Cardiac arrest last ditch medications

[Siggy]

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Last ditch medications for refractory v-fib/v-tach (electrical storm) would include beta blockers.

What population is harmed by epi and what should we use instead?

The better question is "who does it help, and if it doesn't help why are we using it."

 

[Radetzky]

It helps unstable septic patients who sometimes arrest after a turn and only need 100-200 mcg to come back, it helps anaphylactic arrest, it helps beta blocker overdose, and those who have arrested due to some acute cardiomyopathy (peripartum, myocarditis).

While as pointed out there are many counterproductive situations, let’s not throw the baby out with the bath water!

 

[deleted547339]

It helps unstable septic patients who sometimes arrest after a turn and only need 100-200 mcg to come back, it helps anaphylactic arrest, it helps beta blocker overdose, and those who have arrested due to some acute cardiomyopathy (peripartum, myocarditis).

While as pointed out there are many counterproductive situations, let’s not throw the baby out with the bath water!

Does it help beta-blocker OD???

 

[SpacemanSpifff]

Does it help beta-blocker OD???

It's something to do while you wait for the call from pharmacy: "are you sure you want that much insulin?"

 

[Radetzky]

Does it help beta-blocker OD???

Yes... it’s not gonna be the sole therapy, but it helps.

 

[deleted547339]

Yes... it’s not gonna be the sole therapy, but it helps.

If you have maximal beta-blockade it seems unlikely you would overcome that. I’ve always put these folks on levo until I started insulin or ecmo - seems to make more sense, at least to me.