Cardiopulmonary resuscitation-induced consciousness in an elderly patient: a case report in the prehospital setting | International Journal of Emergency Medicine | Full Text

Cardiopulmonary resuscitation (CPR) aims to limit hypoxic injury by providing oxygen to brain and heart tissues during cardiac arrest. There has been an increase in reports of patients exhibiting signs such as eye opening, limb movement, agitation, or even interference with resuscitation maneuvers while receiving CPR. These manifestations cease when chest compressions are stopped, even without achieving return of spontaneous circulation (ROSC). This phenomenon is termed CPR-induced consciousness (CPRIC). CPRIC cases are typically associated with cardiac arrest of cardiac origin, shockable rhythms, and witnessed arrests with timely CPR. Here, we present the case of an 80-year-old man who collapsed in a public setting. During resuscitation by Bystanders, the patient showed purposeful movements and vocalizations, leading to incorrect interruptions of compressions due to presumed ROSC. Once CPRIC was recognized, chest compressions and defibrillation continued, achieving ROSC. This case highlights the importance of training prehospital providers to recognize and manage CPRIC, including the potential use of sedatives—such as ketamine—to control movements that interfere with resuscitation. The case also underscores the need for effective communication strategies with bystanders, given the social and ethical implications of CPRIC manifestations. Further research is necessary to establish clear international guidelines and improve clinical outcomes for patients experiencing CPRIC.
— Read on intjem.biomedcentral.com/articles/10.1186/s12245-025-01032-w

How neo-Nazis used the shield of ‘ordinary mums and dads’ at Australia’s anti-immigration rallies to sell white supremacy | Far right | The Guardian

From online grievances about migration to men dressed in black in a sea of Australian flags, far-right groups clearly intended to capitalise off events
— Read on www.theguardian.com/australia-news/2025/sep/02/how-neo-nazis-used-the-shield-of-ordinary-mums-and-dads-at-australia-anti-immigration-rallies-to-sell-white-supremacy-ntwnfb

Ventilator‐assisted preoxygenation in an aeromedical retrieval setting – Latona – 2024 – Emergency Medicine Australasia – Wiley Online Library

Ventilator-assisted preoxygenation (VAPOX) is a method of preoxygenation and apnoeic ventilation, prior to intubation. This article describes the use of VAPOX during intubation of critically unwell p…
— Read on onlinelibrary.wiley.com/doi/10.1111/1742-6723.14404

Risk of complications using a sedation protocol for aeromedical retrieval of acutely unwell mental health patients: a retrospective cohort study in Outback Australia | Emergency Medicine Journal

Risk of complications using a sedation protocol for aeromedical retrieval of acutely unwell mental health patients: a retrospective cohort study in Outback Australia | Emergency Medicine Journal
— Read on emj.bmj.com/content/early/2025/07/15/emermed-2024-214719.long

Editor’s comments : This is a good article comparing standardised protocol approach vs non protocolised approach to aeromedical retrieval of acute mental health patients . The standardised protocol described is very similar to the RFDS Queensland one developed during my aeromedical career in that state. It uses a standardised risk assessment tool and a standardised tiered chemical sedation protocol focussing on oral olanzapine & diazepam initially then escalating to IM/IV droperidol then ketamine . This overall standardised approach is also very similar to the Surviving Sedation guidelines published on this website .

The notable findings of this study are :

1. Midazolam is associated with highest complication rates and cannot be recommended as monotherapy for sedation during aeromedical transfer of this patient group

2. A standardised protocol approach has fewer complications and reduces length of retrieval compared with non protocol management

3. Ketamine sedation appears safer than midazolam in this setting in unintubated patients

4. Intubation carries high rate of severe complications in this patient group and should be considered a high risk intervention