Paralytics in Myasthenia Gravis

Introduction Myasthenia Gravis (MG), an autoimmune disorder is the most common primary disorder of neuromuscular transmission MG results from the destruction of post-synaptic nicotinic acetylcholine (ACh) receptors located at the neuromuscular junction MG causes significant complications including myasthenic crisis, an acute respiratory paralysis requiring intensive care (e.g. mechanical ventilation) The decreased amount of Ach causes […]

Airway Series: Paralyzing Agents

Introduction Rapid sequence intubation (RSI) is a process whereby an induction agent and a neuromuscular blocking agent are given in rapid succession to facilitate endotracheal intubation The selection of a specific sedative depends on multiple factors: the clinical scenario, which includes patient factors (includes cardiorespiratory and neurologic status, allergies, comorbidity) and the clinician’s experience/training and […]

Airway Series: Induction Medications

Introduction Rapid sequence intubation (RSI) is a process whereby an induction agent and a neuromuscular blocking agent are given in rapid succession to facilitate endotracheal intubation The selection of a specific sedative depends on multiple factors: the clinical scenario, which includes patient factors (includes cardiorespiratory and neurologic status, allergies, comorbidity) and the clinician’s experience/training and […]

Etomidate for RSI: Seizure Considerations

Download PDF Introduction Rapid sequence intubation (RSI) is a process whereby an induction agent and a neuromuscular blocking agent are given in rapid succession to facilitate endotracheal intubation The selection of a specific sedative depends on multiple factors: the clinical scenario, which includes patient factors (includes cardiorespiratory and neurologic status, allergies, comorbidity) and the clinician’s […]

Norepinephrine vs Epinephrine Post Cardiac Arrest

Introduction  1. The effects of epinephrine on animal hemodynamics have been studied since the late 1800s with recent concern with deleterious complications with cerebral and myocardial oxygen supply. 2. Recently, there has been consideration for norepinephrine post cardiac arrest to minimize the  complications associated with epinephrine Epinephrine  Norepinephrine Dose Weight-based dosing: • Usual dosage range: 0.01 […]

Management of Hypokalemia in Cardiac Arrest

Download PDF Introduction Severe hypokalemia may precipitate profound and life-threatening cardiac complications including arrhythmia and asystole. Classical teaching is that in cardiac arrest with non-shockable rhythms the management include to identify and treat the H’s & T’s which include hyper and hypokalemia. Potassium chloride is the therapy of choice, however, the dose and administration of […]

The Use of Thrombolytics for ACS

Introduction Percutaneous coronary intervention (PCI) is the preferred reperfusion strategy during a cardiac arrest; thrombolytic therapy is an option without PCI capability, followed by transfer to a PCI capable center.  Thrombolytic therapy is most effective when administered within 30 minutes of first medical contact, however, may be considered within 12 – 24 hours of symptom […]

The Role of Epinephrine in Cardiac Arrest

Introduction There are greater than 350,000 out-of-hospital cardiac arrests annually, and nearly 90% of them are fatal. The effects of epinephrine on animal hemodynamics have been studied since the late 1800s. While the first advanced cardiac life support (ACLS) guidelines were first published in 1974, the role of epinephrine remains controversial.   Epinephrine [Adrenalin®] Dose […]