Frascone, Ralph J., MD uri icon
Research Investigator and Medical Director, Regions Hospital Emergency Medical Services
About me

Other titles: Medical director, Regions Hospital Emergency Medical Services

Academic appointment: Professor, Department of Emergency Medicine, University of Minnesota, Minneapolis.

Overview/research interests:

Cardiopulmonary resuscitation, airway management, intraosseous access, air medical
Affiliation
positions
  • Research Investigator, Critical Care Research Center
    • Publications
    selected publications
    Journal Article
  • Advanced reperfusion strategies for patients with out-of-hospital cardiac arrest and refractory ventricular fibrillation (ARREST): a phase 2, single centre, open-label, randomised controlled trial. 
    Lancet (London, England). 2020
  • Effect of out-of-hospital tranexamic acid vs placebo on 6-month functional neurologic outcomes in patients with moderate or severe traumatic brain injury. 
    JAMA. 2020
  • Improved survival with extracorporeal cardiopulmonary resuscitation despite progressive metabolic derangement associated with prolonged resuscitation. 
    Circulation. 2020
  • Rationale and strategies for development of an optimal bundle of management for cardiac arrest. 
    Critical care explorations. 2020
  • Supraglottic airway devices variably develop negative intrathoracic pressures: a prospective cross-over study of cardiopulmonary resuscitation in human cadavers. 
    Resuscitation. 2020
  • The Minnesota mobile extracorporeal cardiopulmonary resuscitation consortium for treatment of out-of-hospital refractory ventricular fibrillation: program description, performance, and outcomes. 
    EClinicalMedicine. 2020
  • Tranexamic acid administration in the field does not affect admission thromboelastography after traumatic brain injury. 
    The journal of trauma and acute care surgery. 2020
  • A case of neurologically intact survival after 2 hours and 50 minutes of euthermic cardiac arrest treated with mechanical CPR and intra-arrest percutaneous coronary intervention. 
    Prehospital Emergency Care. 2019
  • Consistent head up cardiopulmonary resuscitation haemodynamics are observed across porcine and human cadaver translational models. 
    Resuscitation. 2018
  • And the dead shall rise: head-up CPR and the revolutionary research model used to develop it. 
    JEMS: A Journal of Emergency Medical Services. 2017
  • Coronary artery disease in patients with out-of-hospital refractory ventricular fibrillation cardiac arrest. 
    Journal of the American College of Cardiology. 2017
  • Intraosseous pressure monitoring in healthy volunteers. 
    Prehospital Emergency Care. 2017
  • Long-term prognostic value of gasping during out-of-hospital cardiac arrest. 
    Journal of the American College of Cardiology. 2017
  • Outcomes of sudden cardiac arrest in a state-wide integrated resuscitation program: results from the Minnesota Resuscitation Consortium. 
    Resuscitation. 2017
  • Resuscitation outcomes consortium (ROC) studies dig deep into the science of CPR. 
    JEMS: A Journal of Emergency Medical Services. 2017
  • Early access to the cardiac catheterization laboratory for patients resuscitated from cardiac arrest due to a shockable rhythm: The Minnesota Resuscitation Consortium Twin Cities Unified Protocol. 
    Journal of the American Heart Association. 2016
  • Minnesota Resuscitation Consortium's advanced perfusion and reperfusion cardiac strategy for out-of-hospital refractory ventricular fibrillation. 
    Journal of the American Heart Association. 2016
  • Evaluation of intraosseous pressure in a hypovolemic animal model. 
    Journal of Surgical Research. 2015
  • The administration of pre-hospital ketamine for chemical restraint does not prolong on-scene times compared to haloperidol based sedation
    2015
  • The association between ketamine given for prehospital chemical restraint with intubation and hospital admission. 
    American Journal of Emergency Medicine. 2015
  • The association of health status and providing consent to continued participation in an out-of-hospital cardiac arrest trial performed under exception from informed consent. 
    Academic Emergency Medicine. 2015
  • Comparison of success rates between two video laryngoscope systems used in a prehospital clinical trial. 
    Prehospital Emergency Care. 2014
  • Hemodynamic improvement of a LUCAS 2 automated device by addition of an impedance threshold device in a pig model of cardiac arrest. 
    Resuscitation. 2014
  • One-year outcomes of out-of-hospital administration of intravenous glucose, insulin, and potassium (GIK) in patients with suspected acute coronary syndromes (from the IMMEDIATE (Immediate Myocardial Metabolic Enhancement During Initial Assessment and Treatment in Emergency Care) Trial). 
    American Journal of Cardiology. 2014
  • Use of an intraosseous device for invasive pressure monitoring in the ED. 
    American Journal of Emergency Medicine. 2014
  • Evaluation of the Storz CMAC(R), Glidescope(R) GVL, AirTraq(R), King LTS-D, and direct laryngoscopy in a simulated difficult airway. 
    American Journal of Emergency Medicine. 2013
  • Marathon runner prolonged normothermic cardiopulmonary arrest and neurologically intact survival. 
    Current Sports Medicine Reports. 2013
  • Supraglottic airway device use as a primary airway during rapid sequence intubation. 
    Air Medical Journal. 2013
  • Treatment of non-traumatic out-of-hospital cardiac arrest with active compression decompression cardiopulmonary resuscitation plus an impedance threshold device. 
    Resuscitation. 2013
  • Impairment of carotid artery blood flow by supraglottic airway use in a swine model of cardiac arrest. 
    Resuscitation. 2012
  • Laryngospasm and hypoxia after intramuscular administration of ketamine to a patient in excited delirium. 
    Prehospital Emergency Care. 2012
  • Medical preparation for the 2008 Republican National Convention: a practical guide. 
    The journal of trauma and acute care surgery. 2012
  • Out-of-hospital administration of intravenous glucose-insulin-potassium in patients with suspected acute coronary syndromes: the IMMEDIATE randomized controlled trial. 
    JAMA. 2012
  • Potential negative effects of epinephrine on carotid blood flow and ETCO2 during active compression-decompression CPR utilizing an impedance threshold device. 
    Resuscitation. 2012
  • The emergency department experience with prehospital ketamine: a case series of 13 patients. 
    Prehospital Emergency Care. 2012
  • Comparison of prehospital insertion success rates and time to insertion between standard endotracheal intubation and a supraglottic airway. 
    Resuscitation. 2011
  • Standard cardiopulmonary resuscitation versus active compression-decompression cardiopulmonary resuscitation with augmentation of negative intrathoracic pressure for out-of-hospital cardiac arrest: a randomised trial. 
    Lancet (London, England). 2011
  • Bispectral index monitoring in helicopter emergency medical services patients. 
    Prehospital Emergency Care. 2009
  • Health and medical preparedness and response to the 2008 Republican National Convention. 
    Disaster Medicine and Public Health Preparedness. 2009
  • Use of the King LTS-D during medication-assisted airway management. 
    Prehospital Emergency Care. 2009
  • Use of the pediatric EZ-IO needle by emergency medical services providers. 
    Pediatric Emergency Care. 2009
  • Focus on RSI. Does training in the or create an optimal RSI program?. 
    JEMS: A Journal of Emergency Medical Services. 2008
  • Shock therapy. How donut magnets can suspend inappropriate ICD shocks. 
    JEMS: A Journal of Emergency Medical Services. 2008
  • Shock therapy. How donut magnets can suspend inappropriate ICD shocks. 
    JEMS: A Journal of Emergency Medical Services. 2008
  • Successful training of HEMS personnel in laryngeal mask airway and intubating laryngeal mask airway placement. 
    Air Medical Journal. 2008
  • Use of the intubating laryngeal mask airway in HEMS. 
    Air Medical Journal. 2008
  • Consecutive field trials using two different intraosseous devices. 
    Prehospital Emergency Care. 2007
  • Implementing emergency research requiring exception from informed consent, community consultation, and public disclosure. 
    Annals of Emergency Medicine. 2007
  • Combination of active compression decompression cardiopulmonary resuscitation and the inspiratory impedance threshold device: state of the art. 
    Current Opinion in Critical Care. 2004
  • Prehospital rapid-sequence intubation: a pilot training program. 
    Prehospital Emergency Care. 2003
  • Successful placement of an adult sternal intraosseous line through burned skin. 
    Journal of Burn Care and Rehabilitation. 2003
  • Does the ILMA make sense in HEMS?. 
    Air Medical Journal. 2001
  • Obtaining vascular access: is there a place for the sternal IO?. 
    Air Medical Journal. 2001
    • Editorial Article
  • The risk versus benefit of LUCAS: is it worth it [editorial]?. 
    Anesthesiology.  120. 2014
  • Milestones in treatment: the tipping point and the ResQ Trial [editorial]. 
    Lancet (London, England).  377. 2011
    • Conference Poster
  • Survival with favorable neurological function decreases after 15 minutes of CPR in a non-linear manner in patients with out-of-hospital cardiac arrest [poster]
    2017
  • Head up position lowers intracranial pressure in a human cadaver model of cardiopulmonary resuscitation [poster]. 
    Circulation. 2016
  • Prehospital ketamine for chemical restraint: administered dose vs intubation rate [poster]
    2014
  • Alternative airway use by paramedics after video laryngoscope failure [poster]
    2013
  • An analysis of on-course emergencies requiring transport by stretcher capable ATV's from an extreme sporting event [poster]
    2013
  • Decreasing intraosseous pressure and increasing respiratory variability track fluid volume reduction in a porcine hypovolemia model [poster]
    2013
  • Decreasing intraosseous pressure and increasing respiratory variability track fluid volume reduction in a porcine hypovolemia model [poster]
    2013
  • Determinants of ventricular fibrillation incidence as first recorded rhythm during out-of-hospital cardiac arrest and association with long-term neurological outcomes. Observations from a large randomized clinical study [poster]
    2013
  • Facilitation of uninterrupted chest compressions by paramedics: the role of the video laryngoscope [poster]
    2013
  • Intraosseous pressure tracings mimic arterial pressure tracings in timing and contour [poster]
    2013
  • Intraosseous pressure tracings mimic arterial pressure tracings in timing and contour [poster]
    2013
  • Treatment of non-traumatic out-of-hospital cardiac arrest with active compression decompression cardiopulmonary resuscitation plus an impedance threshold device [poster]
    2012
  • Frequency of organ and tissue donation in out-of-hospital cardiac arrest patients [poster]
    2011
  • Inadequate baseline and 6-month retention of the Emergency Severity Index by experienced emergency department registered nurses [poster]
    2011
    • Review
  • Quality of CPR: an important effect modifier in cardiac arrest clinical outcomes and intervention effectiveness trials [review]. 
    Resuscitation. 2015
  • HemoDynamic Duo. Improving survival from cardiac arrest using active compression-decompression CPR (ACD-CPR) with an ITD [review]. 
    JEMS: A Journal of Emergency Medical Services. 2014
  • High index of suspicion. Recognizing & managing traumatic neck injuries [review]. 
    JEMS: A Journal of Emergency Medical Services. 2014
    • Abstract
  • Does the use of video laryngoscopy improve first-time success rates or overall success rates in HEMS [abstract]?. 
    Prehospital Emergency Care. 2017
  • Use of the Lucas-2 device in helicopter EMS: is it safe [abstract]?. 
    Prehospital Emergency Care. 2017
  • Gasping during cardiopulmonary resuscitation is associated with a higher likelihood of one-year survival after cardiac arrest [abstract]. 
    Circulation. 2016
  • Intraosseous pressure monitoring in healthy volunteers [abstract]. 
    Prehospital Emergency Care. 2016
  • Intraosseous pressure monitoring in critical care patients [abstract]. 
    Annals of Emergency Medicine. 2015
  • Cadaver laboratory experience for teaching prehospital procedures to EMS fellows [abstract]. 
    Prehospital Emergency Care. 2014
  • Evaluation of the hemodynamic synergy between an impedence threshold device and the LUCAS 2 automated CPR device in a pig model of cardiac arrest [abstract]. 
    Prehospital Emergency Care. 2014
  • Prehospital ketamine does not prolong on-scene time compared to haloperidol when used for chemical restraint [abstract]. 
    Prehospital Emergency Care. 2014
  • Alternative airway use by paramedics after video laryngoscope failure [abstract]. 
    Prehospital Emergency Care. 2013
  • Comparison of success rates between two video laryngoscope systems used in a prehospital clinical trial [abstract]. 
    Prehospital Emergency Care. 2013
  • Determinants of ventricular fibrillation incidence as first-recorded rhythm during out-of-hospital cardiac arrest and association with long-term neurologic outcomes [abstract]. 
    Prehospital Emergency Care. 2013
  • Does health status influence the willingness to provide informed consent? Results from a cardiac arrest trial conducted under waiver of informed consent [abstract]. 
    Prehospital Emergency Care. 2013
  • Facilitation of uninterrupted chest compressions by paramedics: the role of the video laryngoscope [abstract]. 
    Prehospital Emergency Care. 2013
  • Modified Rankin score at hospital discharge is predictive of one-year neurologic function in survivors after cardiac arrest [abstract]. 
    Prehospital Emergency Care. 2013
  • Paramedic time to endotracheal tube placement using a video laryngoscope [abstract]. 
    Academic Emergency Medicine. 2013
  • Survival from hospital discharge to one year after out-of-hospital cardiac arrest: a comparison of standard CPR versus active compression-decompression CPR plus an impedance threshold device [abstract]. 
    Prehospital Emergency Care. 2013
  • Active compression-decompression cardiopulmonary resuscitation and augmentation of negative intrathoracic pressure is neuroprotective in patients with an out-of-hospital cardiac arrest [abstract]. 
    Prehospital Emergency Care. 2012
  • Descriptive review of the subsequent notification process of an exception from informed consent clinical trial [abstract]. 
    Prehospital Emergency Care. 2012
  • Impairment of carotid artery blood flow by supraglottic airway use in a swine model of cardiac arrest [abstract]. 
    Prehospital Emergency Care. 2012
  • Improvement of long-term neurologic function after sudden cardiac death and resuscitation: impact of CPR method and post-resuscitation care [abstract]. 
    Prehospital Emergency Care. 2012
  • Potential negative effects of epinephrine on carotid blood flow and ETCo2 during active compression-decompression CPR utilizing an impedance threshold device [abstract]. 
    Academic Emergency Medicine. 2012
  • Use of an impedance threshold device with active compression-decompression CPR improves survival with good neurologic function following cardiac arrest from nontraumatic ETI [abstract]. 
    Prehospital Emergency Care. 2012
  • Can paramedics accurately diagnose sepsis and severe sepsis in the field [abstract]?. 
    Academic Emergency Medicine. 2011
  • Direct comparison of video laryngoscopes in simulated difficult intubations [abstract]. 
    Academic Emergency Medicine. 2011
  • Evaluation of 4 different video laryngoscopes in a simulated difficult airway scenario: the EMESIS Trial [abstract]. 
    Prehospital Emergency Care. 2011
  • Frequency of organ and tissue donation in out-of-hospital cardiac arrest patients [abstract]. 
    Academic Emergency Medicine. 2011
  • Impairment of carotid artery blood flow by supraglottic airway use in a swine model of cardiac arrest [abstract]. 
    Circulation. 2011
  • Inadequate baseline and 6-month retention of the Emergency Severity Index by experienced Emergency Department registered nurses [abstract]. 
    Academic Emergency Medicine. 2011
  • Training emergency medical services providers in the use of the Emergency Severity Index: a pilot study [abstract]. 
    Prehospital Emergency Care. 2011
  • Use of the King LTS-D as a primary airway over rapid-sequence intubation medications: a prospective, consecutive case series [abstract]. 
    Prehospital Emergency Care. 2011
    • Document
  • Improvement of long-term neurological function after sudden cardiac death and resuscitation: impact of CPR method and post-resuscitation care
    2011
  • Treatment of out-of-hospital cardiac arrest with an impedance threshold device and active compression decompression cardiopulmonary resuscitation improves survival with good neurologic function: results from the ResQ Trial
    2011
    • presentations
    Presentation
  • Active compression decompression cardiopulmonary resuscitation and augmentation of negative intrathoracic pressure is neuro-protective in patients with an out-of-hospital cardiac arrest [presentation]
  • EAGLES bullet rounds #2: intra-osseous monitoring [presentation], Medical Directors Gathering of EAGLES Conference
  • Everything you thought you knew about resuscitation, but probably don't [presentation]
  • Intraosseous pressure monitoring in critically ill and injured patient [presentation]
  • It's a "no brainer!" Using bispectral index monitoring in determining futility [presentation]
  • It's a "no brainer"! Using bispectral index monitoring in determining fulility [presentation], Citizens CPR Foundation Emergency Cardiac Care Update Pre-Conference Workshop
  • It's a "no brainer"! Using bispectral index monitoring in determining fulility [presentation], Medical Directors Gathering of EAGLES Conference
  • Maintaining perfusion till re-perfusion: mechanical devices and bridging the time to the cath lab [presentation]
  • Maintaining perfusion till re-perfusion: mechanical devices and bridging the time to the cath lab [presentation], Citizens CPR Foundation Emergency Cardiac Care Update Pre-Conference Workshop
  • Minding your P's and Q's: what are the actual cardiac effects of sedation practices [presentation]?, Citizens CPR Foundation Emergency Cardiac Care Update Pre-Conference Workshop
  • New skills with drills [presentation], Medical Directors Gathering of EAGLES Conference
  • Pediatric video laryngoscopy: is it time to reconsider [presentation]
  • Potential negative effects of epinephrine on carotid blood flow and ETCo2 during active compression-decompression CPR utilizing an impedance threshold device [presentation]
  • SNPe CPR vs S-CPR [presentation], Medical Directors Gathering of the Eagles XIV Conference
  • So what should we use then? Results of a video-laryngoscope trial [presentation], Medical Directors Gathering of the Eagles XV Conference
  • Supraglottic airway: does it cause decreased cerebral perfusion in patients with marginal flow [presentation]?, Medical Directors Gathering of the Eagles XIV Conference
  • The use of mechanical CPR devices in flight [presentation]
  • To ITD or not to ITD (impedance threshold device): reconciling the ROC and ResQ Trial results [presentation], Medical Directors Gathering of the Eagles XIV Conference
  • Use of an impedance threshold device with active compression decompression cardiopulmonary resuscitation improves survival with good neurologic function following cardiac arrest from non-traumatic etiologies [presentation]
  • What's happening in the Twin Cities: the role of LUCAS in ECLS (extracorporeal life support) [presentation]
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