Very sensible John, the practice of turning up the gain is highly
irritating, as even "true" asystole will eventually look like fine VF if you
turn up the gain enough! But as Craig Ellis pointed out earlier, it's pretty
hopeless trying to treat "true" fine VF anyway as fine VF represents the
patient heading for end-stage asystole (or death) which is untreatable,
while "primary" asystole might actually stand a better chance if it's recent
and if it's vagal in origin.
Finally with nomenclature, I noticed Craig Ellis used the term PEA. Is this
resus council policy now? I ask because it hasn't caught on in the workplace
yet, and I don't suppose it ever will in Britain; I've certainly never heard
anyone using the term PEA during a real arrest! Might simply be that PEA
doesn't roll of the tongue like EMD does. But it's also a confusing term;
let's face it, VF is a form of electrical activity that is pulseless but
clearly PEA isn't meant to include VF or pulseless VT. I suggest we stick
with EMD - besides it's easier to teach this arrhythmia using the concept of
dissociation even though not all cases represent true dissociation of
electrical and mechanical function.
Adrian Fogarty
----- Original Message -----
From: john ryan
Douglas Chamberlain, had the enclosed to say about pre-hospital pronouncing
which we though we should share with you.
>
> I worry that some of our colleagues think that they can improve
> recognition of VF by turning up the gain!! Oh dear...
> Professor Douglas Chamberlain
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