Early epinephrine administration in patients with cardiac arrest in case of shockable rhythm in ER

The objective of the review was to investigate the scientific production and evaluate the effectiveness of epinephrine in the treatment of cardiac arrest in terms of survival and neurological status. PubMed, Embase, and Google Scholar databases were searched up till November 2017 for published studies in English language and human subjects discussing early epinephrine administration in patients with cardiac arrest in case of shockable rhythm in emergency medicine. Prehospital epinephrine management may increase short-term survival [ROSC] yet does not improve survival to release, or neurologic results after out-of-hospital cardiac arrest OHCA. Although there is no clear proof of long-lasting advantages complying with the use of epinephrine in OHCA, there is insufficient evidence to sustain altering present guidelines which recommend its management [1 mg every 3-5 min] throughout resuscitation. As a result, there is a need for additional clinical trials to analyze whether lower dosages or alternative regimes of epinephrine administration. Furthermore, one of the most important aspects of care in cardiac arrest is basic life support [BLS] measures, consisting of adequate compressions and early defibrillation

Narrative review on different clinical aspects of thrombocytopenia

This review article aims to summarize the major causes of thrombocytopenia and characterize the main general symptoms of thrombocytopenia. As well we summarize the diagnosis and treatment methods. We conducted the search using electronic biomedical databases such as; Medline, and Embase, for studies published up to September 2017 in the English language concerning the thrombocytopenia in general. Thrombocytopenia can either be primary or secondary, in that it could go along with a broad spectrum of syndromes and diseases and may be triggered by different systems. Trigger investigation and recognition might be important and sometimes life-saving as in TTP, heparin-induced thrombocytopenia, acute leukemia or perhaps severe ITP. Taking a detailed history and a thorough physical examination can give clues concerning possible underlying illness and clinical treatments. Cautious evaluation of the peripheral blood smear is necessary. When the differential diagnosis is problematic, sometimes a short trial of therapy could help to clarify the reason. For instance, it might be difficult to differentiate inherited thrombocytopenia [without a family history] from immune thrombocytopenia [ITP]; in this example, intravenous immunoglobulin infusion will likely have no effect in inherited thrombocytopenia, however, will generally be useful in ITP