Archive for October 2009

Intranasal as effective as IV naloxone

In this retrospective cohort of pre-hospital patients with suspected opiate overdose, the patients in the intranasal group and the intravenous group had about the same mean time to clinical response (20 vs 21 minutes). In patients with no IV access, intranasal naloxone is an effective alternative (abstract)

Infections rising in implantable cardiac devices

In this retrospective cohort of US patients, researchers found that the number of cardiac implanted electronic devices increased 12% (from 2004 to 2006), and the number of device infections increased 57% in that same time period. Hospitalists should expect to see an increasing number of device infections, as the number of implantations increase in patients with more co-morbidities (abstract).

Zanamivir not to be dispensed by nebulizer/ventilator

The anti-viral medication Zanamivir (Relenza), should be administered via a diskhaler device, is not supposed to be suspended and dispensed via nebulizer or mechanical ventilation. The FDA has released a report of a pregnant woman with influenza, who died in relation to the use of zanamivir, which was suspended and administered through a mechanical ventilator, and caused a malfunction in the ventilator equipment (FDA site). The FDA has approved the use of IV peramivir for critically ill patients with influenza.

Better CPR, better survival

In this large retrospective study of out-of-hospital cardiac arrests, researchers evaluated survival before and after the 2005 update to the American Heart Association (AHA) CPR guide. They found a 1.8 greater adjusted odds of survival after 2005. In a convenience sample of EKG strips, they also found improvements in CPR quality, including higher chest compression rates, higher proportion of time spent in chest compressions, and shorter chest compression pause times. Since the revision of the AHA guidelines, CPR quality and mortality have improved (abstract)

IV anti-viral for influenza

The FDA has issued an emergency use authorization (EUA) for the IV drug Peramivir in children and adults hospitalized with (suspected or confirmed) H1N1. This drug should be used in patients who have not responded (or are not expected to respond) to oral or inhaled anti-viral therapy, or for which the provider determines that IV therapy is appropriate and warranted. Clinicians considering it's use should read this (Fact Sheet)
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