Amiodarone supplants lidocaine in ACLS and CPR protocols.

Selected controversies in cardiopulmonary resuscitation.

Cardiopulmonary resuscitation (CPR) is performed frequently by paramedics, emergency department personnel, and inpatient physicians. Unfortunately, after more than 40 years of practice and study, there are still many controversies and unresolved treatment issues. This article focuses on four current controversies in CPR: (1) the role of end-tidal CO2 (ETCO2) detection, (2) the use of bicarbonat...

Administration of amiodarone during resuscitation of ventricular arrhythmias.

Amiodarone is an antiarrhythmic drug indicated in the treatment of ventricular arrhythmias. Early studies evaluating amiodarone for the management of ventricular arrhythmias demonstrated the efficacy of amiodarone in patients who were refractory to treatment with multiple antiarrhythmic drugs. More recently, 2 major trials, published in 1999 and 2002, described the efficacy of amiodarone as a p...

Amiodarone in the new ACLS guidelines.

Intravenous lidocaine versus intravenous amiodarone (in a new aqueous formulation) for incessant ventricular tachycardia.

The effectiveness of intravenous amiodarone for the treatment of incessant (shock resistant) ventricular tachycardia (VT) has not been established. This study evaluated the efficacy of a water-soluble amiodarone preparation or lidocaine for the treatment of shock-resistant VT. The trial was a double-blinded parallel design. Patients were randomized to receive up to 2 boluses of either 150 mg in...

Modified delta gap equation for quick evaluation of mixed metabolic Acid-base disorders.

An 82 year-old male patient with past medical history of coronary artery disease, hypertension, COPD, diabetes mellitus (Type 2), chronic kidney disease, Alzheimer’s disease and recently treated diarrhea was brought to the emergency department (ED) from home after he vomited, aspirated and developed severe respiratory distress. He was emergently intubated on arrival to ED. Shortly after intubat...