Cardiac arrest, Long QT and oesophageal food bolus

April 27, 2026

Cardiac arrest leads, while Long QT, oesophageal food bolus and recurrent childhood infections show how early sorting changes the next move.

PEARL OF THE DAY

Place feedback pads on every patient receiving chest compressions.

Summary

Cardiac arrest is not one problem, and good intentions do not guarantee good CPR. Start with the high resuscitation excellence episode because it makes the first change obvious: measure compressions, do not guess. Feedback pads, metronome support, rapid full release and a named CPR coach turn arrest care into something the team can improve in real time.

BAMR adds what the leader should do in the room: name roles, use closed-loop communication, weigh frailty and absent reversibility before stopping, and debrief staff soon after the call. The HEMS thoracotomy discussion then narrows traumatic arrest by mechanism, timing, rhythm and suspected tamponade, while Long QT reminds you to review drugs and electrolytes before calling it inherited. Away from arrest, the clearest common presentations are oesophageal food bolus and recurrent childhood infections. On the next shift, apply feedback pads as soon as chest compressions start.

Today's podcasts

Ep 100: Five Things About Foundations for High Resuscitation Excellence with Jenn Hayes

Start here if cardiac arrest care still relies on instinct rather than measured CPR quality. The gain is early feedback pads, metronome support, rapid full release and a CPR coach, then using report card data to coach the next arrest better.

#138 BAMR: Cardiac arrests (part 2)

When non-shockable arrest keeps running, leadership can matter as much as the next intervention. This is worth opening for named roles, closed-loop communication, when frailty and absent reversibility support stopping, and why a hot debrief still matters after return of spontaneous circulation or death.

HEMS Debrief - Retrieval and Pre-Hospital Medicine #2. Thoracotomies, Sydney and London in Conversation

Traumatic cardiac arrest after a stab wound or major chest trauma needs more than one thoracotomy rule. This is the more specialist arrest listen, but it is sharp on tamponade versus exsanguination, how rhythm and witnessed physiology judge viability, and when ultrasound helps or delays chest opening.

#4 Long QT syndrome

Palpitations, syncope or prolonged QT on ECG should trigger a medication and electrolyte review before inherited disease is assumed. Open this for the Long QT syndrome type 2 trigger history, the limits of negative genetic testing, and why nadolol sits first line once diagnosis is made.

TMT - Oesophageal Food Bolus

Food sticking after a meal becomes an emergency when saliva will not go down or perforation signs appear. This is a clear acute care listen on separating oesophageal obstruction from choking, asking about bones or sharp material, and not leaning on hyoscine butylbromide, glucagon or benzodiazepines.

Recurrent Infections in Children (2nd edition)

Repeated coughs and colds in childhood can still be normal, especially around nursery or school. Open this when poor growth, chronic diarrhoea, persistent thrush or severe infection makes the story less ordinary, and when targeted tests should follow the history and examination.

Gender Affirming Care in Exile: The Lawsuits

Adolescent gender care becomes unsafe when diagnosis, comorbidity and expected benefit are blurred. Keep this for later unless you work in mental health or adolescent services; its main value is precise terms, body dysmorphic disorder caution, and honest consent and coordination before irreversible interventions.

What to change on your next shift

When chest compressions start, do not rely on the room’s feeling that CPR is good. Put feedback pads on early, use the metronome if rate runs fast, and give one person the CPR coach role. Turn the data into one clear change after the event.

Quick questions from today’s briefing

What should I reach for first if I want objective CPR quality?

Feedback pads, ideally with metronome support. They show the team whether rate, depth, release and pauses are where they need to be while compressions are happening.

Which part of CPR is easy to neglect when everyone is focused on pushing hard and fast?

Rapid full release and recoil, plus pauses and ventilation quality. The episode makes the point that downward force alone is not enough for good CPR.

Which swallowing problem should make oesophageal food bolus feel urgent?

Inability to swallow saliva should prompt urgent escalation. Severe neck or chest pain, reduced neck movement, voice change, sepsis, tachycardia, tachypnoea or surgical emphysema should also push the case away from conservative measures.

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