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Adrenaline during CPR?
An editorial in Resuscitation (2010;81:637–8) perhaps gives us an early clue that the much anticipated potential exclusion of the use of adrenaline in international guidelines to treat cardiac arrest might not occur. There is a lack of robust data, but a team of international experts argue that what there is hints at some benefit. Sophia awaits the new guidelines (due out later this month) with interest.
Sophia has witnessed many times the combative trauma patient who cannot be managed safely without general anaesthesia and tracheal intubation. Intubation may appear to be in the patient's best interest at the time, but does it ultimately cause more problems? A recent study (J Trauma 2010;68:1305–9) investigated whether patients who were intubated for combativeness rather than immediate medical necessity had more complications, resulting in a longer length of stay. A retrospective analysis revealed that not only did this particular group have a longer length of stay, but also an increased incidence of pneumonia and poorer discharge status when compared with unintubated matched controls. The control group had similar outcomes to those …