ABSTRACT
INTRODUCTION: In patients with myocardial infarction, platelet aggregation inhibition with glycoprotein IIb/IIIa antagonists helps restore and maintain coronary blood flow when administered alone, with fibrinolytics, or with angioplasty. This article evaluates whether an adequate number of patients transported by an air medical program could benefit from flight team administration of these agents and describes the implementation issues surrounding a treatment protocol. METHODS: A retrospective chart review and a discussion of the program's implementation experience RESULTS: Seven percent of the patients transported by the air medical program met clinical and electrocardiographic criteria for administration of glycoprotein IIb/IIIa inhibitors. The program identified systemic, budgetary, and logistical issues with protocol implementation that require ongoing consideration.
Subject(s)
Air Ambulances , Emergency Treatment , Myocardial Infarction/drug therapy , Platelet Aggregation Inhibitors/therapeutic use , Platelet Glycoprotein GPIIb-IIIa Complex/antagonists & inhibitors , Drug Costs , Humans , Medical Audit , Platelet Aggregation Inhibitors/economics , Platelet Glycoprotein GPIIb-IIIa Complex/economics , Practice Guidelines as Topic , Retrospective Studies , United StatesABSTRACT
Rapid sequence induction (RSI) for intubation using neuromuscular blockade (NMB) is the most common method of achieving emergent tracheal intubation.(1) The ideal muscle relaxant for RSI would have four characteristics: a rapid onset to minimize the risk of aspiration and hypoxia, a rapid recovery to facilitate the return of ventilation if intubation proves difficult, minimal hemodynamic effects, and minimal systemic effects.(2) However, the ideal drug has yet to be found or created, so succinylcholine has been widely used for more than 40 years as a muscle relaxant in patients with full stomachs or who require emergent intubation.(3,4) Recently, rocuronium has received consideration as an alternative.(1,4) This article discusses both agents.
Subject(s)
Androstanols/therapeutic use , Intubation, Intratracheal/methods , Neuromuscular Depolarizing Agents/therapeutic use , Neuromuscular Nondepolarizing Agents/therapeutic use , Succinylcholine/therapeutic use , Emergency Treatment/methods , Humans , Rocuronium , United StatesSubject(s)
Adrenergic beta-Antagonists/therapeutic use , Propanolamines/therapeutic use , Adrenergic beta-Antagonists/pharmacology , Aortic Dissection/drug therapy , Aortic Aneurysm/drug therapy , Emergencies , Humans , Laryngoscopy/methods , Propanolamines/pharmacology , Tachycardia, Supraventricular/drug therapySubject(s)
Emergency Treatment , Intubation, Intratracheal , Child , Humans , United States , Urban Health ServicesABSTRACT
Intravenous magnesium has been suggested as a treatment for certain emergency conditions for more than 60 years. It is currently proposed to be beneficial in treating asthma, preeclampsia, eclampsia, myocardial infarction, and cardiac arrhythmias. The use and efficacy of the drug, however, are controversial. This article discusses the current state of magnesium sulfate research and therapy.
