RE: Dr. Bledsoe - Autopulse

[Guest guest]

Kenny: I was at the same Gathering of Eagles conference as you. A couple

of things that I took from it is that: Dr. Ornato

is on the technical advisory board for Zoll so the detractors will

immediately say that this influenced their leanings. The conference

itself is very interesting and worth the time. I would recommend it to

all.

If they are able to get a ROSC (return of spontaneous circulation), then

it is something worthy of a look. The Riverside County, California study

was stopped because of fractured ribs, but someone else gave the data

that manual CPR causes fractured ribs 31% of the time. The ASPIRE study

was stopped, but no one knows why?

It may need to be applied early if repeated randomized, controlled

studies prove its efficacy. The biggest problem I see is that they are

still around $10,000. A hefty price tag for a small service.

We'll keep our eyes open.

Lt. Steve Lemming, AAS, LP

EMS Administration Officer

C-Shift

Azle, Texas Fire Department

This e-mail is confidential and intended solely for the use of the

individual (s) to whom it is addressed. Any views or opinions presented

are solely those of the author and do not necessarily represent those of

The City of Azle or its policies. If you have received this e-mail

message in error, please phone Steve Lemming (817)444-7108. Please also

destroy and delete the message from your computer.

For more information on The City of Azle, visit our web site at:

<http://azle.govoffice.com/ <http://azle.govoffice.com/> >

Dr. Bledsoe - Autopulse

,

I thought about sending this to you privately, but I think the

message is important enough for everyone. This weekend in Dallas,

Dr. Ornato presented some preliminary findings from a randomized

observational Autopulse study that was conducted in Richmond. (The

study will be published soon, but I don't have any details.)

I don't have all my notes with me, but he reported the study had

some positive results. Medics in his system were directed to place

the Autopulse as early in the cardiac arrest as was possible while

not interrupting manual closed chest compressions. Primary outcome

was ROSC. Secondary endpoints were survival to ER admission,

survival to ICU admission, and survival to hospital discharge.

The Autopulse patients were more numerous in all end point

categories compared with manual closed chest compressions. However,

when the discharged patients were evaluated using two different

cerebral performance scores, they found NO statistically significant

differences in neurological outcomes.

Dr. Terry (I can't remember his last name) from Tucson was part of a

group that evaluated interim data from the ASPIRE Autopulse study

that was stopped last summer. His group recommended terminating the

study because it was clear that a higher percentage of patients died

(almost twice as many) when the Autopulse was used compared to

manual CPR.

When the two were questioned about the vastly different outcomes

from the two studies, neither could explain it. Dr. Ornato

suggested that the Autopulse may be very time dependant (must be

applied with a couple of minutes of arrest.)

All of the Medical Directors at the meeting advised that systems

without the device should probably not purchase one until more

definitive data is available.

A third study is planned but no details were available.

OK, now everyone can start the debate!

Kenny Navarro

UT Southwestern Medical Center

[Guest guest]

Kenny: I was at the same Gathering of Eagles conference as you. A couple

of things that I took from it is that: Dr. Ornato

is on the technical advisory board for Zoll so the detractors will

immediately say that this influenced their leanings. The conference

itself is very interesting and worth the time. I would recommend it to

all.

If they are able to get a ROSC (return of spontaneous circulation), then

it is something worthy of a look. The Riverside County, California study

was stopped because of fractured ribs, but someone else gave the data

that manual CPR causes fractured ribs 31% of the time. The ASPIRE study

was stopped, but no one knows why?

It may need to be applied early if repeated randomized, controlled

studies prove its efficacy. The biggest problem I see is that they are

still around $10,000. A hefty price tag for a small service.

We'll keep our eyes open.

Lt. Steve Lemming, AAS, LP

EMS Administration Officer

C-Shift

Azle, Texas Fire Department

This e-mail is confidential and intended solely for the use of the

individual (s) to whom it is addressed. Any views or opinions presented

are solely those of the author and do not necessarily represent those of

The City of Azle or its policies. If you have received this e-mail

message in error, please phone Steve Lemming (817)444-7108. Please also

destroy and delete the message from your computer.

For more information on The City of Azle, visit our web site at:

<http://azle.govoffice.com/ <http://azle.govoffice.com/> >

Dr. Bledsoe - Autopulse

,

I thought about sending this to you privately, but I think the

message is important enough for everyone. This weekend in Dallas,

Dr. Ornato presented some preliminary findings from a randomized

observational Autopulse study that was conducted in Richmond. (The

study will be published soon, but I don't have any details.)

I don't have all my notes with me, but he reported the study had

some positive results. Medics in his system were directed to place

the Autopulse as early in the cardiac arrest as was possible while

not interrupting manual closed chest compressions. Primary outcome

was ROSC. Secondary endpoints were survival to ER admission,

survival to ICU admission, and survival to hospital discharge.

The Autopulse patients were more numerous in all end point

categories compared with manual closed chest compressions. However,

when the discharged patients were evaluated using two different

cerebral performance scores, they found NO statistically significant

differences in neurological outcomes.

Dr. Terry (I can't remember his last name) from Tucson was part of a

group that evaluated interim data from the ASPIRE Autopulse study

that was stopped last summer. His group recommended terminating the

study because it was clear that a higher percentage of patients died

(almost twice as many) when the Autopulse was used compared to

manual CPR.

When the two were questioned about the vastly different outcomes

from the two studies, neither could explain it. Dr. Ornato

suggested that the Autopulse may be very time dependant (must be

applied with a couple of minutes of arrest.)

All of the Medical Directors at the meeting advised that systems

without the device should probably not purchase one until more

definitive data is available.

A third study is planned but no details were available.

OK, now everyone can start the debate!

Kenny Navarro

UT Southwestern Medical Center

[Guest guest]

Kenny: I was at the same Gathering of Eagles conference as you. A couple

of things that I took from it is that: Dr. Ornato

is on the technical advisory board for Zoll so the detractors will

immediately say that this influenced their leanings. The conference

itself is very interesting and worth the time. I would recommend it to

all.

If they are able to get a ROSC (return of spontaneous circulation), then

it is something worthy of a look. The Riverside County, California study

was stopped because of fractured ribs, but someone else gave the data

that manual CPR causes fractured ribs 31% of the time. The ASPIRE study

was stopped, but no one knows why?

It may need to be applied early if repeated randomized, controlled

studies prove its efficacy. The biggest problem I see is that they are

still around $10,000. A hefty price tag for a small service.

We'll keep our eyes open.

Lt. Steve Lemming, AAS, LP

EMS Administration Officer

C-Shift

Azle, Texas Fire Department

This e-mail is confidential and intended solely for the use of the

individual (s) to whom it is addressed. Any views or opinions presented

are solely those of the author and do not necessarily represent those of

The City of Azle or its policies. If you have received this e-mail

message in error, please phone Steve Lemming (817)444-7108. Please also

destroy and delete the message from your computer.

For more information on The City of Azle, visit our web site at:

<http://azle.govoffice.com/ <http://azle.govoffice.com/> >

Dr. Bledsoe - Autopulse

,

I thought about sending this to you privately, but I think the

message is important enough for everyone. This weekend in Dallas,

Dr. Ornato presented some preliminary findings from a randomized

observational Autopulse study that was conducted in Richmond. (The

study will be published soon, but I don't have any details.)

I don't have all my notes with me, but he reported the study had

some positive results. Medics in his system were directed to place

the Autopulse as early in the cardiac arrest as was possible while

not interrupting manual closed chest compressions. Primary outcome

was ROSC. Secondary endpoints were survival to ER admission,

survival to ICU admission, and survival to hospital discharge.

The Autopulse patients were more numerous in all end point

categories compared with manual closed chest compressions. However,

when the discharged patients were evaluated using two different

cerebral performance scores, they found NO statistically significant

differences in neurological outcomes.

Dr. Terry (I can't remember his last name) from Tucson was part of a

group that evaluated interim data from the ASPIRE Autopulse study

that was stopped last summer. His group recommended terminating the

study because it was clear that a higher percentage of patients died

(almost twice as many) when the Autopulse was used compared to

manual CPR.

When the two were questioned about the vastly different outcomes

from the two studies, neither could explain it. Dr. Ornato

suggested that the Autopulse may be very time dependant (must be

applied with a couple of minutes of arrest.)

All of the Medical Directors at the meeting advised that systems

without the device should probably not purchase one until more

definitive data is available.

A third study is planned but no details were available.

OK, now everyone can start the debate!

Kenny Navarro

UT Southwestern Medical Center

[Guest guest]

Might want to talk to Dr. Y, Hurst FD has them and from what I understand

have a pretty high save rate.

Lee

Dr. Bledsoe - Autopulse

,

I thought about sending this to you privately, but I think the

message is important enough for everyone. This weekend in Dallas,

Dr. Ornato presented some preliminary findings from a randomized

observational Autopulse study that was conducted in Richmond. (The

study will be published soon, but I don't have any details.)

I don't have all my notes with me, but he reported the study had

some positive results. Medics in his system were directed to place

the Autopulse as early in the cardiac arrest as was possible while

not interrupting manual closed chest compressions. Primary outcome

was ROSC. Secondary endpoints were survival to ER admission,

survival to ICU admission, and survival to hospital discharge.

The Autopulse patients were more numerous in all end point

categories compared with manual closed chest compressions. However,

when the discharged patients were evaluated using two different

cerebral performance scores, they found NO statistically significant

differences in neurological outcomes.

Dr. Terry (I can't remember his last name) from Tucson was part of a

group that evaluated interim data from the ASPIRE Autopulse study

that was stopped last summer. His group recommended terminating the

study because it was clear that a higher percentage of patients died

(almost twice as many) when the Autopulse was used compared to

manual CPR.

When the two were questioned about the vastly different outcomes

from the two studies, neither could explain it. Dr. Ornato

suggested that the Autopulse may be very time dependant (must be

applied with a couple of minutes of arrest.)

All of the Medical Directors at the meeting advised that systems

without the device should probably not purchase one until more

definitive data is available.

A third study is planned but no details were available.

OK, now everyone can start the debate!

Kenny Navarro

UT Southwestern Medical Center

[Guest guest]

Austin had a flail chest. They are closer to $15,000.00

BEB

_____

From: [mailto: ] On

Behalf Of Lemming, Steve

Sent: Monday, February 20, 2006 10:09 PM

To:

Subject: RE: Dr. Bledsoe - Autopulse

Kenny: I was at the same Gathering of Eagles conference as you. A couple

of things that I took from it is that: Dr. Ornato

is on the technical advisory board for Zoll so the detractors will

immediately say that this influenced their leanings. The conference

itself is very interesting and worth the time. I would recommend it to

all.

If they are able to get a ROSC (return of spontaneous circulation), then

it is something worthy of a look. The Riverside County, California study

was stopped because of fractured ribs, but someone else gave the data

that manual CPR causes fractured ribs 31% of the time. The ASPIRE study

was stopped, but no one knows why?

It may need to be applied early if repeated randomized, controlled

studies prove its efficacy. The biggest problem I see is that they are

still around $10,000. A hefty price tag for a small service.

We'll keep our eyes open.

Lt. Steve Lemming, AAS, LP

EMS Administration Officer

C-Shift

Azle, Texas Fire Department

This e-mail is confidential and intended solely for the use of the

individual (s) to whom it is addressed. Any views or opinions presented

are solely those of the author and do not necessarily represent those of

The City of Azle or its policies. If you have received this e-mail

message in error, please phone Steve Lemming (817)444-7108. Please also

destroy and delete the message from your computer.

For more information on The City of Azle, visit our web site at:

<http://azle.govoffice.com/ <http://azle.govoffice.com/> >

Dr. Bledsoe - Autopulse

,

I thought about sending this to you privately, but I think the

message is important enough for everyone. This weekend in Dallas,

Dr. Ornato presented some preliminary findings from a randomized

observational Autopulse study that was conducted in Richmond. (The

study will be published soon, but I don't have any details.)

I don't have all my notes with me, but he reported the study had

some positive results. Medics in his system were directed to place

the Autopulse as early in the cardiac arrest as was possible while

not interrupting manual closed chest compressions. Primary outcome

was ROSC. Secondary endpoints were survival to ER admission,

survival to ICU admission, and survival to hospital discharge.

The Autopulse patients were more numerous in all end point

categories compared with manual closed chest compressions. However,

when the discharged patients were evaluated using two different

cerebral performance scores, they found NO statistically significant

differences in neurological outcomes.

Dr. Terry (I can't remember his last name) from Tucson was part of a

group that evaluated interim data from the ASPIRE Autopulse study

that was stopped last summer. His group recommended terminating the

study because it was clear that a higher percentage of patients died

(almost twice as many) when the Autopulse was used compared to

manual CPR.

When the two were questioned about the vastly different outcomes

from the two studies, neither could explain it. Dr. Ornato

suggested that the Autopulse may be very time dependant (must be

applied with a couple of minutes of arrest.)

All of the Medical Directors at the meeting advised that systems

without the device should probably not purchase one until more

definitive data is available.

A third study is planned but no details were available.

OK, now everyone can start the debate!

Kenny Navarro

UT Southwestern Medical Center

[Guest guest]

How can that be? The city council in Hurst just approved the purchase in

January of 2006 per the Star Telegram. More anecdote.

_____

From: [mailto: ] On

Behalf Of Lee

Sent: Monday, February 20, 2006 10:16 PM

To:

Subject: RE: Dr. Bledsoe - Autopulse

Might want to talk to Dr. Y, Hurst FD has them and from what I understand

have a pretty high save rate.

Lee

Dr. Bledsoe - Autopulse

,

I thought about sending this to you privately, but I think the

message is important enough for everyone. This weekend in Dallas,

Dr. Ornato presented some preliminary findings from a randomized

observational Autopulse study that was conducted in Richmond. (The

study will be published soon, but I don't have any details.)

I don't have all my notes with me, but he reported the study had

some positive results. Medics in his system were directed to place

the Autopulse as early in the cardiac arrest as was possible while

not interrupting manual closed chest compressions. Primary outcome

was ROSC. Secondary endpoints were survival to ER admission,

survival to ICU admission, and survival to hospital discharge.

The Autopulse patients were more numerous in all end point

categories compared with manual closed chest compressions. However,

when the discharged patients were evaluated using two different

cerebral performance scores, they found NO statistically significant

differences in neurological outcomes.

Dr. Terry (I can't remember his last name) from Tucson was part of a

group that evaluated interim data from the ASPIRE Autopulse study

that was stopped last summer. His group recommended terminating the

study because it was clear that a higher percentage of patients died

(almost twice as many) when the Autopulse was used compared to

manual CPR.

When the two were questioned about the vastly different outcomes

from the two studies, neither could explain it. Dr. Ornato

suggested that the Autopulse may be very time dependant (must be

applied with a couple of minutes of arrest.)

All of the Medical Directors at the meeting advised that systems

without the device should probably not purchase one until more

definitive data is available.

A third study is planned but no details were available.

OK, now everyone can start the debate!

Kenny Navarro

UT Southwestern Medical Center

[Guest guest]

How can that be? The city council in Hurst just approved the purchase in

January of 2006 per the Star Telegram. More anecdote.

_____

From: [mailto: ] On

Behalf Of Lee

Sent: Monday, February 20, 2006 10:16 PM

To:

Subject: RE: Dr. Bledsoe - Autopulse

Might want to talk to Dr. Y, Hurst FD has them and from what I understand

have a pretty high save rate.

Lee

Dr. Bledsoe - Autopulse

,

I thought about sending this to you privately, but I think the

message is important enough for everyone. This weekend in Dallas,

Dr. Ornato presented some preliminary findings from a randomized

observational Autopulse study that was conducted in Richmond. (The

study will be published soon, but I don't have any details.)

I don't have all my notes with me, but he reported the study had

some positive results. Medics in his system were directed to place

the Autopulse as early in the cardiac arrest as was possible while

not interrupting manual closed chest compressions. Primary outcome

was ROSC. Secondary endpoints were survival to ER admission,

survival to ICU admission, and survival to hospital discharge.

The Autopulse patients were more numerous in all end point

categories compared with manual closed chest compressions. However,

when the discharged patients were evaluated using two different

cerebral performance scores, they found NO statistically significant

differences in neurological outcomes.

Dr. Terry (I can't remember his last name) from Tucson was part of a

group that evaluated interim data from the ASPIRE Autopulse study

that was stopped last summer. His group recommended terminating the

study because it was clear that a higher percentage of patients died

(almost twice as many) when the Autopulse was used compared to

manual CPR.

When the two were questioned about the vastly different outcomes

from the two studies, neither could explain it. Dr. Ornato

suggested that the Autopulse may be very time dependant (must be

applied with a couple of minutes of arrest.)

All of the Medical Directors at the meeting advised that systems

without the device should probably not purchase one until more

definitive data is available.

A third study is planned but no details were available.

OK, now everyone can start the debate!

Kenny Navarro

UT Southwestern Medical Center

[Guest guest]

How can that be? The city council in Hurst just approved the purchase in

January of 2006 per the Star Telegram. More anecdote.

_____

From: [mailto: ] On

Behalf Of Lee

Sent: Monday, February 20, 2006 10:16 PM

To:

Subject: RE: Dr. Bledsoe - Autopulse

Might want to talk to Dr. Y, Hurst FD has them and from what I understand

have a pretty high save rate.

Lee

Dr. Bledsoe - Autopulse

,

I thought about sending this to you privately, but I think the

message is important enough for everyone. This weekend in Dallas,

Dr. Ornato presented some preliminary findings from a randomized

observational Autopulse study that was conducted in Richmond. (The

study will be published soon, but I don't have any details.)

I don't have all my notes with me, but he reported the study had

some positive results. Medics in his system were directed to place

the Autopulse as early in the cardiac arrest as was possible while

not interrupting manual closed chest compressions. Primary outcome

was ROSC. Secondary endpoints were survival to ER admission,

survival to ICU admission, and survival to hospital discharge.

The Autopulse patients were more numerous in all end point

categories compared with manual closed chest compressions. However,

when the discharged patients were evaluated using two different

cerebral performance scores, they found NO statistically significant

differences in neurological outcomes.

Dr. Terry (I can't remember his last name) from Tucson was part of a

group that evaluated interim data from the ASPIRE Autopulse study

that was stopped last summer. His group recommended terminating the

study because it was clear that a higher percentage of patients died

(almost twice as many) when the Autopulse was used compared to

manual CPR.

When the two were questioned about the vastly different outcomes

from the two studies, neither could explain it. Dr. Ornato

suggested that the Autopulse may be very time dependant (must be

applied with a couple of minutes of arrest.)

All of the Medical Directors at the meeting advised that systems

without the device should probably not purchase one until more

definitive data is available.

A third study is planned but no details were available.

OK, now everyone can start the debate!

Kenny Navarro

UT Southwestern Medical Center

[Guest guest]

Ok so we have one study that says the device isn't worth throwing away and this

study seems to indicate it may be the greatest thing since CPR itself?

Two different ends of the country are getting two different outcomes from the

use of this device. I have to ask, Did one agency missuse the device or just

fail to understand the criteriea for the study?

Kenny Navarro wrote:

,

I thought about sending this to you privately, but I think the

message is important enough for everyone. This weekend in Dallas,

Dr. Ornato presented some preliminary findings from a randomized

observational Autopulse study that was conducted in Richmond. (The

study will be published soon, but I don't have any details.)

I don't have all my notes with me, but he reported the study had

some positive results. Medics in his system were directed to place

the Autopulse as early in the cardiac arrest as was possible while

not interrupting manual closed chest compressions. Primary outcome

was ROSC. Secondary endpoints were survival to ER admission,

survival to ICU admission, and survival to hospital discharge.

The Autopulse patients were more numerous in all end point

categories compared with manual closed chest compressions. However,

when the discharged patients were evaluated using two different

cerebral performance scores, they found NO statistically significant

differences in neurological outcomes.

Dr. Terry (I can't remember his last name) from Tucson was part of a

group that evaluated interim data from the ASPIRE Autopulse study

that was stopped last summer. His group recommended terminating the

study because it was clear that a higher percentage of patients died

(almost twice as many) when the Autopulse was used compared to

manual CPR.

When the two were questioned about the vastly different outcomes

from the two studies, neither could explain it. Dr. Ornato

suggested that the Autopulse may be very time dependant (must be

applied with a couple of minutes of arrest.)

All of the Medical Directors at the meeting advised that systems

without the device should probably not purchase one until more

definitive data is available.

A third study is planned but no details were available.

OK, now everyone can start the debate!

Kenny Navarro

UT Southwestern Medical Center

[Guest guest]

Ok so we have one study that says the device isn't worth throwing away and this

study seems to indicate it may be the greatest thing since CPR itself?

Two different ends of the country are getting two different outcomes from the

use of this device. I have to ask, Did one agency missuse the device or just

fail to understand the criteriea for the study?

Kenny Navarro wrote:

,

I thought about sending this to you privately, but I think the

message is important enough for everyone. This weekend in Dallas,

Dr. Ornato presented some preliminary findings from a randomized

observational Autopulse study that was conducted in Richmond. (The

study will be published soon, but I don't have any details.)

I don't have all my notes with me, but he reported the study had

some positive results. Medics in his system were directed to place

the Autopulse as early in the cardiac arrest as was possible while

not interrupting manual closed chest compressions. Primary outcome

was ROSC. Secondary endpoints were survival to ER admission,

survival to ICU admission, and survival to hospital discharge.

The Autopulse patients were more numerous in all end point

categories compared with manual closed chest compressions. However,

when the discharged patients were evaluated using two different

cerebral performance scores, they found NO statistically significant

differences in neurological outcomes.

Dr. Terry (I can't remember his last name) from Tucson was part of a

group that evaluated interim data from the ASPIRE Autopulse study

that was stopped last summer. His group recommended terminating the

study because it was clear that a higher percentage of patients died

(almost twice as many) when the Autopulse was used compared to

manual CPR.

When the two were questioned about the vastly different outcomes

from the two studies, neither could explain it. Dr. Ornato

suggested that the Autopulse may be very time dependant (must be

applied with a couple of minutes of arrest.)

All of the Medical Directors at the meeting advised that systems

without the device should probably not purchase one until more

definitive data is available.

A third study is planned but no details were available.

OK, now everyone can start the debate!

Kenny Navarro

UT Southwestern Medical Center

[Guest guest]

Ok so we have one study that says the device isn't worth throwing away and this

study seems to indicate it may be the greatest thing since CPR itself?

Two different ends of the country are getting two different outcomes from the

use of this device. I have to ask, Did one agency missuse the device or just

fail to understand the criteriea for the study?

Kenny Navarro wrote:

,

I thought about sending this to you privately, but I think the

message is important enough for everyone. This weekend in Dallas,

Dr. Ornato presented some preliminary findings from a randomized

observational Autopulse study that was conducted in Richmond. (The

study will be published soon, but I don't have any details.)

I don't have all my notes with me, but he reported the study had

some positive results. Medics in his system were directed to place

the Autopulse as early in the cardiac arrest as was possible while

not interrupting manual closed chest compressions. Primary outcome

was ROSC. Secondary endpoints were survival to ER admission,

survival to ICU admission, and survival to hospital discharge.

The Autopulse patients were more numerous in all end point

categories compared with manual closed chest compressions. However,

when the discharged patients were evaluated using two different

cerebral performance scores, they found NO statistically significant

differences in neurological outcomes.

Dr. Terry (I can't remember his last name) from Tucson was part of a

group that evaluated interim data from the ASPIRE Autopulse study

that was stopped last summer. His group recommended terminating the

study because it was clear that a higher percentage of patients died

(almost twice as many) when the Autopulse was used compared to

manual CPR.

When the two were questioned about the vastly different outcomes

from the two studies, neither could explain it. Dr. Ornato

suggested that the Autopulse may be very time dependant (must be

applied with a couple of minutes of arrest.)

All of the Medical Directors at the meeting advised that systems

without the device should probably not purchase one until more

definitive data is available.

A third study is planned but no details were available.

OK, now everyone can start the debate!

Kenny Navarro

UT Southwestern Medical Center

[Guest guest]

I hate when I misspell. It should be CRITERIA.

Danny wrote:

Ok so we have one study that says the device isn't worth throwing away and

this study seems to indicate it may be the greatest thing since CPR itself?

Two different ends of the country are getting two different outcomes from the

use of this device. I have to ask, Did one agency missuse the device or just

fail to understand the criteriea for the study?

Kenny Navarro wrote:

,

I thought about sending this to you privately, but I think the

message is important enough for everyone. This weekend in Dallas,

Dr. Ornato presented some preliminary findings from a randomized

observational Autopulse study that was conducted in Richmond. (The

study will be published soon, but I don't have any details.)

I don't have all my notes with me, but he reported the study had

some positive results. Medics in his system were directed to place

the Autopulse as early in the cardiac arrest as was possible while

not interrupting manual closed chest compressions. Primary outcome

was ROSC. Secondary endpoints were survival to ER admission,

survival to ICU admission, and survival to hospital discharge.

The Autopulse patients were more numerous in all end point

categories compared with manual closed chest compressions. However,

when the discharged patients were evaluated using two different

cerebral performance scores, they found NO statistically significant

differences in neurological outcomes.

Dr. Terry (I can't remember his last name) from Tucson was part of a

group that evaluated interim data from the ASPIRE Autopulse study

that was stopped last summer. His group recommended terminating the

study because it was clear that a higher percentage of patients died

(almost twice as many) when the Autopulse was used compared to

manual CPR.

When the two were questioned about the vastly different outcomes

from the two studies, neither could explain it. Dr. Ornato

suggested that the Autopulse may be very time dependant (must be

applied with a couple of minutes of arrest.)

All of the Medical Directors at the meeting advised that systems

without the device should probably not purchase one until more

definitive data is available.

A third study is planned but no details were available.

OK, now everyone can start the debate!

Kenny Navarro

UT Southwestern Medical Center

[Guest guest]

I hate when I misspell. It should be CRITERIA.

Danny wrote:

Ok so we have one study that says the device isn't worth throwing away and

this study seems to indicate it may be the greatest thing since CPR itself?

Two different ends of the country are getting two different outcomes from the

use of this device. I have to ask, Did one agency missuse the device or just

fail to understand the criteriea for the study?

Kenny Navarro wrote:

,

I thought about sending this to you privately, but I think the

message is important enough for everyone. This weekend in Dallas,

Dr. Ornato presented some preliminary findings from a randomized

observational Autopulse study that was conducted in Richmond. (The

study will be published soon, but I don't have any details.)

I don't have all my notes with me, but he reported the study had

some positive results. Medics in his system were directed to place

the Autopulse as early in the cardiac arrest as was possible while

not interrupting manual closed chest compressions. Primary outcome

was ROSC. Secondary endpoints were survival to ER admission,

survival to ICU admission, and survival to hospital discharge.

The Autopulse patients were more numerous in all end point

categories compared with manual closed chest compressions. However,

when the discharged patients were evaluated using two different

cerebral performance scores, they found NO statistically significant

differences in neurological outcomes.

Dr. Terry (I can't remember his last name) from Tucson was part of a

group that evaluated interim data from the ASPIRE Autopulse study

that was stopped last summer. His group recommended terminating the

study because it was clear that a higher percentage of patients died

(almost twice as many) when the Autopulse was used compared to

manual CPR.

When the two were questioned about the vastly different outcomes

from the two studies, neither could explain it. Dr. Ornato

suggested that the Autopulse may be very time dependant (must be

applied with a couple of minutes of arrest.)

All of the Medical Directors at the meeting advised that systems

without the device should probably not purchase one until more

definitive data is available.

A third study is planned but no details were available.

OK, now everyone can start the debate!

Kenny Navarro

UT Southwestern Medical Center

[Guest guest]

How can you get any type of valid conclusion when the study was never

completed? Sort of like doing a 50 person study with snake oil and

stopping when the first five survive.

AJL

________________________________

From: [mailto: ] On

Behalf Of Danny

Sent: Tuesday, February 21, 2006 11:43 AM

To:

Subject: Re: Dr. Bledsoe - Autopulse

Ok so we have one study that says the device isn't worth throwing away

and this study seems to indicate it may be the greatest thing since CPR

itself?

Two different ends of the country are getting two different outcomes

from the use of this device. I have to ask, Did one agency missuse the

device or just fail to understand the criteriea for the study?

Kenny Navarro wrote:

,

I thought about sending this to you privately, but I think the

message is important enough for everyone. This weekend in Dallas,

Dr. Ornato presented some preliminary findings from a randomized

observational Autopulse study that was conducted in Richmond. (The

study will be published soon, but I don't have any details.)

I don't have all my notes with me, but he reported the study had

some positive results. Medics in his system were directed to place

the Autopulse as early in the cardiac arrest as was possible while

not interrupting manual closed chest compressions. Primary outcome

was ROSC. Secondary endpoints were survival to ER admission,

survival to ICU admission, and survival to hospital discharge.

The Autopulse patients were more numerous in all end point

categories compared with manual closed chest compressions. However,

when the discharged patients were evaluated using two different

cerebral performance scores, they found NO statistically significant

differences in neurological outcomes.

Dr. Terry (I can't remember his last name) from Tucson was part of a

group that evaluated interim data from the ASPIRE Autopulse study

that was stopped last summer. His group recommended terminating the

study because it was clear that a higher percentage of patients died

(almost twice as many) when the Autopulse was used compared to

manual CPR.

When the two were questioned about the vastly different outcomes

from the two studies, neither could explain it. Dr. Ornato

suggested that the Autopulse may be very time dependant (must be

applied with a couple of minutes of arrest.)

All of the Medical Directors at the meeting advised that systems

without the device should probably not purchase one until more

definitive data is available.

A third study is planned but no details were available.

OK, now everyone can start the debate!

Kenny Navarro

UT Southwestern Medical Center

[Guest guest]

How can you get any type of valid conclusion when the study was never

completed? Sort of like doing a 50 person study with snake oil and

stopping when the first five survive.

AJL

________________________________

From: [mailto: ] On

Behalf Of Danny

Sent: Tuesday, February 21, 2006 11:43 AM

To:

Subject: Re: Dr. Bledsoe - Autopulse

Ok so we have one study that says the device isn't worth throwing away

and this study seems to indicate it may be the greatest thing since CPR

itself?

Two different ends of the country are getting two different outcomes

from the use of this device. I have to ask, Did one agency missuse the

device or just fail to understand the criteriea for the study?

Kenny Navarro wrote:

,

I thought about sending this to you privately, but I think the

message is important enough for everyone. This weekend in Dallas,

Dr. Ornato presented some preliminary findings from a randomized

observational Autopulse study that was conducted in Richmond. (The

study will be published soon, but I don't have any details.)

I don't have all my notes with me, but he reported the study had

some positive results. Medics in his system were directed to place

the Autopulse as early in the cardiac arrest as was possible while

not interrupting manual closed chest compressions. Primary outcome

was ROSC. Secondary endpoints were survival to ER admission,

survival to ICU admission, and survival to hospital discharge.

The Autopulse patients were more numerous in all end point

categories compared with manual closed chest compressions. However,

when the discharged patients were evaluated using two different

cerebral performance scores, they found NO statistically significant

differences in neurological outcomes.

Dr. Terry (I can't remember his last name) from Tucson was part of a

group that evaluated interim data from the ASPIRE Autopulse study

that was stopped last summer. His group recommended terminating the

study because it was clear that a higher percentage of patients died

(almost twice as many) when the Autopulse was used compared to

manual CPR.

When the two were questioned about the vastly different outcomes

from the two studies, neither could explain it. Dr. Ornato

suggested that the Autopulse may be very time dependant (must be

applied with a couple of minutes of arrest.)

All of the Medical Directors at the meeting advised that systems

without the device should probably not purchase one until more

definitive data is available.

A third study is planned but no details were available.

OK, now everyone can start the debate!

Kenny Navarro

UT Southwestern Medical Center

[Guest guest]

How can you get any type of valid conclusion when the study was never

completed? Sort of like doing a 50 person study with snake oil and

stopping when the first five survive.

AJL

________________________________

From: [mailto: ] On

Behalf Of Danny

Sent: Tuesday, February 21, 2006 11:43 AM

To:

Subject: Re: Dr. Bledsoe - Autopulse

Ok so we have one study that says the device isn't worth throwing away

and this study seems to indicate it may be the greatest thing since CPR

itself?

Two different ends of the country are getting two different outcomes

from the use of this device. I have to ask, Did one agency missuse the

device or just fail to understand the criteriea for the study?

Kenny Navarro wrote:

,

I thought about sending this to you privately, but I think the

message is important enough for everyone. This weekend in Dallas,

Dr. Ornato presented some preliminary findings from a randomized

observational Autopulse study that was conducted in Richmond. (The

study will be published soon, but I don't have any details.)

I don't have all my notes with me, but he reported the study had

some positive results. Medics in his system were directed to place

the Autopulse as early in the cardiac arrest as was possible while

not interrupting manual closed chest compressions. Primary outcome

was ROSC. Secondary endpoints were survival to ER admission,

survival to ICU admission, and survival to hospital discharge.

The Autopulse patients were more numerous in all end point

categories compared with manual closed chest compressions. However,

when the discharged patients were evaluated using two different

cerebral performance scores, they found NO statistically significant

differences in neurological outcomes.

Dr. Terry (I can't remember his last name) from Tucson was part of a

group that evaluated interim data from the ASPIRE Autopulse study

that was stopped last summer. His group recommended terminating the

study because it was clear that a higher percentage of patients died

(almost twice as many) when the Autopulse was used compared to

manual CPR.

When the two were questioned about the vastly different outcomes

from the two studies, neither could explain it. Dr. Ornato

suggested that the Autopulse may be very time dependant (must be

applied with a couple of minutes of arrest.)

All of the Medical Directors at the meeting advised that systems

without the device should probably not purchase one until more

definitive data is available.

A third study is planned but no details were available.

OK, now everyone can start the debate!

Kenny Navarro

UT Southwestern Medical Center

[Guest guest]

Very true. I thought the reason why it was stopped was because more were dying

from the use of the device than were surviving.

Perhaps it was that at the time of the study heaven needed more souls? Just a

thought.

Alan Lambert wrote:

How can you get any type of valid conclusion when the study was never

completed? Sort of like doing a 50 person study with snake oil and

stopping when the first five survive.

AJL

________________________________

From: [mailto: ] On

Behalf Of Danny

Sent: Tuesday, February 21, 2006 11:43 AM

To:

Subject: Re: Dr. Bledsoe - Autopulse

Ok so we have one study that says the device isn't worth throwing away

and this study seems to indicate it may be the greatest thing since CPR

itself?

Two different ends of the country are getting two different outcomes

from the use of this device. I have to ask, Did one agency missuse the

device or just fail to understand the criteriea for the study?

Kenny Navarro wrote:

,

I thought about sending this to you privately, but I think the

message is important enough for everyone. This weekend in Dallas,

Dr. Ornato presented some preliminary findings from a randomized

observational Autopulse study that was conducted in Richmond. (The

study will be published soon, but I don't have any details.)

I don't have all my notes with me, but he reported the study had

some positive results. Medics in his system were directed to place

the Autopulse as early in the cardiac arrest as was possible while

not interrupting manual closed chest compressions. Primary outcome

was ROSC. Secondary endpoints were survival to ER admission,

survival to ICU admission, and survival to hospital discharge.

The Autopulse patients were more numerous in all end point

categories compared with manual closed chest compressions. However,

when the discharged patients were evaluated using two different

cerebral performance scores, they found NO statistically significant

differences in neurological outcomes.

Dr. Terry (I can't remember his last name) from Tucson was part of a

group that evaluated interim data from the ASPIRE Autopulse study

that was stopped last summer. His group recommended terminating the

study because it was clear that a higher percentage of patients died

(almost twice as many) when the Autopulse was used compared to

manual CPR.

When the two were questioned about the vastly different outcomes

from the two studies, neither could explain it. Dr. Ornato

suggested that the Autopulse may be very time dependant (must be

applied with a couple of minutes of arrest.)

All of the Medical Directors at the meeting advised that systems

without the device should probably not purchase one until more

definitive data is available.

A third study is planned but no details were available.

OK, now everyone can start the debate!

Kenny Navarro

UT Southwestern Medical Center

[Guest guest]

Very true. I thought the reason why it was stopped was because more were dying

from the use of the device than were surviving.

Perhaps it was that at the time of the study heaven needed more souls? Just a

thought.

Alan Lambert wrote:

How can you get any type of valid conclusion when the study was never

completed? Sort of like doing a 50 person study with snake oil and

stopping when the first five survive.

AJL

________________________________

From: [mailto: ] On

Behalf Of Danny

Sent: Tuesday, February 21, 2006 11:43 AM

To:

Subject: Re: Dr. Bledsoe - Autopulse

Ok so we have one study that says the device isn't worth throwing away

and this study seems to indicate it may be the greatest thing since CPR

itself?

Two different ends of the country are getting two different outcomes

from the use of this device. I have to ask, Did one agency missuse the

device or just fail to understand the criteriea for the study?

Kenny Navarro wrote:

,

I thought about sending this to you privately, but I think the

message is important enough for everyone. This weekend in Dallas,

Dr. Ornato presented some preliminary findings from a randomized

observational Autopulse study that was conducted in Richmond. (The

study will be published soon, but I don't have any details.)

I don't have all my notes with me, but he reported the study had

some positive results. Medics in his system were directed to place

the Autopulse as early in the cardiac arrest as was possible while

not interrupting manual closed chest compressions. Primary outcome

was ROSC. Secondary endpoints were survival to ER admission,

survival to ICU admission, and survival to hospital discharge.

The Autopulse patients were more numerous in all end point

categories compared with manual closed chest compressions. However,

when the discharged patients were evaluated using two different

cerebral performance scores, they found NO statistically significant

differences in neurological outcomes.

Dr. Terry (I can't remember his last name) from Tucson was part of a

group that evaluated interim data from the ASPIRE Autopulse study

that was stopped last summer. His group recommended terminating the

study because it was clear that a higher percentage of patients died

(almost twice as many) when the Autopulse was used compared to

manual CPR.

When the two were questioned about the vastly different outcomes

from the two studies, neither could explain it. Dr. Ornato

suggested that the Autopulse may be very time dependant (must be

applied with a couple of minutes of arrest.)

All of the Medical Directors at the meeting advised that systems

without the device should probably not purchase one until more

definitive data is available.

A third study is planned but no details were available.

OK, now everyone can start the debate!

Kenny Navarro

UT Southwestern Medical Center

[Guest guest]

Very true. I thought the reason why it was stopped was because more were dying

from the use of the device than were surviving.

Perhaps it was that at the time of the study heaven needed more souls? Just a

thought.

Alan Lambert wrote:

How can you get any type of valid conclusion when the study was never

completed? Sort of like doing a 50 person study with snake oil and

stopping when the first five survive.

AJL

________________________________

From: [mailto: ] On

Behalf Of Danny

Sent: Tuesday, February 21, 2006 11:43 AM

To:

Subject: Re: Dr. Bledsoe - Autopulse

Ok so we have one study that says the device isn't worth throwing away

and this study seems to indicate it may be the greatest thing since CPR

itself?

Two different ends of the country are getting two different outcomes

from the use of this device. I have to ask, Did one agency missuse the

device or just fail to understand the criteriea for the study?

Kenny Navarro wrote:

,

I thought about sending this to you privately, but I think the

message is important enough for everyone. This weekend in Dallas,

Dr. Ornato presented some preliminary findings from a randomized

observational Autopulse study that was conducted in Richmond. (The

study will be published soon, but I don't have any details.)

I don't have all my notes with me, but he reported the study had

some positive results. Medics in his system were directed to place

the Autopulse as early in the cardiac arrest as was possible while

not interrupting manual closed chest compressions. Primary outcome

was ROSC. Secondary endpoints were survival to ER admission,

survival to ICU admission, and survival to hospital discharge.

The Autopulse patients were more numerous in all end point

categories compared with manual closed chest compressions. However,

when the discharged patients were evaluated using two different

cerebral performance scores, they found NO statistically significant

differences in neurological outcomes.

Dr. Terry (I can't remember his last name) from Tucson was part of a

group that evaluated interim data from the ASPIRE Autopulse study

that was stopped last summer. His group recommended terminating the

study because it was clear that a higher percentage of patients died

(almost twice as many) when the Autopulse was used compared to

manual CPR.

When the two were questioned about the vastly different outcomes

from the two studies, neither could explain it. Dr. Ornato

suggested that the Autopulse may be very time dependant (must be

applied with a couple of minutes of arrest.)

All of the Medical Directors at the meeting advised that systems

without the device should probably not purchase one until more

definitive data is available.

A third study is planned but no details were available.

OK, now everyone can start the debate!

Kenny Navarro

UT Southwestern Medical Center

[Guest guest]

Dr. Terry Valenzuela from Tucson reported at Eagles that the ASPIRE

study was stopped after 1000 of the planned 1800 patients due survival

to hospital discharge in the control group was 5% and 10% for the

Auto-Pulse group. They performed an analysis of what the results would

have to be in the remaining 800 patients to change the outcome and

determined that was unlikely and stopped the study. It is good

scientific methodology and a correct decision by the data monitoring

safety board - of which Dr. Valenzuela was a member.

There was much discussion of why there were different results. Dr.

Valenzuela indicated that the level of evidence of a multi-center

prospective randomized trial is much higher than a single center before

and after study - the exact term he used was " robustness " . Some of the

experts felt that there were implementation problems in the ASPIRE trial

that could have accounted for the difference. That is why a 3rd trial

is going to occur.

Sims EMT-P

Director of Operations

Cypress Creek EMS

________________________________

From: [mailto: ] On

Behalf Of Alan Lambert

Sent: Tuesday, February 21, 2006 12:14

To:

Subject: RE: Dr. Bledsoe - Autopulse

How can you get any type of valid conclusion when the study was never

completed? Sort of like doing a 50 person study with snake oil and

stopping when the first five survive.

________________________________

[Guest guest]

Dr. Terry Valenzuela from Tucson reported at Eagles that the ASPIRE

study was stopped after 1000 of the planned 1800 patients due survival

to hospital discharge in the control group was 5% and 10% for the

Auto-Pulse group. They performed an analysis of what the results would

have to be in the remaining 800 patients to change the outcome and

determined that was unlikely and stopped the study. It is good

scientific methodology and a correct decision by the data monitoring

safety board - of which Dr. Valenzuela was a member.

There was much discussion of why there were different results. Dr.

Valenzuela indicated that the level of evidence of a multi-center

prospective randomized trial is much higher than a single center before

and after study - the exact term he used was " robustness " . Some of the

experts felt that there were implementation problems in the ASPIRE trial

that could have accounted for the difference. That is why a 3rd trial

is going to occur.

Sims EMT-P

Director of Operations

Cypress Creek EMS

________________________________

From: [mailto: ] On

Behalf Of Alan Lambert

Sent: Tuesday, February 21, 2006 12:14

To:

Subject: RE: Dr. Bledsoe - Autopulse

How can you get any type of valid conclusion when the study was never

completed? Sort of like doing a 50 person study with snake oil and

stopping when the first five survive.

________________________________