricular Fibrillation/diagnosis ; Ventricular Fibrillation/etiology ; Ventricular Fibrillation/therapy
Language	English
Publishing date	2013-05
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	2080040-X
ISSN	1537-8918 ; 1537-890X
ISSN (online)	1537-8918
ISSN	1537-890X
DOI	10.1249/JSR.0b013e3182927534
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