crazycanuck

The rate from digoxin toxicity is not necessarily slow though it may be primarily what people see. Dig can make the rate do anything, like magic...bad magic --or good magic depending on how much of it you eat. From EMedicine reference link http://www.emedicine.com/emerg/topic137.htm

with his kindness.

his small cage

were mossy green

cough *bullshiit* cough ?!?!?! :twisted: (JUST KIDDING SIS YA KNOW I LOVE YA)

then he barfed

got super baked

yummy chocolate cake

a chocolate lollipop (dont make this dirty)

over there yonder

brent beat me

into my eyes

stand with its

HAPPEEE BIRFDAAAYYYY TERI!

Which one Anthony? Kelly's link?

Dear Brent, Watch out for those ear drops. :wink:

On a related note and fitting into this thread theme: The LifeVest® wearable defibrillator http://www.zoll.com/product.aspx?id=902 This device is not used in EMS treatment, rather home-based protection for patient awaiting ICD implant or who are not candidates for implantable defibrillators. Just a heads up, as the indications and use of this device expand it may be something else you encounter.

Nice post Kelly. I have heard of the ResQPOD before but haven't done much reading on it. Here are some references: Community Consultation for the Proposed Cardiac Arrest Study powerpoint slides http://www.mcw.edu/display/router.asp?docid=11740 http://www.zoll.com/product.aspx?id=377 Big list of related publications: http://www.advancedcirculatory.com/CET/articles.htm *from manufacturer site but articles are in reputable journals*

Here's a few references for adenosine: http://www.drugs.com/pro/adenosine.html anesthesia.slu.edu/pdf/keywords/ADENOSINE%20PHARMACOLOGY.pdf (cut and paste, I dont know how to make it clicky) Everyone is going to have a different definition for SVT, some will cite it as any atrial rhythm >100bpm if there is no reason for sinus tachycardia such as illness, stress, exercise, compensatory response. For most patients, it will not become hemodynamically unstable until it reaches a much higher rate so it really isn't so much the semantics of what you will define SVT as, but more so about when it becomes a rate that you want to treat as symptomatic. As for the rapid push to get it in as quickly as possible, this is debatable too and I'll leave that for someone else...I'm not sure of the longterm effects of the drug, I believe the half life and mechanism of action are short. Half life less than 10sec, and action on the AV node is short too, the specific amount of time I do not have the answer....

Do you mean DC or WA? I looked up requirements for both and do not see CPR listed as a requirement for licensing, but that would be a pretty dang good requirement! http://dmv.dc.gov/serv/dlicense/get_DL.shtm http://www.dol.wa.gov/driverslicense/18over.html And as far as literature you can search by geographical data, but outcomes would be difficult to compare between cities due to extraneous variable unless you are looking at a multi-site outcome studies with the same reporting parameters. Here is another excellent resource and interesting site: http://www.nrcpr.org/research_publications.html

AND ME. *grabs hockey stick* Don't bash my sister or you're going down. :twisted:

http://www.pubmedcentral.nih.gov/articlere...i?artid=1336161 Cardiac arrest in Ontario: circumstances, community response, role of prehospital defibrillation and predictors of survival. R J Brison, J R Davidson, J F Dreyer, G Jones, J Maloney, D P Munkley, H M O'Connor, and B H Rowe http://www.aemj.org/cgi/content/abstract/8/5/424 The Relationship between Out-of-hospital Cardiac Arrest Survival and Community Bystander CPR Rates Valerie J De Maio, Ian G Stiell, George A Wells, Michael T Martin, Daniel W Spaite, Graham Nichol, David Brisson, Donna Cousineau, Jeremy Doherty, Marion B Lyver, Brian J Field, Douglas P Munkley and , the OPALS Study Group *edit for formt

I would say something to this but....I believe I will let the others have a go first. Dust, we think you're charming.....after all you have your own post ALL about YOU.

I could not agree more. Thank you for expanding upon your points and thoughts. My post was not to pick at you or criticize your education or abilities. I misunderstood you to be saying there's not a hope in hell so why try, which is not really what you are saying I think. Your point right here is of the utmost importance: The latter of the two seems more reasonable, no? Outcome based measures and adapting treatment algorithms, protocols, and patient care are not the answer to saving everyone, and living in a rose-coloured glasses kind of world where people are saved by fairies and wishes is not going to help either. Education is going to be what makes the difference. Education of the public to be more effective bystanders and primary prevention of heart disease and illness need to be a bigger focus than our currently short-sighted model of damage control....but that's a whole other discussion Thanks for your comments whit. :wink:

This is going to vary dependent on the study parameters and so many factors. You will find a pretty wide range of numbers depending on the operational definitions used.... Did you not know that 98.376% of statistics are made up. This percetage survival to discharge of 0% is false. Though the OHCA survival rate is poor, it is more constructive to do as Medic26 is here, to educate oneself on the definitions, process, and outcomes in attempt to improve it. This attitude sucks. Plain and simple. If you expect 0% guess what you will get???....0% Here's a few references for OHCA survival figures. 1) High Discharge Survival Rate After Out-of-Hospital Ventricular Fibrillation With Rapid Defibrillation by Police and Paramedics. Annals of Emergency Medicine, Volume 28, Issue 5, Pages 480-485 R. White, B. Asplin, T. Bugliosi, D. Hankins http://linkinghub.elsevier.com/retrieve/pi...196064496701099 2) Predicting survival from out-of-hospital cardiac arrest: A graphic model. Annals of Emergency Medicine, Volume 22, Issue 11, Pages 1652-1658 M. Larsen, M. Eisenberg, R. Cummins, A. Hallstrom http://linkinghub.elsevier.com/retrieve/pi...0644(05)81302-2 3) Cardiac arrest and resuscitation: A tale of 29 cities. Annals of Emergency Medicine, Volume 19, Issue 2, Pages 179-186 M. Eisenberg, B. Horwood, R. Cummins, R. Reynolds-Haertle, T. Hearne http://linkinghub.elsevier.com/retrieve/pi...0644(05)81805-0 4) Outcome of out-of-hospital cardiac arrest in New York City. The Pre-Hospital Arrest Survival Evaluation (PHASE) Study http://jama.ama-assn.org/cgi/content/abstract/271/9/678 5) Improved Out-of-Hospital Cardiac Arrest Survival Through the Inexpensive Optimization of an Existing Defibrillation Program OPALS Study Phase II http://jama.highwire.org/cgi/content/abstract/281/13/1175 6) Incidence of cardiac arrest: A neglected factor in evaluating survival rates. Annals of Emergency Medicine, Volume 22, Issue 1, Pages 86-91 L. Becker, D. Smith, K. Rhodes http://linkinghub.elsevier.com/retrieve/pi...0644(05)80257-4