August 2021

Deep Dive: Medications

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No me gusta!

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tom f. -

once again, super.

actually we have a patient in our shop who regularly comes in with a calcium of 5-6. hypocalcemia secondary to hypoparathyroidism.
it had been thought that very severe hypocalcemia can cause cardiac arrest or seizures, but a recent-ish article in Endocrine Connections 10/2018 concluded its unclear if that's the case.

meds: some say "nothing works"
some shops (Weingart (and he says the more sophisticated (not his word) shops of resuscitationists) use a "background " drip of 50 mcg/min of norepinephrine !! on every code. I am quite sure I'm quoting him right (hope so, I'd hate to piss him off).. I think it was in this year's. "essentials of EM".

amiodurone , as well as any med that blocks at the a-v node , is contraindicated in WPR with a rapid A fib. so... if you don't know that the patient has WPW, but you see a patient with a wide complex polymorphic afib, with a rate over 180, certainly think: "is this possibly WPW" before you give amiodurone, or any A-V nodal blocker.

thank you both again..

tom fiero, merced , ca.

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Cardiac Arrest Full episode audio for MD edition 71:56 min - 78 MB - M4AC3: Cardiac Arrest MP3 Files 84 MB - ZIP