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Antidysrhythmics in Cardiac Arrest (BLS Version)
Antidysrhythmics in Cardiac Arrest (ALS Version)
Medications have long been one of the mainstays of cardiac arrest management. Some medications have been deemphasized or eliminated based on good evidence, some because of a lack of availability, and the use of any drugs— even the most standard of all, epinephrine—is being questioned. So what does the literature say about the use of antidysrhythmic agents in cardiac arrest? There are several studies that can help us understand the evidence base for these agents.
Penetrating thoracic trauma, primarily from knives and firearms, is a common mechanism for cardiac injury. Overall 10% of firearm deaths may be attributed to cardiac injury. As can be expected, cardiac injury is frequently fatal, and most patients do not survive long enough to reach a hospital. For patients with traumatic cardiac arrest who reach the emergency department, resuscitative thoracotomy is a maneuver that can save some who otherwise would not be successfully resuscitated. But is there more we could be doing to increase survival in these patients?
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