High-dose epinephrine in adult cardiac arrest

Article Abstract:

High-dose epinephrine may not be more effective than low-dose epinephrine for treatment of cardiac arrest in adults. The percentage of patients who survive cardiac arrest is low, and those who survive often suffer neurological damage. Among 650 patients who suffered a cardiac arrest, 317 were treated with up to five doses of seven milligrams (mg) of epinephrine and 333 were treated with up to five doses of one mg of epinephrine. Fifty-six patients (18%) treated with high-dose epinephrine survived one hour after cardiac arrest, compared to 76 (23%) treated with low-dose epinephrine. Ten patients (3%) treated with high-dose epinephrine survived to be discharged from the hospital, compared to 16 (5%) treated with epinephrine. Among the patients who survived, the neurological outcome of patients in the high-dose group was not significantly better than patients in the low-dose group.

Health aspects, Epinephrine

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The Ontario trial of active compression-decompression cardiopulmonary resuscitation for in-hospital and prehospital cardiac arrest

Article Abstract:

Active compression-decompression cardiopulmonary resuscitation (ACD CPR) does not appear to be more effective than regular CPR. During ACD CPR, the rescuer uses a suction device that allows the chest to expand, or decompress, following each compression. Research has suggested that this may improve blood flow and ventilation. Researchers followed 773 people who developed cardiac arrest in a hospital and 1,011 people who arrested in the community and were transported to a hospital. Approximately half of both groups received regular CPR and half received ACD CPR. ACD CPR did not improve survival rates at one hour or at hospital discharge. This was true for the groups overall and for subgroups with specific characteristics, such as age, type of arrhythmia that led to cardiac arrest or how soon they received CPR. Many of the rescuers found it very difficult to administer ACD CPR.

Care and treatment, CPR (First aid), Cardiopulmonary resuscitation

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Outpatient oral prednisone after emergency treatment of chronic obstructive pulmonary disease

Article Abstract:

Patients treated for chronic obstructive pulmonary disease (COPD) in a hospital emergency department may benefit from taking a corticosteroid drug called prednisone once they are discharged, according to a study of 147 patients. Twenty-seven percent of the patients who took prednisone for 10 days had a relapse within 30 days compared to 43% of those who took a placebo, or inactive substance. Corticosteroid drugs have serious adverse effects and may not be suitable for all COPD patients.

Lung diseases, Obstructive, Chronic obstructive lung disease, Prednisone, Ambulatory medical care, Ambulatory care

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