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Gewt92 t1_iugi5r3 wrote

Reply to comment by I-goes-to-eleven in TIL: Asthmador was an asthma treatment in the US in the 1950s. It was made up of 3 toxic/hallucinogenic compounds belladonna (atropine), stramonium (nightshade/jimson weed), and potassium perchlorate (oxidant commonly used in fireworks). One common delivery method for Asthmador - cigarettes! by Geek_Nan

No one uses atropine for cardiac arrests here anymore. I haven’t seen it used in a cardiac arrest in years.

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I-goes-to-eleven t1_iugoa2u wrote

We give it initially with epi because it helps with secretions and intubation. After that its just epi. By that time pacing pads are in place.

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MrTastey t1_iuh5ota wrote

Protocols vary wildly state to state, service to service and probably more so in different countries

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Gewt92 t1_iuh6b99 wrote

https://emedicine.medscape.com/article/757257-medication#1

Giving a shit ton of atropine and Epi for Asystole/PEA isn’t recommended anymore. I know people have different protocols elsewhere but evidence based medicine suggests they shouldn’t.

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I-goes-to-eleven t1_iuhecec wrote

ACLS says otherwise. Current standards instruct epi every 3-5 min. Any provider over 40 gives atropine also to start for the reasons I gave above.

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NoMalarkyZone t1_iuheo7q wrote

Atropine isn't part of ACLS for any cardiac arrest. Only symptomatic bradycardia.

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I-goes-to-eleven t1_iuhpbxw wrote

Epinephrine. See how I linked this to the algorithm? Atropine is for reducing respiratory secretions and also given with initial dose only of epinephrine to sustain a recoverable rhythm at the discretion of the provider. This is how I do it most of the time, unless something tells me it’s unnecessary. And with most of my codes and rapid responses, there is a respiratory component that initial dose of atropine will benefit from. I forgot how many “internet doctors” are on Reddit. I typically do not engage for this very reason. Thanks for reminding me.

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NoMalarkyZone t1_iuhpym9 wrote

Maybe most "providers" give atropine to a dead heart but it's not part of ACLS, and most physicians don't.

In fact i don't think I've never seen an ED physician or intensivist give atropine to a pulseless person. There's no evidence of that helping in asystole, or anything other than symptomatic bradycardia - essentially pre-arrest.

Maybe follow the guidelines? It would also help to be less combative with everyone you're talking to.

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