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Paramedic research, 3 August 2026

4 new paramedic and prehospital papers from the 3 August 2026 scan.

• Refractory VF rare with worse outcomes

  Resuscitation · Registry · Hypothesis-generating

  This registry study of 436 OHCA patients compared refractory VF (all three shocks failed to terminate, 5% of cases) versus recurrent VF, finding refractory VF patients had lower ROSC (41% vs 59%) and 30-day survival (23% vs 46%) with predictors including no CPR/AED before EMS, longer delay to first shock, and lower amplitude spectral area.

• Bystander rescue breathing no benefit in suffocation OHCA

  Resuscitation · Cohort · Hypothesis-generating

  This retrospective cohort of 76,774 Japanese patients with witnessed suffocation-related OHCA found no bystander CPR was associated with higher favourable neurological outcomes compared with compression-only CPR (OR 1.20, 95% CI 1.04-1.38), while CCV-CPR showed no significant difference versus compression-only.

• Mechanical vs manual ventilation in CPR equal

  Resuscitation · Systematic review · Context only

  This systematic review of 13 articles (six RCTs, seven non-randomised studies) found very low to low certainty evidence showing no significant difference in ROSC between volume-controlled mechanical ventilation and manual ventilation during CPR.

• Team leaders carry highest cognitive load

  Resuscitation · Cross-sectional · Context only

  This multicentre cross-sectional study of 58 resuscitations found perceived cognitive load was highest among team leaders (mean 5.5/9) and higher team leader cognitive load was associated with higher load among team members and lower TEAM-assessed performance.