There will be those of you who remember my grumbling about the Resuscitation protocols. I had a rather fine example
today, when a patient who had arrested and had a ROSC became a little bradycardic and dropped his pressure a bit.
Hmm, let's give 500 micrograms of atropine, I thought and did. I watched as his rate gently climbed to 70or so and his
pressure improved. "Oh, that's not the correct dose in the protocol!"announced the medical SHO, and promptly gave
another 2.5mg. Of course, the patient developed a rampaging "adrenaline-induced" tachycardia (like 160) with fearsome
ST segment depression and total cardiovascular instability. Yes, it brought his rate up, but at what cost? He needed
gentleness, not pedal to the metal. She didn't really understand the pharmacology of what she had done, but she sure
knew her protocols.
Best wishes,
Rowley Cottingham
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http://www.emergencyunit.com
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