Saturday, October 5, 2019
Discuss the evidence, or lack of evidence, that exists to support the Essay
Discuss the evidence, or lack of evidence, that exists to support the use of adrenaline (epinephrine) in cardiac arrest in pre-hospital setting (ambulance work) - Essay Example patients outside of hospital had no substantially greater success or improved survival rates over medical technicians supplied with basic CPR skills and semi-automatic defibrillators (paraphrased from graphs. 1-3). In a related study (Heart, 1997), researchers found results consistent with a continued skepticism over the use of adrenaline. According to this article, "Some emergency medical staff were authorised to give standard doses of adrenaline during the observational period. Adrenaline was given to 35% of patients and was associated with a significantly greater rate of restoration of spontaneous circulation and hospital admission. However, there was no significant difference in hospital discharge rates between the two groups. Thus adrenaline and its dosage during cardiac arrest remain controversial" (412-414). It appears that when paramedics and other qualified emergency medical personnel give adrenaline to cardiac arrest patients in the field, it significantly improves the chance that the patient will live long enough to be admitted to the hospital, but it does not significantly improve the chance that patient will survive long enough to be discharged from the hospital. Adrenaline is good for buying the patient an extra few hours or an extra day filled with tests and possibly some invasive treatments. It may not be good for much more. It should be pointed out that these findings may be more germane to patients who are found in ventricular fibrillation, rather than asystole. According to a study carried out in Sweden and reported in Resuscitation (1995a) Jun;29(3):195-201., "A large proportion of cardiac arrests outside hospital are caused by ventricular fibrillation. Although it is frequently used, the exact role of treatment with adrenaline in these patients remains to be determined. AIM: "To describe the proportion of patients with witnessed out-of-hospital cardiac arrest found in ventricular fibrillation who survived and were discharged from
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