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Commentary on EMS (Emergency Medical Services), medicine, and science.

Rogue Medic
182 posts

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  • November 30, -1
  • 12:00 AM
  • 1,394 views

More evidence that antibiotics are over-prescribed - How should that change?

by Rogue Medic in Rogue Medic

Today Lancet Infectious Diseases posted an early release of an article that shows that the antibiotic amoxicillin still does not work on viruses.

Many doctors still routinely prescribe antibiotics for viral infections.

Bias, perhaps the biggest confounder in medical research, is controlled for very well.

What does the study show?... Read more »

  • November 30, -1
  • 12:00 AM
  • 1,258 views

The PROCAMIO Trial – IV Procainamide vs IV Amiodarone for the Acute Treatment of Stable Wide Complex Tachycardia

by Rogue Medic in Rogue Medic

This is a very interesting trial that may surprise the many outspoken amiodarone advocates, but it should not surprise anyone who pays attention to research.

ALPS showed that we should stop giving amiodarone for unwitnessed shockable cardiac arrest. The lead researcher is still trying to spin amiodarone for witnessed shockable cardiac arrest, even though the results do not show improvement in the one outcome that matters – leaving the hospital with a brain that still works.[1],[2],[3]... Read more »

Kudenchuk PJ, Brown SP, Daya M, Rea T, Nichol G, Morrison LJ, Leroux B, Vaillancourt C, Wittwer L, Callaway CW.... (2016) Amiodarone, Lidocaine, or Placebo in Out-of-Hospital Cardiac Arrest. The New England journal of medicine, 374(18), 1711-22. PMID: 27043165  

Marill KA, deSouza IS, Nishijima DK, Senecal EL, Setnik GS, Stair TO, Ruskin JN, & Ellinor PT. (2010) Amiodarone or procainamide for the termination of sustained stable ventricular tachycardia: an historical multicenter comparison. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 17(3), 297-306. PMID: 20370763  

Marill KA, deSouza IS, Nishijima DK, Stair TO, Setnik GS, & Ruskin JN. (2006) Amiodarone is poorly effective for the acute termination of ventricular tachycardia. Annals of emergency medicine, 47(3), 217-24. PMID: 16492484  

Kułakowski P, Karczmarewicz S, Karpiński G, Soszyńska M, & Ceremuzyński L. (2000) Effects of intravenous amiodarone on ventricular refractoriness, intraventricular conduction, and ventricular tachycardia induction. Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, 2(3), 207-15. PMID: 11227590  

Bonny A, De Sisti A, Márquez MF, Megbemado R, Hidden-Lucet F, & Fontaine G. (2012) Low doses of intravenous epinephrine for refractory sustained monomorphic ventricular tachycardia. World journal of cardiology, 4(10), 296-301. PMID: 23110246  

Kowey PR. (1988) The calamity of cardioversion of conscious patients. The American journal of cardiology, 61(13), 1106-7. PMID: 3364364  

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