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While patients hospitalized for a heart attack have long been treated with morphine to relieve chest pain, a new analysis by researchers from the Duke Clinical Research Institute has shown that these patients have almost a 50 percent higher risk of dying.
The researchers call for a randomized clinical trial to confirm their analysis. Meanwhile, they advise cardiologists to begin treatment with sufficient doses of nitroglycerin to relive pain before resorting to morphine.
In their analysis of the clinical data and outcomes of more than 57,000 high-risk heart attack patients -- 29.8 percent of whom received morphine within the first 24 hours of hospitalization -- the researchers found that those who received morphine had a 6.8 percent death rate, compared to 3.8 percent for those receiving nitroglycerin. The increase in mortality persisted even after adjustment for the patients' baseline clinical risk.
"The results of this analysis raise serious concerns about the safety of the routine use of morphine in this group of heart patients," said Duke cardiologist Trip Meine, M.D., who presented the results of the Duke analysis Nov. 10, 2004, at the American Heart Association's (AHA) annual scientific sessions in New Orleans.
Read More HERE: http://www.defrance.org/artman/publish/article_1106.shtml
The researchers call for a randomized clinical trial to confirm their analysis. Meanwhile, they advise cardiologists to begin treatment with sufficient doses of nitroglycerin to relive pain before resorting to morphine.
In their analysis of the clinical data and outcomes of more than 57,000 high-risk heart attack patients -- 29.8 percent of whom received morphine within the first 24 hours of hospitalization -- the researchers found that those who received morphine had a 6.8 percent death rate, compared to 3.8 percent for those receiving nitroglycerin. The increase in mortality persisted even after adjustment for the patients' baseline clinical risk.
"The results of this analysis raise serious concerns about the safety of the routine use of morphine in this group of heart patients," said Duke cardiologist Trip Meine, M.D., who presented the results of the Duke analysis Nov. 10, 2004, at the American Heart Association's (AHA) annual scientific sessions in New Orleans.
Read More HERE: http://www.defrance.org/artman/publish/article_1106.shtml
lol, ahhhh, just kidding. remember people, BLS before ALS. In my protocols, I can start tridil drips (liquid nitro if you didn't know) and between the O2 and bumping up the tridil, that almost always gets rid of the active chest pain. I get to bump up to as high as I need to go as long as the BP stays over 90. I do give MSO4 on quite a few cases, but always go with increasing the tridil first.
