Is CPAP the Standard of Care?

[marineman]

licorice is known to raise the BP

cool, that was not known by me but now it is. I'm going to start hanging bags of twizzlers instead of dopamine.

 

[Aidey]

lol, I think it's only the real licorice, not twizzlers, which are arguably not real licorice (at least it's not according to my best friend).

 

[VentMedic]

lol, I think it's only the real licorice, not twizzlers, which are arguably not real licorice (at least it's not according to my best friend).

The black Twizzlers can also have cause sodium retention and potassium loss if consumed in large quantities.

 

[Aidey]

Oooo, I forgot they made black ones. I HATE licorice with a passion.

 

[Ridryder911]

Well written and informative rid. I have a few questions from it though, first is towards the end you mention a last line possibility being dopamine. We will probably never hit that point in the field but hanging dopamine for CHF you go with a lower dose than our ACLS 2-10mcg/kg/min right? Also at the lower dose does that prevent some of the vasoconstricting effects of dopamine? It seems like hanging a vasoconstrictor would be counter productive unless at that dose it's positive inotropic effect greatly outweighs the vasoconstriction.

Last question why avoid licorice?

Actually the side effect of Dopamine is vasoconstriction. Dopamine has three major effects all dependent upon the dosage. Low doses at one time was considered to actually lower bood pressure and increase venous return. In reality it does some, not as much as we thought. Middle range dosages increases messentric dilatation and can increase renal perfusion somewhat. It is at the high range (Alpha) that vasoconstriction occurs, and one will also witness a decrease in urine and increasing risk to the renal system.


Licorice-licorice active ingredient is glycyrrhizin and that itself can cause 'pseudoaldosteronism' or 'mineralocorticoid syndrome' due to the effects on the adrenal glands. Symptoms include headache, lethargy, muscular weakness or aches, high blood pressure, sodium and water retention, increased potassium loss, and sometimes even cardiac arrest. Symptoms can manifest within one week if the daily ingestion of licorice is over 100 g. Deglycyrrhizinated extracts are virtually free of adverse mineralocorticoid side effects.
Adverse reactions to ingesting licorice products are more common in individuals who have hypertension, kidney or heart disorders, hypokalemia, liver disease, and hypertonia.
Licorice may affect the way certain drugs work, especially diuretics and anti-hypertensive drugs

 

[Outbac1]

This was a study done only in the Metro/Halifax area of the province. Despite the outcome from the study there are still no CPAP devices on any ambulances in the province. When the study was done the units came off the trucks.

There are a lot of medics who would like to have CPAP as a tool to use.

The wheels of politics and medicine can move slowly everywhere.