Factual reason behind using 1:10000 over 1:1000 Epi in Cardiac Arrest

[Smash]

It was 1992 and twas foretold in Mobile Intensive Care Officer training that drugs in cardiac arrest do little .... and nobody seems to have really picked up on that nye 20 years later.

That's not entirely true Brown. Drugs in cardiac arrest make barely homestasing paragod wannabes think that they are somehow locked in mortal combat with death itself, using all the fearsome tools that modern science provides...

All epi in dead people does is keep earthworms up at night!

But yes, at this stage 1mg=1mg. I'm still working on my proof that 1mg does not equal 1mg, but I'm getting bogged down with the Bosonic Fields while attempting to expand the path integral formalism before attempting Poincare transformation, which are of course covariant with the Feynman propagtor, which doesn't make life any easier.

 

[Smash]

Yep. I have offered what I can to explain the rationale. Could it be done? Probably. Is it a good idea? Probably not. Talk to your OMD and try to get it approved. Hell, give it a shot next time and see what happens.

But you haven't explained a rationale as to why people use 1:10000 as opposed to 1:1000. How is it that 1mg is not the same as 1mg?

 

[MrBrown]

Smash please ... stop talking sense

You know there is no room for sense in the 100 hour curricula

 

[Melclin]

All epi in dead people does is keep earthworms up at night!

Hahaha, I'm stealing this and claiming that I was witty enough to think of it myself.

I'm still working on my proof that 1mg does not equal 1mg, but I'm getting bogged down with the Bosonic Fields while attempting to expand the path integral formalism before attempting Poincare transformation, which are of course covariant with the Feynman propagtor, which doesn't make life any easier.

Well duh. Geez, thanks captain obvious.

 

[Smash]

Well duh. Geez, thanks captain obvious.

Yeah, I know, but I got a bit tied up with the Feynman representation of the Wicks expansion in the pertubative s-matrix before I realised that if I just substituted a scalar field Lagrangian equation I would come up with a clearer probability amplitude to apply to the Fourier transformations. :wacko:

Look, it was late and I hadn't had any coffee, so you'll have to excuse my ridiculous, basic error.

While I work on this, has anyone else come up with a reason why 1mg of epi does not equal 1mg of epi? Have we worked out why it is "too concentrated" or anything? It concerns me; I have been giving 1:1000 epi IV for over a decade and I had no idea I was making people explode or whatever it is it is meant to do. (Maybe I would have noticed the exploding thing, but...)

 

[usalsfyre]

Yep. I have offered what I can to explain the rationale. Could it be done? Probably. Is it a good idea? Probably not. Talk to your OMD and try to get it approved. Hell, give it a shot next time and see what happens.

You know I actually had a conversation about this with clinical services personel about two days ago. They agreed, completely pointless that we carry 1:10,000, other than to make 1:100,000 to use as a push dose pressor. Good luck getting it off of our trucks though. I can hear the howls of derission now....

 

[Shishkabob]

I'm one to take the less liked position and say you can't have more survivals without having more ROSCs, and more ROSCs have been proven to come from the drugs.


Clearly there's a disconnect between ROSC and survival... a piece of the puzzle we're missing. Therapeutic Hypothermia is a part of that. Now what else?

 

[usalsfyre]

I'm one to take the less liked position and say you can't have more survivals without having more ROSCs, and more ROSCs have been proven to come from the drugs.


Clearly there's a disconnect between ROSC and survival... a piece of the puzzle we're missing. Therapeutic Hypothermia is a part of that. Now what else?

There's "good" survival and there's "bad" survival. Theraputic hypothermia is a piece of the puzzle to prevent cell apoptosis. BUT...when you have 20+ minute response times like we do, you can probably get a ROSC, but MODS has already been set in motion.

 

[Shishkabob]

Agreed, and I'm not the biggest fan of running 25 minutes to a cardiac arrest that should have been picked up by another agency but NOOO it was out of their service area... And work a code that I know is futile, but meets ALL the criteria to work.


But as I said, A gets C, F gets H... now we just need to find B, D, E, and G.


ACLS drugs get a pulse back. Plenty of evidence to back that up. The problem is KEEPING the pulse... and with a good neural outcome.

 

[usalsfyre]

Agreed, and I'm not the biggest fan of running 25 minutes to a cardiac arrest that should have been picked up by another agency but NOOO it was out of their service area... And work a code that I know is futile, but meets ALL the criteria to work.

Hate this as well...for instance today one of my arrest had 40 minutes of CPR done PTA.

But as I said, A gets C, F gets H... now we just need to find B, D, E, and G.

I'm not sure in a lot of cases there is a B,D,E and G. Maybe in some cases, but not all.

ACLS drugs get a pulse back. Plenty of evidence to back that up. The problem is KEEPING the pulse... and with a good neural outcome.

Some of these drugs do enough damage to other end organs that a good neural outcome may still not equal a good outcome. Kidneys, liver and gut in particular.

 

[Shishkabob]

Hate this as well...for instance today one of my arrest had 40 minutes of CPR done PTA.

Though there are always the outliers that get an hour of CPR and have good outcome....

Some of these drugs do enough damage to other end organs that a good neural outcome may still not equal a good outcome. Kidneys, liver and gut in particular.

Shhh. The less drugs I have to push, the more I'm expected to do CPR.

 

[usalsfyre]

Shhh. The less drugs I have to push, the more I'm expected to do CPR.

:unsure:
They took away our intubations, they made IOs an EMT-I skill, crap what's next, medics doing CPR....h34r:

:lol::lol::lol:

 

[Smash]

:unsure:
They took away our intubations, they made IOs an EMT-I skill, crap what's next, medics doing CPR....h34r:

:lol::lol::lol:

Christ, why would you even say something like that?! Can we have this post moderated please, there is no need for that sort of talk. I need a shower now...