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Pharmacology question


camev

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I'd rather have the pt. tubed, even if they do come out of the full arrest and then have to pull it. Airway #1. You need that tube in during the entire code, and if you are going to give the Narcan and/ or D50, that's way down the line of what you are going to do first. I doubt if anyone is going to come into a full arrest with the intention of giving those two drugs first no matter what the suspicions.

I follow what you are saying, but.........

If you suspect something causes the arrest and can be easily fixed (hypoglycemia, narcotic OD, tension pneumo) why push the drug/intervention to fix the problem down the line when they have a good chance to wake up in the next few minutes? I am just thinking that if I suspect they will wake up, I would not want to "come to" with a tube sticking down my throat.

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I'd rather have the pt. tubed, even if they do come out of the full arrest and then have to pull it. Airway #1. You need that tube in during the entire code, and if you are going to give the Narcan and/ or D50, that's way down the line of what you are going to do first. I doubt if anyone is going to come into a full arrest with the intention of giving those two drugs first no matter what the suspicions.

I follow what you are saying, but.........

If you suspect something causes the arrest and can be easily fixed (hypoglycemia, narcotic OD, tension pneumo) why push the drug/intervention to fix the problem down the line when they have a good chance to wake up in the next few minutes? I am just thinking that if I suspect they will wake up, I would not want to "come to" with a tube sticking down my throat.

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I follow what you are saying, but.........

If you suspect something causes the arrest and can be easily fixed (hypoglycemia, narcotic OD, tension pneumo) why push the drug/intervention to fix the problem down the line when they have a good chance to wake up in the next few minutes? I am just thinking that if I suspect they will wake up, I would not want to "come to" with a tube sticking down my throat.

Usually if they are in full arrest already, it's going to take more than D50 or Narcan to resuscitate them. They are not going to "snap" out of it as they would if they were only non-responsive. You'll have to do at least the first line of drugs. Early intubation is critical for delivering the high concentration of O2 needed for resuscitation.

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Personally, I grab a blood glucose on all cardiac arrest patients early in the action.

Someone usually is assigned this early, running with a crew of two it can be tricky, although first responders these days are on their game and eager to obtain it for you.

I have only caught one hypoglycemia /c cardiac arrest in 8 years.

Of course the important stuff is done first ie: Airway, CPR, Multi-function pads.

A lesson learned long ago while doing my clinical rotations.

48 y/o cardiac arrest patient /c no medical history.

EMS crew did 2 full rounds of drugs: EPI, Atropine, BiCarb.

PEA throughout.

Upon return of patients labs, Glucose 12 mg/dl.

Not saying it would have made a different outcome but it is a bit of poor form.

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im trying to read everyones reply and yet i cant find where anyone has mentioned the H's and T's.

Just look at what the other 3 post wonder wrote two posts above your post.

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