reply to post by Kail918
Hey Kail918, congrats on going to paramedic school. I'm a Nurse/Paramedic as well. As Binder will tell you also, once you get into this field you
will never stop learning!!
also what do you think about the AHA taking Lidocaine off of the ACLS first line drug for cardiac arrest and replacing it with amiodorone? i have seen
lidocaine work many times and it seems better then amiodorone. do yo think the makers paid off the AHA to pull lidocaine and replace it with their own
I'll chime in on this one as I'm an AHA instructor for CPR, ACLS, & ACLS-EP (Experienced Provider). This is an old issue that still seems to persist
even after almost a decade. When addressing these kind of issues we should refrain from anecdotes as quantitative facts or evidence. We need to look
at the hard facts and keep emotions out of it. Having said that, we know AHA makes recommendations and changes, it seems, at a drop of a hat, and can
be somewhat whishy-washy at times. Yep, I agree, Lidocaine had been a Class IIb action for quite some time, then, Amiodarone comes along and Lidocaine
gets bumped down to a Class III. Also, its not that Amiodarone is "their drug." What looks fishy
is that the makers of Amiodarone financially
endorsed the study. That's a little hinky-hinky for most of us. Those studies should have been conducted independently. No question of bias.
What you want to do Kail is review the ALIVE Study and the ARREST trial. (I included a link). As Binder and I'll tell you, what we're really
concerned with is one-thing SURVIVAL-to-DISCHARGE and how neurologically intact our patients are. Quite simply, the reason for the change is that
Amiodarone was more effective than Lidocaine for patients with refractory ventricular fibrillation in SURVIVAL-to-ADMISSION.
Although this is
good, it doesn't necessarily mean these patients survived rolling past the emergency department doors. I don't believe anyone has studied that, and
that, would be most important. What is good is that maybe some of those families got just a little more time with a loved one to say goodbye. Another
benefit is that perhaps some of those patients became organ donors, and as you know working EMS, none of the patients we "work in the field" have a
chance of donating any organs or tissues.
And lastly, to just blow your mind, you should realize there have been NO controlled studies evaluating the effectiveness of vasopressors in cardiac
arrest patients...EVER! And yet we push enough Epinephrine to return a pulse to a rock! Hahaha
Anyways, great question! Gotta run for some grub! I'm sure Binder has a lot to contribute with his experience! Here's the link