Monday, June 28, 2010

Call Us If You Need Us

A report from JAMA says that hyperoxia during cardiac resuscitation can actually be detrimental to the patient's health.  Patients whose blood gases came back with a pO2 of greater than 300 mm Hg were found to have an 80% greater chance of dying compared to patients with normal oxygen tension. 

I recently came back from an ACLS recertification course.  During the course they said the new recommendations are that patients should not have their chest compressions interrupted for the ten seconds it takes to intubate and protect the airway.  Also the patients should be bagged at a rate of no more than 8-10 breaths per second as hypocarbia can worsen tissue hypoxia, as demonstrated with the oxyhemoglobin dissociation curve.

Well great.  That means anesthesiologists no longer have to go running to every Code Blue in the hospital to emergently intubate.  The American Heart Association says intubations only delay the resuscitation algorithm.  Intubations usually lead to hypocarbia worsening tissue hypoxia.  And now hyperoxia leads to greater mortality.  Call me after you get the patient's pulse back.

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