camev Posted July 19, 2008 Posted July 19, 2008 I'm doing my medic drug cards and I found reference to D50 being used for "refractory cardiac arrest (controversial)". Other than that simple notation I have found nothing to tell me why is useful, why it is controversial, etc... And I have looked. And looked. And looked some more. Can anyone help me out on this? Thanks!
jwraider Posted July 20, 2008 Posted July 20, 2008 I'm another student so take this with a grain of salt. Refractory cardiac arrest I'm assuming means a code where ACLS drugs / interventions have not worked. So then going to d50 is considered "possibly" useful and controversial according to the card.
AZCEP Posted July 20, 2008 Posted July 20, 2008 The heart and brain need sugar to function. If you've gone through your causes of cardiac arrest and can't come up with a good reason, trying some dextrose may be reasonable. It is even more so if your patient has a history that suggests they may be hypoglycemic prior to arrest.
PRPGfirerescuetech Posted July 20, 2008 Posted July 20, 2008 The cardiac arrest rule of thumb. You treat the arrest, with a hope to figure out why it happened. Easy problems, we can treat. Narcan for the OD arrest, sugar for the hypoglycemic arrest, etc. Cardiac arrest treatment protocols are many times useless variant on the nature of the arrest itself?
TheOldMan Posted July 20, 2008 Posted July 20, 2008 Probably they want you to know that D-50 is to correct Hypoglycemia, when you begin to work through your H's and T's.
jwraider Posted July 20, 2008 Posted July 20, 2008 I think The only reason it would be controversial is if it's just given without suspecting or proving hypoglycemia. Maybe someone with a bit more experience can help me out but didn't we use to push bicarb in every arrest?
chbare Posted July 20, 2008 Posted July 20, 2008 Both bicarb and calcium chloride were used frequently in cardiac arrest management. Take care, chbare.
firedoc5 Posted July 20, 2008 Posted July 20, 2008 Both bicarb and calcium chloride were used frequently in cardiac arrest management. Take care, chbare. Just before I left the field work, we had stopped with the calcium chloride, but we would still give bicarb as a last ditch effort. One medic put it as giving it when you have nothing else to do but ventilate and chest compressions. But I really never saw it that way. Some of us were a little hesitant to give it without labs and to do acid-base balance. I did compromise though by just giving a 1/2 amp instead of a full amp. when in the field. Hopefully it would be enough to be effective if it does work, but less enough to do any harm. Clear as mud???
camev Posted July 20, 2008 Author Posted July 20, 2008 Thanks to everyone for the input. I was piecing together the likely possibilities and you helped me out. I was just wondering if there were something more specific that I had missed somehow!
EMT Foose Posted August 5, 2008 Posted August 5, 2008 Just a guess- Systemic cellular respiration continues to occur when in cardiac arrest, so why not try glucose in the same way bicarb is used..? You would ultimately be addressing 2 of the H's and T's with these interventions, and if you've exhausted all other options.... This (I think) would give the body more of a fighting chance for ROSC. P.S. I haven't started medic school yet, so take that into consideration when reading my responses... :wink:
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