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Pharmacy & Acute Care University
Pharmacy & Acute Care University
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Emergency Medicine 201

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  1. Intro to Emergency Medicine
    6 Topics
    |
    2 Quizzes
  2. Rapid Sequence Intubation
    8 Topics
    |
    2 Quizzes
  3. Cardiac Arrest Pharmacotherapy
    8 Topics
    |
    3 Quizzes
  4. Hyperglycemic Crisis: Diabetic Ketoacidosis and Hyperosmolar Hyperglycemic Syndrome
    11 Topics
    |
    3 Quizzes
  5. Community-Acquired Pneumonia
    7 Topics
    |
    3 Quizzes

Quizzes

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Emergency Medicine 201 Cardiac Arrest Pharmacotherapy Literature Review: Cardiac Arrest Pharmacotherapy
Lesson 3, Topic 7
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Literature Review: Cardiac Arrest Pharmacotherapy

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Adult Basic and Advanced Life Support: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care

Part 3: Adult Basic and Advanced Life Support: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care | Circulation (ahajournals.org)

  • Review the guidelines above and prepare to answer questions on the information in a quiz following this section

PACU Literature Review #17

Wagner D, Kronick SL, Nawer H, Cranford JA, Bradley SM, Neumar RW. Comparative Effectiveness of Amiodarone and Lidocaine for the Treatment of: In-Hospital Cardiac Arrest. Chest. Published online November 2, 2022:S0012-3692(22)04039-9.

PMID: 336332663

BACKGROUND

  • ACLS guidelines support the use of either amiodarone or lidocaine for cardiac arrest caused by ventricular fibrillation or ventricular tachycardia based on studies of out-of-hospital cardiac arrest. Studies comparing the two in in-hospital cardiac arrest (IHCA) are lacking

STUDY OBJECTIVE

  • To determine if treatment with amiodarone vs lidocaine has differential associations with outcomes among adults with IHCA

STUDY DESIGN

  • Retrospective cohort study with data sourced from the American Heart Association’s Get With the Guidelines-Resuscitation inpatient registry, a national, multicenter, prospective registry

Study Intervention & Comparison

  • Amiodarone vs lidocaine during cardiac arrest
    • Dosing not specified, presumed to be dosed according to ACLS

Results

  • Primary Outcome
    • Lidocaine associated with significantly higher odds of return of spontaneous circulation (aOR 1.15, p=0.01)
  • Secondary Outcomes
    • Lidocaine associated with significantly higher odds of:
      • 24-hour survival postarrest (aOR 1.16, p=0.004)
      • Survival to hospital discharge (aOR 1.19, p<0.001)
      • Favorable neurologic outcome at discharge (aOR 1.18, p<0.001)

*Outcomes reported above are statistically controlled for all covariates

Summary

  • Compared with amiodarone, lidocaine was associated with significantly higher rates of ROSC, 24h survival, survival to hospital discharge, and favorable neurologic outcome among adult patients with in-hospital cardiac arrest from ventricular fibrillation or ventricular tachycardia.

Review the PARAMEDIC 2 Trial below and be prepared to answer question on it and the other content in this section

PARAMEDIC 2 Trial
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