Improving in-hospital cardiac resuscitation

Recurrent Ventricular Fibrillation:
New Strategies for Challenging Patients


This program is approved for 1.0 Contact hour for Nurses and Respiratory Therapists. After watching the video, you may go to and register to take the test. Once you have sucessfully completed the test, you may print out your certificate immediately.


Advances in the management of cardiac arrest have led to dramatically improved outcomes. However, patients with refractory or recurrent VF still present a challenge to resuscitate. This session will identify those patients who may benefit from immediate percutaneous coronary intervention (PCI), during cardiac arrest.  In addition, we will discuss the cutting edge use of mechanical CPR and extracorporeal membrane oxygenation (ECMO) to support patients and preserve the myocardium while coronary intervention is provided.



Upon completion of this activity, the participant will be able to:

  1. Discuss the importance of performing high quality CPR and defining defibrillation success in patients with refractory or recurrent VF.
  2. Describe evolving EMS and hospital-based treatment strategies for these patients.
  3. Describe the new evidence on the role of mechanical CPR as a bridge to advanced circulatory support and/or PCI.


Nicole Kupchik has practiced as a critical care nurse for over twenty years. After joining Harborview Medical Center, Nicole was part of a multidisciplinary team that was one of the first in the US to implement therapeutic hypothermia after cardiac arrest.  As part of this effort, Nicole was responsible for protocol development and has published numerous papers on this topic.

In 2008, Nicole lead a team that implemented a formalized Sepsis program at Harborview Medical Center that led to a reduction in mortality, hospital length of stay and a significant cost avoidance.  For this collaborative efforts,  she was awarded three Patient Safety & Clinical Leadership awards.

Currently she works as a staff nurse at Harborview Medical Center in Seattle, WA.  In 2013 Nicole founded Nicole Kupchik Consulting & Education


Tim Phalen has provided ECG education to over 75,000 healthcare providers nationally and internationally. The American Heart Association in the 1997 ACLS Textbook has recognized Tim for his approach to teaching 12-lead ECG interpretation. A published writer, Tim has authored and co-authored textbooks including, The 12-lead ECG in Acute Myocardial Infarction and The 12-lead ECG in Acute Coronary Syndromes.


© Saxe Healthcare Communications 2017