Comments on: Lidocaine http://medicscribe.com/2010/02/lidocaine/ Peter Canning's EMS Journal Fri, 10 Sep 2010 01:26:07 +0000 hourly 1 http://wordpress.org/?v=3.0.1 By: medicscribe http://medicscribe.com/2010/02/lidocaine/comment-page-1/#comment-9193 medicscribe Sun, 28 Feb 2010 14:07:24 +0000 http://medicscribe.com/?p=3307#comment-9193 Hi JonMedic -- We only carry the EZ-IO. In extremis we can go right to the IO if we want. If I see veins with a quick visual scan I will go for the vein, but if the person is a one-legged diabetic with nothing showing and nothing likely to be found, I go right for the IO. Peter Hi JonMedic –

We only carry the EZ-IO. In extremis we can go right to the IO if we want. If I see veins with a quick visual scan I will go for the vein, but if the person is a one-legged diabetic with nothing showing and nothing likely to be found, I go right for the IO.

Peter

]]> By: Jonmedic http://medicscribe.com/2010/02/lidocaine/comment-page-1/#comment-9174 Jonmedic Thu, 25 Feb 2010 08:18:04 +0000 http://medicscribe.com/?p=3307#comment-9174 hey i love the IO routes. since i started using it, i even sometimes refrain to search for a vein if i think it will take too long. next time try using an automatic device for the IO, something like the bone injection gun (BIG) as the penetration is very fast and no more painful then normal IV. just prior to administration of fluids anasthesize the bone with Lido. i had great results with that. Jon Paramedic from Israel. hey
i love the IO routes. since i started using it, i even sometimes refrain to search for a vein if i think it will take too long.
next time try using an automatic device for the IO, something like the bone injection gun (BIG) as the penetration is very fast and no more painful then normal IV. just prior to administration of fluids anasthesize the bone with Lido.
i had great results with that.
Jon
Paramedic from Israel.

]]> By: medicscribe http://medicscribe.com/2010/02/lidocaine/comment-page-1/#comment-9170 medicscribe Wed, 24 Feb 2010 00:36:05 +0000 http://medicscribe.com/?p=3307#comment-9170 You are definitely right about the literature. The only literature that to my knowledge supports amiodarone is somewhat shaky and was supported by the makers of amiodarone. I have heard inklings that procainimde may be making a comeback. Who knows? As I said I had better luck with amio, but that is strictly anecdotal and in all likelihood that patients that responded to amio would have responded to lidocaine and the ones who had bad outcomes for me with lidocaine would have had the same with amio. Thanks again for the thoughtful comments, Peter You are definitely right about the literature. The only literature that to my knowledge supports amiodarone is somewhat shaky and was supported by the makers of amiodarone. I have heard inklings that procainimde may be making a comeback. Who knows? As I said I had better luck with amio, but that is strictly anecdotal and in all likelihood that patients that responded to amio would have responded to lidocaine and the ones who had bad outcomes for me with lidocaine would have had the same with amio.

Thanks again for the thoughtful comments,

Peter

]]> By: totwtytr http://medicscribe.com/2010/02/lidocaine/comment-page-1/#comment-9167 totwtytr Tue, 23 Feb 2010 23:05:58 +0000 http://medicscribe.com/?p=3307#comment-9167 I still prefer Lidocaine to Amiodarone, especially since the data for Amio is, well, not all that clear. We had a case recently with a patient in sustained V-Tac, unresolved by a dozen shocks from his AICD. We chose Lidocaine because it seemed that cardiac arrest was imminent for this patient it takes less time to set up and administer than does Amio. Oh, and it worked, which is the key factor. Maybe there will be better evidence this time around when the AHA redoes the ACLS protocols. Or maybe not. I still prefer Lidocaine to Amiodarone, especially since the data for Amio is, well, not all that clear. We had a case recently with a patient in sustained V-Tac, unresolved by a dozen shocks from his AICD. We chose Lidocaine because it seemed that cardiac arrest was imminent for this patient it takes less time to set up and administer than does Amio. Oh, and it worked, which is the key factor.

Maybe there will be better evidence this time around when the AHA redoes the ACLS protocols. Or maybe not.

]]> By: Ted Maze http://medicscribe.com/2010/02/lidocaine/comment-page-1/#comment-9165 Ted Maze Tue, 23 Feb 2010 22:05:56 +0000 http://medicscribe.com/?p=3307#comment-9165 Being an old school medic and an ACLS instructor since 1983 I firmly believe in Lidocaine. Amiodarone may be ok but when you work as a single medic and you either have to pull up 300 mg or use two prefilled syringes v.s. one lido, guess where my hand goes? I have not seen that much difference in resuscitation using amio. Using it after I get in the truck and have some extra time maybe, of course this is post lido use in the house. Lido/amio against VT with pulses not much luck there either. Being an old school medic and an ACLS instructor since 1983 I firmly believe in Lidocaine. Amiodarone may be ok but when you work as a single medic and you either have to pull up 300 mg or use two prefilled syringes v.s. one lido, guess where my hand goes? I have not seen that much difference in resuscitation using amio. Using it after I get in the truck and have some extra time maybe, of course this is post lido use in the house. Lido/amio against VT with pulses not much luck there either.

]]>