This is the art vs science part of medicine. The whole science of
resusciation is poorly understood and despite vast efforts the progress is
very slow - there is still so much we dont know. It all boils down to how
evidence based you want your practice to be. I personally have had a lot of
success with MgSO4 in arrests - but my numbers are small, but to me it seems
to work in VF/VT - but I have to reconcile that with the large trial
evidence that, with the exception of special circumstances, says it doesnt
work. The same can be said for a number of resus scenarios - the "expert"
bit is surely being able to put the whole picture together and work around
the edges looking at the "what if's" ( what if it is fine VF not asystole,
what if it really is a slightly atypical toursades, rather than VT ), -
what its not though is saying, I think Mg works works despite good evidence
to the contrary so Im going to keep using it routinely in all my arrests -
thats just bad practice. It seems to me to be a fairly fine line.
Craig
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