Thursday, October 20, 2022

Antiarrhythmic Drugs and ROSC

emDOCs (52 in 52 #16) - By Cristiana van Nispen & Brannon Inman
October 20, 2022
Effect of Time to Treatment with Antiarrhythmic Drugs on Return of Spontaneous Circulation in Shock-Refractory Out-of-Hospital Cardiac Arrest
Welcome back to the “52 in 52” series. This collection of posts features recently published must-know articles. Our sixteenth post looks at antiarrhythmics in shock refractory OHCA.
My Take:
Based on the results of these data I will continue ACLS in the way I always have with a primary focus on good-quality CPR and early defibrillation. I may consciously shift to using earlier antiarrhythmics based on these data in select patients. I would consider lidocaine instead of amiodarone in patients in persistent VF or pVT in whom amiodarone has already been given (consistent with current ACLS guidelines) or who arrive at the hospital still in VF/pVT after prolonged downtime.