User talk:Jet731

Welcome to the Wikipedia, Jet731! The comment you made about defibrillation being the only proven way to resuscitate unwitnessed arrest was unsourced, and I happen to disagree with it. There is no compelling evidence I am aware of to suggest that unwitnessed arrests can be successfully resuscitated, with or without a defibrillator. Could you please amend the statement or support it with a reference? MoodyGroove 22:47, 20 January 2007 (UTC)MoodyGroove

efficacy of defibrillation
I added a link to a Pub Med article. The link does not give the entire article, but does give the abstract. Any medical library should be able to provide the actual article. The problem with advanced cardiac life support for the prehospital patient is that over the years the only proven modality is defibrillation. None of the drugs we have used over the years have shown any efficacy. If anything many of them have been shown to increase mortality. I would be happy to discuss this point. I can also pull more articles if neccessary. This is acutally an area of interest of mine. I have taken care of many cardiac arrest patients over the years in the emergency department and in the prehospital setting as an emergency medical physician.--Jet731 23:59, 20 January 2007 (UTC)
 * You're absolutely right about antiarrhythmics, and I don't disagree that defibrillation is one of the few evidence based therapies we have, but I respectfully question the value of any therapy for unwitnessed arrest. Consider the best case scenario: witnessed arrest, immediate call to 911, call processing interval < 1 minute, reaction time < 1 minute, wheels up to wheels down < 4 minutes, curb side to patient's side < 1 minute, patient's side to first shock < 1 minute. We're already pushing 8 minutes for our collapse to first shock interval, and that's a best case scenario. Granted, the new guidelines suggest that 2 minutes of CPR will increase the efficacy of the first shock when the down time > 4 minutes and no CPR has been performed prior to EMS arrival, but I assume they are talking about a case like this one (witnessed arrest but no CPR performed prior to EMS arrival). Can you honestly say you've resuscitated a non-hypothermic, unwitnessed arrest and the patient walked out of the hospital neurologically intact? How is that possible? Best, MoodyGroove 00:37, 21 January 2007 (UTC)MoodyGroove

Unwitnessed might be poor choice wording
I think we are on the same page here. My main point is that drugs don't work and that nothing works well. If there is an unwittnessed arrest and either an AED or an EMS defibrilator is placed within 4 minutes ( I can't give an exact time) then that will be that patient's only chance. Unfortunately electricity has been shown to this patient's only shot at survival. In the main body of the article perhaps unwittnessed is a bad choice of words. What I am trying to describe is a prehospital arrest that takes place when EMS personnel are not present. I am happy to reword this. I think this is a good discussion.--Jet731 01:08, 21 January 2007 (UTC)
 * I understand now! You meant unwitnessed by EMS. It goes to show how easy it is to be misunderstood in this medium, particularly when terms aren't strictly defined. I wonder if this is addressed by the Utstein criteria. Thanks for talking this out and helping me see where you were coming from. Best, MoodyGroove 02:21, 21 January 2007 (UTC)MoodyGroove