@minoruta0815 ま、まさかPerkins先生とか?ww 退院時の良好な神経学的アウトカムを持つ生存者の割合は、救命士がアドレナリンを投与するか否かで差がなかった。 このデザインを実施してしまうイギリスって。。。。 https://t.co/9O80yhcWwN
@CatherineCounts @slcfire I guess it’s congruent with Paramedic 2, though with better survival https://t.co/ARNZon1z8i
RT @yotsumex: A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest | NEJM https://t.co/UMTPA0na4b 現場レベルではアドレナリンの効果を肌感覚として感じ…
A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest | NEJM https://t.co/UMTPA0na4b 現場レベルではアドレナリンの効果を肌感覚として感じることができないのは、30日生存を達成するための治療必要数ーNNT(number needed to treat)ーが112だからです。
@davidcarr333 @sadiyeayhan Totally agree! Paramedic2 (2018) told us already, but „for some reason“ didn’t make it into the guidelines 🤨 https://t.co/8C6ETZSEW9
@CARE_1975 @NYCEMSwatch And probably not epinephrine. Sure you get ROSC but the end outcome may be worse. As you note, BLS is the key. https://t.co/am6YPlzqjh
OHCA/IHCA/Peri-arrest/low flow states In need of some RCT diagnostic/managerial refinement. Will be challenging. Carotid Pulse https://t.co/YY5xQzBDah Paramedic2 https://t.co/LAMugWo4a4 All or nothing still 😱
#TrialOfTheDay for July 18th is the PARAMEDIC2 trial, published ahead of print on this date in 2018 in @NEJM Demonstrating efficacy for epinephrine in out-of-hospital cardiac arrest Open-access article link: https://t.co/yU8TpiGrSz #pharmicu #pharmem #
@tamishtah Paramedic 2(2018) study of adrenaline vs. placebo: but lets look at it for times. 999 arrival 6.6 mins, 30-day survival 3.2% (intervention) vs. 2.4% (control) https://t.co/1gelnotpFz
@wolfhautz @hellfridge1 Hierzu dies👇🏼, auch wenn nicht unter Umständen extremer Hypothermie. https://t.co/1SE00m9nBC
We pursued this work in the context of the PARAMEDIC-2 trial, published in @NEJM in 2018. https://t.co/GKjt2CpV1v PARAMEDIC-2 found that epinephrine improved 30-day survival, but also found no improvement in survival with good functional outcomes (a seco
@____Dopamine___ Je conçois que ce soit variable car j ai fait un peu de samu. Néanmoins c est bien plus la pression des habitudes qu un vrai rationnel hormis le patient incarcéré comme dit avant. Je vous donne un exemple illustratif https://t.co/HF8UNSc1A
@ESICM PARAMEDIC 2 - big study 8007 pts, adrenaline 4000, placebo 3999 - a lot of discussion post trial - need a nuanced interpretation. - 19 "more good" survivors and 5 "more bad" survivors in adrenaline arm. https://t.co/1gelnotpFz
The paramedic2 trial being described by Gavin Perkins #SOA22 https://t.co/jZBlaohy4Z
.@rvarel Adrenalina en PCR: - mejora ROSC - no mejora sobrevida neurologicamente intacto ¿Será momento de sacarla de los algoritmos? 🤔 https://t.co/NR6vjL9u6S https://t.co/ozkPaK2Uki https://t.co/BcWMacYDqM #desafiosCAS #ChileEM #educarsalvavidas htt
RT @tony_breu: 4/ This was followed by a 2018 randomized, placebo-controlled trial. It included 8014 patients with out-of-hospital cardiac…
6/ What about neurologic outcomes? Rates of survival with favorable neurologic outcomes were no different: ➤2.2% epinephrine ➤1.9% placebo But, rates of severe neurologic impairment were higher in the epinephrine arm: ➤31% epinephrine ➤18% placebo http
5/ The rates of return of spontaneous circulation (ROSC) were significantly higher in the epinephrine arm: ➤36% epinephrine ➤12% placebo 30-day survival was also higher in the epinephrine arm: ➤3.2% epinephrine ➤2.4% placebo https://t.co/HNRMb2TYuo http
4/ This was followed by a 2018 randomized, placebo-controlled trial. It included 8014 patients with out-of-hospital cardiac arrest. Patients received either epinephrine or a saline placebo. https://t.co/HNRMb2TYuo https://t.co/B3T5INsSKk
RT @AnesthCritCare: #Epinephrine in Out-of-Hospital Cardiac Arrest #PARAMEDIC2 trial: good to restart the heart but bad for the brain? Epi…
RT @SayreMR: Prehospital epinephrine at a dose of 1 mg every 3-5 minutes does NOT increase neurologically intact survival from out-of-hospi…
RT @Nat_anest: Да, так было. Пока в Британии не провели знаменитое исследование PARAMEDIC 2 - первой, рандомизированное, плацебо контролиру…
RT @Nat_anest: Да, так было. Пока в Британии не провели знаменитое исследование PARAMEDIC 2 - первой, рандомизированное, плацебо контролиру…
RT @Nat_anest: Да, так было. Пока в Британии не провели знаменитое исследование PARAMEDIC 2 - первой, рандомизированное, плацебо контролиру…
Да, так было. Пока в Британии не провели знаменитое исследование PARAMEDIC 2 - первой, рандомизированное, плацебо контролируемое исследований на людях по применению адреналина при СЛР. https://t.co/iU7rPZb9lm
@charleskfisher @T_Allen1998 @ADAlthousePhD PARAMEDIC2 trial also did that https://t.co/vIduFV98ym
@4mmk36 @emlitofnote @First10EM Similar arguments were made about lack of equipoise & near impossibility to conduct an RCT on epinephrine for OHCA. Epinephrine is part of ACLS algorithm and supported by many guidelines including the AHA. Yet the study
@macwalterMD @CritCareReviews There's a great review of evidence of epi in arrest, and then the PARAMEDIC-2 trialp published after the review, also showing increased ROSC but worse neurologic outcomes. https://t.co/JUWXDc5at8 https://t.co/qEAQNSGnOF
@R3cklinghausen https://t.co/qNHH4cTROZ Oui. Mais de l’outcome clinique qui ne rend pas forcément service au patient et à sa vie future.
@DrAnkushSinghal You are absolutely right. I was shocked too. I don’t know if the relatives of the dead people who were given placebo were ever told. https://t.co/b4TggI8vsn
退院時に、プラセボ群よりもエピネフリン群の生存者の多くで重度の神経障害 とか書かれてて身が震える
@kRYNu54oWVZUH6c これを読んでどう思うかです A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest https://t.co/NLPCZiCtLM
RT @rcpEspana: Dra Poonam Velagapudi @Pooh_Velagapudi Omaha – Nebraska Cardiologist - Associate PD-Cardiology Fellowship University of Nebr…
RT @rcpEspana: Dra Poonam Velagapudi @Pooh_Velagapudi Omaha – Nebraska Cardiologist - Associate PD-Cardiology Fellowship University of Nebr…
5/ #paramedic2 trial (2018) 💉adrenalina OHCA ⬆️ROSC ⬆️transporte a hospital 🚑 ⬆️ingreso a UCI ⬆️sobrevida a 30d 👀NNT 112 para prevenir 1 muerte (vs NNT 5 descarga precoz, NNT 11 reconocer PCR, NNT 15 BLS por testigos) ⚠️x2 peor pronóstico neurológico 🧠 htt
Today is a good reminder that all other interventions are secondary to high-quality CPR and early defibrillation in OHCA (from: https://t.co/mCecC2WBZx) https://t.co/UJkvBxBVxM
@DIntubator Bon on fait les malins mais l'adrénaline fait pas mieux comme outcome à un mois d'un ACR contre un placebo. https://t.co/eXQj6XKU3c
RT @DrJeffJarvis: I’m thinking about PARAMEDIC2 again tonight. 0.8% improved 30 day survival w/o improved neuro survival and 13% more neu…
RT @DrJeffJarvis: I’m thinking about PARAMEDIC2 again tonight. 0.8% improved 30 day survival w/o improved neuro survival and 13% more neu…
RT @DrJeffJarvis: I’m thinking about PARAMEDIC2 again tonight. 0.8% improved 30 day survival w/o improved neuro survival and 13% more neu…
I’m thinking about PARAMEDIC2 again tonight. 0.8% improved 30 day survival w/o improved neuro survival and 13% more neuro devastation among survivors. NNT 112 for survival vs 5 for early defib. 0% probability of at least 2% neuro survival. 1/2 http
@BrianKingNeo @DrAbdulRazak_MD @rehman_naveed @adrisdoc @AAPneonatal @EBNEO @souvik_neo @NeoTECaN @neosatyan @waseemoddin @NielsRochow Researchers asked this question in adults a half century after epi use became part of routine practice and subjected it t
RT @rcpEspana: Dra Poonam Velagapudi @Pooh_Velagapudi Omaha – Nebraska Cardiologist - Associate PD-Cardiology Fellowship University of Nebr…
The scores are becoming a focus for discussions around the effectiveness of interventions, perhaps most famously in the PARAMEDIC-2 trial which showed adrenaline improved survival but did not improve survival with good neurological outcome. https://t.co/dq
RT @TheSGEM: PICO from this RCT on epinephrine for OHCA. https://t.co/CoC7cb1HbG @NEJM @JWatch https://t.co/IIac5wAFQ8
PICO from this RCT on epinephrine for OHCA. https://t.co/CoC7cb1HbG @NEJM @JWatch https://t.co/IIac5wAFQ8
RT @realscientists: The PARAMEDIC2 trial compared epinephrine (adrenaline) to placebo in OHCA. Epi got more pulses back (ROSC), but those…
The PARAMEDIC2 trial compared epinephrine (adrenaline) to placebo in OHCA. Epi got more pulses back (ROSC), but those that survived had worse neurological outcomes at hospital discharge. Trial had overall low survival rate, making generalizability tough.
RT @EmilyIngridST: @wendyburn Not anaphylaxis but related and interesting in case you missed it (can’t read everything!) https://t.co/9wpuZ…
@wendyburn Not anaphylaxis but related and interesting in case you missed it (can’t read everything!) https://t.co/9wpuZLBRnD and the Resus Room discussion at the time https://t.co/J0uzxJAmR1
@MarkGeyerMD @VPrasadMDMPH @Luke1732Mullen Adrenaline in cardiac arrest was always accepted as SoC. The UK were brave enough to run a trial... https://t.co/5OxsGI62Ai No big pharma...
A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest | NEJM https://t.co/EHzqVXznAv
@sargsyanz we could fix the problem if we stop giving Epi in cardiac arrest! 🤷♂️🤷♂️ https://t.co/OhnA6axN5p https://t.co/W8eGHdvxdQ
院外心停止を対象としたエピネフリンのランダム化比較試験 https://t.co/cxMrcuEOb8
RT @littlepixie3: @C7RKY They were testing to see if adrenaline had an effect on arrest patients in the community. Paramedics were sent out…
RT @rcpEspana: Dr Sergio García Gutierrez @SergioGarciamdt Fundador RCP Tour HISPANO-MEXICANO Ambassador of CPR Tour SPAIN in MEXICO https:…
RT @CHESTCritCare: Epi is also the first ACLS drug, and has been considered "standard of care" for decades now, several studies have associ…
RT @CHESTCritCare: Epi is also the first ACLS drug, and has been considered "standard of care" for decades now, several studies have associ…
Epi is also the first ACLS drug, and has been considered "standard of care" for decades now, several studies have associated it with increased rate of ROSC, but more recent evidence not showing better survival. https://t.co/i4Fy3xz1nc
RT @rcpEspana: Dra MARINA DEL VALLE @maru_armani Especialista en Ginecología y Obstetricia Ambassador of CPR Tour SPAIN Project in ARGENTIN…
RT @rcpEspana: D. Sandro Ortega @LicOrtegasan Director Defensa Civil y Emergencias Municipalidad de Malvinas Argentinas @munimalvinas Ambas…
RT @rcpEspana: Dr Sergio Garcia Gutierrez @Sergiogarciamdt Instructor Certificado AHA (@American_Heart) - Estimulación Cardiaca Artificial…
RT @rcpEspana: The NEW ENGLAND JOURNAL of MEDICINE (NEJM): "Adrenaline in resuscitation for Out-of-Hospital Cardiac Arrest: better for surv…
RT @rcpEspana: Dra MARINA DEL VALLE @maru_armani Especialista en Ginecología y Obstetricia Ambassador of CPR Tour SPAIN Project in ARGENTIN…
RT @rcpEspana: Dr Sergio Garcia Gutierrez @Sergiogarciamdt Instructor Certificado AHA (@American_Heart) - Estimulación Cardiaca Artificial…
Dr Sergio Garcia Gutierrez @Sergiogarciamdt Instructor Certificado AHA (@American_Heart) - Estimulación Cardiaca Artificial - Fundador RCP Tour HISPANO-MEXICANO - Ambassador of CPR Tour SPAIN Project in MEXICO
D. Sandro Ortega @LicOrtegasan Director Defensa Civil y Emergencias Municipalidad de Malvinas Argentinas @munimalvinas Ambassador of CPR Tour SPAIN Project in MALVINAS ARGENTINAS-BUENOS AIRES (ARGENTINA)
RT @rcpEspana: The NEW ENGLAND JOURNAL of MEDICINE (NEJM): "Adrenaline in resuscitation for Out-of-Hospital Cardiac Arrest: better for surv…
RT @rcpEspana: Dra MARINA DEL VALLE @maru_armani Especialista en Ginecología y Obstetricia Ambassador of CPR Tour SPAIN Project in ARGENTIN…
Dra MARINA DEL VALLE @maru_armani Especialista en Ginecología y Obstetricia Ambassador of CPR Tour SPAIN Project in ARGENTINA @alferdez @ginesggarcia @Pontifex_es @rcpEspana @JOSEANT13462674
RT @rcpEspana: Dr Jorge Rembis Miranda @rembis Coordinador RCP México - Ambassador of CPR Tour SPAIN Project in NAUCALPAN DE JUAREZ (México)
RT @rcpEspana: Dr Sergio García Gutierrez @SergioGarciamdt Fundador RCP Tour HISPANO-MEXICANO Ambassador of CPR Tour SPAIN in MEXICO
RT @rcpEspana: Dr Mauricio Cantillano @CantillMauricio Paediatric Intensive Care Physician Ambassador of CPR Tour SPAIN Project in HONDURAS…
RT @rcpEspana: Dr Luis Antonio Martínez Chacon @chacon_dr Managing Obstetric Emergencies and Trauma (M.O.E.T) Ambassador of CPR Tour SPAIN…
RT @rcpEspana: Dr Sergio García Gutierrez @SergioGarciamdt Fundador RCP Tour HISPANO-MEXICANO Ambassador of CPR Tour SPAIN in MEXICO https:…
RT @rcpEspana: Verónica @VERNICANEZ11 Pediatríc Nurse Ambassador of CPR Tour SPAIN Project in MEXICO https://t.co/fEMrAk1ylq
RT @rcpEspana: Dra GABRIELA BORRAYO SÁNCHEZ @gabrielaborray3 Vicepresidenta Asociación Nacional de Cardiólogos de México (ANCAM) Ambassador…
RT @rcpEspana: Dra María Guadalupe Parra Machuca @DraMariaParra Ambassador of CPR Tour SPAIN Project in GUADALAJARA (MEXICO) https://t.co/f…
RT @rcpEspana: Dr Jorge Rembis Miranda @rembis Coordinador RCP México - Ambassador of CPR Tour SPAIN Project in NAUCALPAN DE JUAREZ (México…
RT @rcpEspana: Libby Johnston @Libbyextra Worked in Women's Health - Interests in the Heart, OHCA, Emergency Services, Nursing + Midwifery…
RT @rcpEspana: MARÍA RAMÍREZ SÁNCHEZ @lovenursingmery Enfemería Comunitaria - M@ster en Enfermería Escolar Ambassador of CPR Tour SPAIN Pr…
RT @rcpEspana: Dr Luis Antonio Martínez Chacon @chacon_dr Managing Obstetric Emergencies and Trauma (M.O.E.T) Ambassador of CPR Tour SPAIN…
MARÍA RAMÍREZ SÁNCHEZ @lovenursingmery Enfemería Comunitaria - M@ster en Enfermería Escolar Ambassador of CPR Tour SPAIN Project in VALENCIA
Libby Johnston @Libbyextra Worked in Women's Health - Interests in the Heart, OHCA, Emergency Services, Nursing + Midwifery - Actively Promote CPR + use of AEDs Ambassador of Project CPR Tour SPAIN in SCOTLAND (United Kingdom)
RT @rcpEspana: D. Sandro Ortega @LicOrtegasan Director Defensa Civil y Emergencias Municipalidad de Malvinas Argentinas @munimalvinas Ambas…
RT @rcpEspana: DUE Mary Carmen Porres @LaPorres Ambassador of CPR Tour SPAIN Project in MELIPILLA (CHILE)
RT @rcpEspana: Dra María Guadalupe Parra Machuca @DraMariaParra Ambassador of CPR Tour SPAIN Project in GUADALAJARA (MEXICO)