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Disaster Podcast

Disaster Podcast

By: Jamie Davis Sam Bradley Joe Holley Kyle Nelson
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 For Emergency Responders at All LevelsMedicCast Productions, LLC Biological Sciences Hygiene & Healthy Living Physical Illness & Disease Science
Episodes
  • The Science and Physiology of Head-up CPR – Elevated CPR Discussion Part 4

    The Science and Physiology of Head-up CPR – Elevated CPR Discussion Part 4
    Dec 6 2025
    Kurt Bramer from Advanced CPR Solutions returns again this week to continue the series on Head-Up CPR and other promising sudden cardiac arrest treatments. There are three previous episodes in this series. Elevated CPR Series Episode One Elevated CPR Series Episode Two Elevated CPR Series Episode Three After the severe weather update from disaster meteorologist Dan DePodwin, the Disaster Podcast team focuses on the science and physiology of Head-Up CPR. They ask why this approach provides for better protection of neurological function during a cardiac arrest. Dr. Joe Holley does an excellent job of describing the specific concepts of pressure gradients in blood flow to and from the heart during CPR in various patient positions. Kurt outlines what he calls the Four Rules of Head-Up CPR that are essential components for successful resuscitation during cardiac arrest treatment. These rules come from Dr. Joanna Moore’s Editorial The Do’s and Don’ts of Head Up CPR: 1) Use of Suction Cup CPR and an ITD 2) A Priming Period is Needed 3) Cannot Lift the Patient Too High 4) You Cannot Lift the Patient Too Quickly CARES Registry for Cardiac Arrest Stats Follow up on more of these segments as we continue to look at the current research trends in future episodes and what is on the horizon for the future. The episode was co-hosted by Sam Bradley and Jamie Davis. Scroll down for Podcast Discussion Summary Thank you as always to Paragon Medical Education Group for their long-term support of the Disaster Podcast. Dr. Joe Holley and the team at Paragon continue to provide excellent and customized disaster response training to jurisdictions around the U.S. and internationally as well. Podcast Discussion Summary Episode Opening segment and Weather update The meeting began with a discussion about travel weather for the country and record cold in many parts of the upper midwest and northeast with Dan DePodwin. The group then transitioned to their main topic, the physiology of CPR, with Dr. Joe Holley focusing our attention on the specific anatomy and process inside the body during CPR. Head-Up CPR Techniques Discussed Kurt and Joe discussed the importance of adhering to the “four rules” of head-up CPR, which were derived from a published editorial by Dr. Moore. They emphasized that studies showing no improved outcomes often violate these rules, highlighting the significance of proper technique. Jamie Davis, the host of the Disaster Podcast, introduced the episode, which would focus on the science and physiology of elevated CPR, while Sam and Dan briefly discussed the early winter weather conditions across the United States. Head-Up CPR Research Advances The discussion focused on head-up CPR, a novel research advancement in resuscitation aimed at improving neurologic survival. Kurt explained its origins, highlighting a case study involving a ski hill cardiac arrest patient who survived due to an elevated head position, which was later recognized as a critical factor. The conversation also touched on a study conducted in South Korea, where researchers developed a modified EMS stretcher to accommodate patients in high-rise buildings with small elevators, leading to the question of the optimal CPR position. Initial findings from animal studies suggested that a head-up position could reduce intracranial pressure, potentially improving outcomes during CPR. CPR Physiology and Blood Flow Joe explained the physiology of CPR, focusing on how differences in pressure inside the body create blood flow. He described how chest compressions increase intrathoracic pressure, pushing blood towards the brain and other areas of lower pressure. He emphasized that over-ventilation and incomplete chest recoil can be detrimental during CPR, as they prevent blood from flowing back into the heart. He also noted that patients who exhibit “guppy breathing” during resuscitation have a better chance of successful resuscitation. CPR Vacuum Technology and Physiology Joe explained the physiology of blood flow during CPR, focusing on the importance of preload and the manipulation of pressure differences between the thoracic cavity and the brain. He described how the ITD16 device creates a vacuum in the chest to enhance blood flow to the brain and reduce intracranial pressure. Joe also discussed the concept of “head-up CPR,” which combines enhanced vacuum with gravity assistance to improve blood flow and neuroprotective outcomes. Head-Up CPR Techniques and Safety Sam and Kurt discussed the importance of using proper equipment and techniques for head-up CPR, as outlined by Dr. Joanna Moore’s “four rules.” Kurt emphasized that suction cup CPR in conjunction with an ITD or rescue pod is crucial for effective and safe head-up CPR. He also stressed the need for a priming period, avoiding excessive head elevation, and slow head-up positioning to prevent blood from draining from the head faster than CPR can pump it back in. Kurt noted that ...
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    55 mins
  • Changes in AHA CPR and Cardiac Arrest Guidelines Over the Years – Elevated CPR Discussion Part 3

    Changes in AHA CPR and Cardiac Arrest Guidelines Over the Years – Elevated CPR Discussion Part 3
    Nov 28 2025
    We are joined by Kurt Bramer from Advanced CPR Solutions again this week to continue the series on Heads Up CPR and other promising sudden cardiac arrest treatments. He and Dr. Joe Holley kicked off the discussion in two previous episodes. Elevated CPR Series Episode One Elevated CPR Series Episdoe Two We open this week’s episode with a holiday severe weather update from our disaster meteorologist, Dan DePodwin. He reports on several storm systems that will impact Thanksgiving holiday travel across the eastern half of the country. Following that update, we kick off episode 3 of our heads-up CPR series with a look at the long history of the evolutionary changes to cardiac arrest treatment. Kurt Bramer from Advanced CPR Solutions leads off with a response to some comments to the first two episodes in this series. A few listeners worried that we might sound like we were criticizing the individual responders on cardiac arrest calls over the low survival rates for the condition. The team made a joint statement that no criticism of providers in the field was intended. We all are providers ourselves and are merely commenting on the results that everyone has been getting in response to treating cardiac arrest. Some systems do better with resource management than others, but even those areas fail to save even a simple majority of their cardiac arrest patients. CARES Registry for Cardiac Arrest Stats Follow up on more of these segments as we continue to look at the current research trends in future episodes and what is on the horizon for the future. The episode was co-hosted by Sam Bradley and Jamie Davis. Scroll down for Podcast Discussion Summary Thank you as always to Paragon Medical Education Group for their long-term support of the Disaster Podcast. Dr. Joe Holley and the team at Paragon continue to provide excellent and customized disaster response training to jurisdictions around the U.S. and internationally as well. Podcast Discussion Summary CPR Challenges and Future Improvements The meeting began with a discussion about travel weather for the Thanksgiving weekend, with Dan DePodwin warning of widespread lake effect snow in the eastern United States and a potential ground blizzard in the Dakotas and Minnesota. The group then transitioned to their main topic, CPR, where Joe clarified that their previous discussion about CPR’s limitations was not meant to criticize CPR providers, but rather to highlight the challenges and lack of progress in the field over the past 50 years. They planned to explore potential improvements to CPR in future episodes. Advancements in CPR Techniques Kurt Bramer, with 40 years of experience in EMS and emergency management, discussed the history of CPR, highlighting its evolution from mouth-to-mouth resuscitation to modern techniques. He emphasized the need for better tools and more effective methods for emergency responders, as current practices are often based on outdated or insufficiently tested techniques. The group acknowledged that while responders are doing their best with limited tools, recent research may lead to positive changes in CPR practices. They also touched on the introduction of high-performance CPR in the 2010s, which aimed to maximize the effectiveness of current technologies and minimize detrimental pauses during resuscitation efforts. Mechanical CPR Guidelines Review The discussion focused on the American Heart Association’s recent guidelines regarding mechanical CPR, which recommend against routine use but allow for exceptions like transport scenarios. Kurt and Joe highlighted that the guidelines lump together different types of mechanical compressors, ignoring their unique physiological effects and training limitations. They emphasized that current research primarily focuses on patient survival as an endpoint, which may not fully capture the benefits of mechanical CPR, such as improved blood flow and reduced pauses during resuscitation. The conversation also touched on the importance of considering neurological outcomes beyond mere survival and the need for better training on integrating mechanical devices into overall cardiac arrest management. Bundle Care Approach in Resuscitation The group discussed the bundle of care approach in resuscitation, focusing on the use of multiple therapies simultaneously to improve patient outcomes. Kurt and Joe highlighted the success of the ITD (Impedance Threshold Device) when used with high-quality CPR, leading to a 50% increase in one-year survival. They also noted that only a small percentage of resuscitation guidelines are supported by randomized control trials, emphasizing the challenges in interpreting research data. The group discussed the importance of disaster preparedness and the role of specialized training, with Jamie highlighting the sponsorship of the Disaster Podcast by Paragon Medical Education Group. Catch the full episode using the player above or on your favorite podcast platform, and don’t ...
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    1 hr and 1 min
  • Flawed Approaches to Sudden Cardiac Arrest Research – Elevated CPR Discussion Part 2

    Flawed Approaches to Sudden Cardiac Arrest Research – Elevated CPR Discussion Part 2
    Nov 21 2025
    In this second episode installment of the sudden cardiac arrest and CPR series Kurt and Dr. Joe Holley discuss some key flaws in approaching cardiac arrest research like other medical diseases and treatments. The large number of unknown and uncontrollable variables surrounding sudden cardiac arrest make it hard for randomized control trials to effectively pinpoint positive treatment modalities.
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    28 mins
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