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David Purkarthofer @davidpurkarthofer.at · 08/10/2026

After ROSC, ST-elevation is a rather reliable sign of coronary occlusion - but not the only one. I was lucky to contribute to a study led by Claudio Silwanis & Thomas Lambert: in 214 post-ROSC patients, strict ST-elevation criteria caught 44% of angiographically confirmed coronary occlusions.

Graphical abstract, retrospective analysis of 214 patients after cardiac arrest. A donut chart of 101 patients with angiographically confirmed coronary occlusion shows 44% had a STEMI pattern (anterior 24%, inferior 17%) and 48% a non-ST-elevation occlusion (NST-OMI) pattern. The most frequent NST-OMI patterns, each with a schematic ECG sketch: left-main equivalent (8%), modified Sgarbossa (8%), Aslanger pattern (5%), posterior OMI, shark-fin sign and hyperacute T-wave (4% each). Key findings: NST-OMI patients not undergoing coronary angiography had the highest 30-day mortality (STEMI with angiography 34%, NST-OMI with angiography 35%, NST-OMI without angiography 75%). Longer PR-segment was associated with higher 30-day mortality (median 57 ms in survivors vs 74 ms in non-survivors).

Screenshot of the article page in Resuscitation (Volume 228, November 2026, Open Access): "The post-ROSC ECG: morphological spectrum of non-ST-elevation occlusion and prognostic markers after cardiac arrest" by Claudio Silwanis, Thomas Lambert and 14 co-authors including David Purkarthofer. Highlights: A few ECG patterns account for most non-ST-elevation coronary occlusions. Left-main equivalent and Sgarbossa patterns are frequent OMI patterns. Longer PR-segment predicted lower 30-day survival. After cardiac arrest, occlusion often appears on ECG without ST-elevation. The first ECG after resuscitation informs both diagnosis and prognosis.

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David Purkarthofer @davidpurkarthofer.at · 21/09/2026

Physiology-guided CPR: targeted interventions, aiming for ill defined goals? Not news, but it emerged clearer than ever in the session at #RESUS26. A thread on why we can't trust the numbers our devices show us during CPR — and what it would take to fix that. 🧵

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David Purkarthofer @davidpurkarthofer.at · 14/09/2026

Chest compression induced airflow reversals complicate flow-based detection of respiratory phases. Multiply flow by airway pressure & phases reappear: perfect phase classification, F1 0.971 for exact onsets during ongoing compressions. Led by @simonorlob.bsky.social doi.org/10.1016/j.re...

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David Purkarthofer @davidpurkarthofer.at · 11/09/2026

Try it (and use free forever) at deduplicate.it - source code (and a python-based command line tool for those who like it even faster) available at GitHub (github.com/dpurkarthofe...)

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David Purkarthofer @davidpurkarthofer.at · 26/08/2026

Evaluating for pneumothorax is the most accurate aspect within the eFAST protocol - and the most actionable finding in a pre-hospital setting. For an optimized eFAST algorithm in an Austrian ambulance system, we therefore put the thorax first - a long way before the abdomen. doi.org/10.31247/agn...

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David Purkarthofer @davidpurkarthofer.at · 15/07/2026

#DSED is increasingly implemented for refractory VF, and dual cardioversion seems effective for elective cases too. Question I've discussed too often with colleagues - everyone had opinions, no one a well-founded answer - is simple: is this safe for the #defibrillators? doi.org/10.1016/j.re...

Graphical abstract titled "DSED (double sequential defibrillation) and dual cardioversion are promising interventions… but can they damage defibrillators?" — a scoping-review summary. Left: 5 published sources reported 8 lasting device damages and 4 temporary malfunctions; 24 regulatory adverse-event reports added 11 lasting damages and 16 temporary malfunctions. Right, under "Sequential vs. simultaneous": in published sources all damages followed simultaneous shocks, while in regulatory reports most were labelled DSED but the exact shock timing could not be determined. Bottom line: some damage was not detected until later testing or a subsequent case, so devices should be tested after dual defibrillator use. Citation: Purkarthofer et al., Resuscitation 2026.

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David Purkarthofer @davidpurkarthofer.at · 08/07/2026

Great exchange with Nehme & team on trial of manual pressure augmented defibrillation. Overall neutral, sex-stratified signal favoured females - plausible because breast/subcutaneous tissue raises impedance and is compressible. doi.org/10.1016/j.resuscitation.2026.111185 @resuscitation.bsky.social

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David Purkarthofer @davidpurkarthofer.at · 13/05/2026

Do CPR manikins simulate ventilation accurately? We tested 10, found leakage in all models, even with advanced airways, wide variation in compliance and peak pressure, and air leaking through the i-gel® gastric channel in some combinations. doi.org/10.1016/j.resplu.2026.101318 #Resuscitation #CPR

Graphical abstract of the paper ventilation characteristics of cardiopulmonary resuscitation manikins.

Mechanism/pathway of leakage through the i-gel gastric channel in some manikin-device combinations.

Different expiration pathways, with only variations I(a) and I(b) allowing quantification of expiratory flow or tidal volume.

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David Purkarthofer @davidpurkarthofer.at · 18/11/2025

Taking the probe away from an ultrasound learner is like taking the bike away from someone learning to ride — and showing them a video instead. We shouldn’t expect applicable skill without real hands-on practice. doi.org/10.24908/poc... @simonorlob.bsky.social @pocusjournal.bsky.social

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David Purkarthofer @davidpurkarthofer.at · 11/10/2025

🏆 Grateful and proud: our project “Fokussierte Sonographie durch NKI-Rettungsmedizinerinnen”* on #prehospital #POCUS has been awarded the Camillo Award 2025 by @bvrd.bsky.social ! A big shout-out to the amazing #Medizinercorps Graz team — this is truly a collective achievement.

Clemens Kaltenberger, David Purkarthofer and Stefan Koloszar at the Camillo Awards Ceremony at the Austrian Parliament, David Purkarthofer holding the award.
Photo: Parlamentsdirektion / A. Rastegar

Group photo of winners of the Camillo Award 2025 at the Austrian parliament.
Photo: Parlamentsdirektion / A. Rastegar

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David Purkarthofer @davidpurkarthofer.at · 26/02/2025

#Women are shown in less than 10% of easily findable educational depictions of #CPR - we have to change that. doi.org/10.1016/j.re... @ercresus.bsky.social @simonorlob.bsky.social @americanheart.bsky.social @eusem.bsky.social #Resuscitation #Inequalities #CPR #Women

Infographic showing that out of 150 image search results for the terms "CPR", "Chest compressions" and "Basic life support", 94 depicted chest compressions, and out of those 70 had CPR recipients with male features, 17 without distinctive features, and 7 with female features.

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