New to Meducation?
Sign up
Already signed up? Log In

Category

Www.bmj
1
30

Is adrenaline safe and effective as a treatment for out of hospital cardiac arrest?

Adrenaline (epinephrine) has been an integral component of advanced resuscitation algorithms since the early 1960s. Initial guidelines for the treatment of cardiac arrest recommended the use of intracardiac adrenaline (0.5 mg) or high dose intravenous adrenaline (10 mg), repeating with larger doses if required.1 The mechanism of action for adrenaline in cardiac arrest is attributed to stimulation of α2 receptors in vascular smooth muscle, causing vasoconstriction. This increases aortic diastolic pressure, which in turn leads to increased coronary perfusion pressures, which improves short term survival. Experimental studies, however, suggest that adrenaline impairs cerebral macrovascular2 and microvascular blood flow,3 4 increases ventricular arrhythmias, and increases myocardial dysfunction after return of spontaneous circulation.5 This creates the paradox of better short term survival but at the potential cost of worse long term outcomes.  
bmj.com
over 5 years ago
Www.bmj
1
24

Time to administration of epinephrine and outcome after in-hospital cardiac arrest with non-shockable rhythms: retrospective analysis of large in-hospital data registry

Objective To determine if earlier administration of epinephrine (adrenaline) in patients with non-shockable cardiac arrest rhythms is associated with increased return of spontaneous circulation, survival, and neurologically intact survival.  
bmj.com
about 5 years ago
Www.bmj
1
22

Time to administration of epinephrine and outcome after in-hospital cardiac arrest with non-shockable rhythms: retrospective analysis of large in-hospital data registry

Objective To determine if earlier administration of epinephrine (adrenaline) in patients with non-shockable cardiac arrest rhythms is associated with increased return of spontaneous circulation, survival, and neurologically intact survival.  
bmj.com
about 5 years ago
5
0
21

Why do resus kits talk about doses of adrenaline in ratios instead of units?

Why do resus kits not talk about doses of adrenaline in milligrams? They state things like 1:1000 or 1:10000! I was in A+E today and was being shown around the resus stuff. The adrenaline is in 1:10000 for example, and I couldn't workout why this was. I didn't have the courage to ask at the time.  
Sally Ralton
almost 7 years ago
10
0
17

Hormone sensitive Lipase in Type 2 Diabetes mellitus

Hello. My question is regarding the rise of NEFAs as a pathogenic cause of type 2 DM. In a healthy human hormone sensitive lipase responds to epinephrine, ACTH & glucagon to release glycerol + NEFAs. I thought this enzyme would be the main culprit acting to release glycerol + NEFAs in DM2, however, several papers are saying it markedly reduced! My question is then, if HSL is reduced in type 2 DM/Obese patients, what enzyme is responsible for the lipolysis? Which hormone stimulates it? I hope someone can shed some light on this. Thanks!  
m altidor
over 6 years ago
0
0
1196

Why does heart rate fall when you jump in cold water?

I thought your heart rate would increase when you jump in cold water because of adrenaline release, but I've been told it decreases. Why is this? Thanks!  
Katy Kershaw
over 6 years ago
Preview
0
29

Widespread incorrect use of epinephrine auto-injectors and asthma inhalers

Millions of Americans with severe allergies and asthma are prescribed medical devices to help relieve symptoms and sometimes, to treat potentially fatal allergic reactions.  
medicalnewstoday.com
over 4 years ago
Preview
0
18

RAGEback: Swami on Adrenaline in Cardiac Arrest - The RAGE Podcast

Anand 'Swami' Swaminathan delivers this RAGEback to EMCrit's Scott Weingart on the role of adrenaline in cardiac arrest.  
ragepodcast.com
over 4 years ago
Preview
0
51

Shock! The 4 Types of Shock

Dear emin5 team Your page is very nice. When watching the shock-video, I have two questions / remarks: – dopamine is a drug, that don’t be applied today. Epinephrine is the drug of choice, for intoxications (with beta blockers ..) – PE could be treated by systemic thrombolysis?  
emin5.com
over 4 years ago
Preview
0
13

Beyond ACLS: Epinephrine in Out-of-Hospital Cardiac Arrest Poll - R.E.B.E.L. EM - Emergency Medicine Blog

Recently, I wrote a post on the use of epinephrine in out-of-hospital cardiac arrest (OHCA) and this triggered some interesting discussion on twitter...  
rebelem.com
over 4 years ago
Preview
0
17

Beyond ACLS: Is It Time to Abandon Epinephrine in Out-Of-Hospital Cardiac Arrest? - R.E.B.E.L. EM - Emergency Medicine Blog

The effectiveness of epinephrine in OHCA on neurologic outcomes has never been established.  
rebelem.com
over 4 years ago
Preview
0
17

PERIPHERAL NORADRENALINE

Peripheral noradrenaline (or norepinephrine), or any peripheral pressor, is shunned in many centers. High doses can cause gangrene. If extravasated, it can cause tissue necrosis. But is this a big risk? Also, weighing against the risks of CVC or delayed pressor start-up – what’s the best approach? I work in a teaching hospital where short-term noradrenalin infusions are fully acceptable, and the norm in many settings – but other places I’ve worked, it’s a big no-no. Recently, we got a systematic review on the subject.  
scancrit.com
about 4 years ago
Preview
0
24

Effects of prehospital epinephrine administration on neurological outcomes in patients with out-of-hospital cardiac arrest

Just released online a retrospective study of prehospital epinephrine/adrenaline on neurologic outcomes in OHCA! Showing benefit in sub group with CPR 15-19 min duration Read and decide for yourself! Effects of prehospital epinephrine administration on neurological outcomes in patients with out-of-hospital cardiac arrest Editor's opinion: I have always believed epinephrine has a role in cardiac…  
prehospitalmed.com
about 4 years ago
Preview
0
36

Beyond ACLS: CPR, Defibrillation, and Epinephrine - R.E.B.E.L. EM - Emergency Medicine Blog

ACLS provides a well structured framework for those who resuscitate infrequently, but there is room to move beyond the algorithm for those who resuscitate frequently.  
rebelem.com
about 4 years ago
Preview
3
152

Why we do what we do: Epinephrine in anaphylaxis

Epinephrine is the most important drug in the management of anaphylaxis. It is so important because it saves lives! This is no hyperbole. This edition of the Why we do what we do series focuses on the evidence behind the use of IM Epi in Anaphylaxis.  
pemcincinnati.com
about 4 years ago
Preview
0
14

Unlearning in Medicine by Dr Lauren Westafer

What do Pluto, left bundles, and lidocaine w/epinephrine have in common? Unlearning in medicine #FOAMed #CAEP15 talk https://t.co/HLZlLBiOKJ— Lauren Westafer (@LWestafer) August 16, 2015  
prehospitalmed.com
about 4 years ago
Preview
0
8

More Dogma: Epinephrine in Digital Nerve Blocks - R.E.B.E.L. EM - Emergency Medicine Blog

The use of epinephrine in digital nerve blocks has been shown to increase duration of action for the anesthetic, and to allow the avoidance of bupivacaine, thereby decreasing the pain of the injection.  
rebelem.com
almost 4 years ago
Preview
0
7

Critical Care

Endotracheal intubation is frequently complicated by laryngeal edema, which may present as postextubation stridor or respiratory difficulty or both. Ultimately, postextubation laryngeal edema may result in respiratory failure with subsequent reintubation. Risk factors for postextubation laryngeal edema include female gender, large tube size, and prolonged intubation. Although patients at low risk for postextubation respiratory insufficiency due to laryngeal edema can be identified by the cuff leak test or laryngeal ultrasound, no reliable test for the identification of high-risk patients is currently available. If applied in a timely manner, intravenous or nebulized corticosteroids can prevent postextubation laryngeal edema; however, the inability to identify high-risk patients prevents the targeted pretreatment of these patients. Therefore, the decision to start corticosteroids should be made on an individual basis and on the basis of the outcome of the cuff leak test and additional risk factors. The preferential treatment of postextubation laryngeal edema consists of intravenous or nebulized corticosteroids combined with nebulized epinephrine, although no data on the optimal treatment algorithm are available. In the presence of respiratory failure, reintubation should be performed without delay. Application of noninvasive ventilation or inhalation of a helium/oxygen mixture is not indicated since it does not improve outcome and increases the delay to intubation.  
ccforum.com
almost 4 years ago