Mike, I dont think your mad. There are several small and not overly helpful
studies / case series looking at this. Dont have the references handy. My
current hospital is running a RCT looking at TNKase in cardiac arrest.
Currently at patient no 36 I think. Basic protocol is TNKase or placebo is
the first drug administed on obtaining IV access and resus continues for a
minimum of 10 minutes post drugs. So far I understand a significant
difference between the groups - but outside a large multi-centre trial I
dont think we will ever get the real numbers we need to say for sure.
Craig
>From: Mike Bjarkoy <[log in to unmask]>
>Reply-To: Accident and Emergency Academic List <[log in to unmask]>
>To: [log in to unmask]
>Subject: Lysis in the treatment of Cardiac Arrest
>Date: Sat, 19 Oct 2002 13:37:54 -0400
>
>OK - I know you are gonna say - 'Mike's lost it at last!' but here's a
>thought...
>cardiac arrest is often dues to coronary thrombus/plaque rupture.
>There are other causes - the 4 H's and the 4 T's.
>
>Of these most can be identified and treated in the field. Those which are
>difficult to ID are events such as aortic rupture and so on, which have an
>extremly poor progostic outcome anyway.
>
>So. If a paramedic is able to rule out the majority of the reasons for
>cardiac arrest -trauma, OD, hypothermia etc then what remains is cardiac in
>origin - yes?
>Therefore why should we not consider fibrinolysis as part of our treatment
>protocol for cardiac arrest? I know what you are going to say - CPR and
>lysis - bad move, but is it?
>
>Any thoughts
>Mike
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