Re: Vasopressin: coming to a rig near you?

[Guest guest]

In a message dated 1/8/04 5:13:26 PM Central Standard Time,

lverrett@... writes:

> If the study proves that vasopressin works better, will we have to wait

> untill AHA comes out with new guidelines or will they issue a single update

>

Why would we have to wait? The AHA is not a regulatory agency, only an

advisory association. They issue guidelines only.

[Guest guest]

>This article offers pretty convincing

>evidence that Vasopressin should be used instead of epi as a first

>line drug for cardiac arrest:

>

><http://www.cnn.com/2004/HEALTH/a01/07/cardiac.arrest.drugs.ap/index.html>http:\

//www.cnn.com/2004/HEALTH/a01/07/cardiac.arrest.drugs.ap/index.html

>

>~RS~

The actual research these conclusions came from can be found at:

http://content.nejm.org/cgi/content/short/350/2/105 and I will post

the pdf of the entire article on my EMS_Research list.

Jim<

[Guest guest]

We are using Vasopressin as first line drug in Beaumont. Our numbers are

significantly higher since using it. We are in the middle of a year long study

as to why we are higher and this may be the answer. In the past 3 months we

has an ROSC of 60% in October, 40% in November and 50% in December. These

numbers are abnormally high and immediately caught our attention. We have

always

been right up there with King County in Seattle (around the 17-20% area) and we

are talking about full arrests, conversion, and walking out of hospital

resuming normal activities. We have maintained these numbers for over 4 years

now

and this was prior to Vasopressin and Cardarone. We still use both and have

the numbers to prove it.

Andy Foote

EMS Manager

City of Beaumont

A Division of Public Health

[Guest guest]

Already using it here, 1st line in cardiac arrest, one time dose, then

back to Epi.

Unfortunately, it hasn't been in use here long enough to draw personal

conclusions.

Mike

" Some days you're the dog, and some days you're the hydrant; pretty easy

to figure out which is which. "

Hatfield EMT-P

Vasopressin: coming to a rig near you?

This article offers pretty convincing

evidence that Vasopressin should be used instead of epi as a first

line drug for cardiac arrest:

http://www.cnn.com/2004/HEALTH/a01/07/cardiac.arrest.drugs.ap/index.html

~RS~

[Guest guest]

Mike, are ya'll just using it by the current AHA guidelines in like V-fib or

in ALL pulseless arrests? Gene Gandy and I were having a discussion about

this just the other day and were wondering WHY vasopressin was not

recommended in all the pulseless arrest algorhythms when they put it in V-fib

and pulseless V-tach? Considering its properties and its success in some

European studies prior to the last ACLS change, I would think that there

WOULD be benefit in all these cardiac arrest scenarios if it benefits in one -

like Epi for so many years.... We were cussing and discussing the fact that

the next set of guidelines may include it in a much more expanded role.

Jane Hill

[Guest guest]

>Mike, are ya'll just using it by the current AHA guidelines in like V-fib or

>in ALL pulseless arrests? Gene Gandy and I were having a discussion about

>this just the other day and were wondering WHY vasopressin was not

>recommended in all the pulseless arrest algorhythms when they put it in V-fib

>and pulseless V-tach? Considering its properties and its success in some

>European studies prior to the last ACLS change, I would think that there

>WOULD be benefit in all these cardiac arrest scenarios if it benefits in one -

>like Epi for so many years.... We were cussing and discussing the fact that

>the next set of guidelines may include it in a much more expanded role.

>

>Jane Hill

Jane, Have you read this most recent NEJM release? I don't see it

stating any advantage of vasopressin over epi in VF and PEA arrests.

There numbers, especially since it's a sub group are appearing to not

even being statistically significant.

I would not jump on the Vasopressin band wagon just yet.

Jim<

[Guest guest]

I didn't read it that closely yet. I HAD read several European studies that

backed each other up (studies on pigs) that seemed very promising though.

Jane

[Guest guest]

If the study proves that vasopressin works better, will we have to wait

untill AHA comes out with new guidelines or will they issue a single update

[Guest guest]

Jane,

We just updated our protocols to include it in all pulseless arrests, over the

last year it was only in place for v-fib according to AHA guidelines.

Our latest set of protocols broadened the horizons for it's use so to speak.

Our Medical Director is progressive and aggressive, and expects the same from

his field staff, we are more than happy to oblige him....

Mike

From: je.hill@...

> Mike, are ya'll just using it by the current AHA guidelines in like V-fib or

> in ALL pulseless arrests? Gene Gandy and I were having a discussion about

> this just the other day and were wondering WHY vasopressin was not

> recommended in all the pulseless arrest algorhythms when they put it in V-fib

> and pulseless V-tach? Considering its properties and its success in some

> European studies prior to the last ACLS change, I would think that there

> WOULD be benefit in all these cardiac arrest scenarios if it benefits in one -

> like Epi for so many years.... We were cussing and discussing the fact that

> the next set of guidelines may include it in a much more expanded role.

>

> Jane Hill

>

>

>

>

>

[Guest guest]

Well, it's really saying statistically it has better results than

epinephrine in reviving a patient in asystole. If you read the study,

it has the same stats as epinephrine in reviving the patient in VF/VT

Regards,

Alfonso R. Ochoa, NREMT-P

> This article offers pretty convincing

> evidence that Vasopressin should be used instead of epi as a first

> line drug for cardiac arrest:

>

> http://www.cnn.com/2004/HEALTH/a01/07/cardiac.arrest.drugs.ap/index.

html

>

> ~RS~

[Guest guest]

Thanks, Mike.

Jane