Document Detail


Usefulness of self-administration of intramuscular lidocaine in the prehospital setting for ventricular tachyarrhythmias unassociated with acute myocardial infarction (the "Shahal" experience in Israel).
MedLine Citation:
PMID:  9068518     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We report on the experience accumulated by the subscribers of SHAHAL cardiac services who self-injected intramuscular lidocaine (using an automatic injector "LidoPen") for documented ventricular tachyarrhythmias which were not associated with an acute myocardial infarction. SHAHAL provides professional care to its subscribers who telephone a monitor center and describe their symptoms, whereupon therapeutic measures are decided upon. Patient data are stored in a central computer, and the center can dispatch mobile intensive care units. All subscribers carry a portable transtelephonic electrocardiographic transmitter and are provided with the LidoPen. Indications for self-injection were: transmission of a wide-QRS tachycardia (rate > 100 beats/min), symptomatic multiple or complex ventricular premature complexes in association with chest discomfort, and when the time of arrival of a medical team to the patient was estimated to be at least 8 to 10 minutes. Successful usage of the LidoPen was reported in 137 cases (123 patients). An additional 11 patients failed to use the injector properly. There was a success rate in abolishing rapid sustained ventricular tachycardia (27 of 76 patients) and nonsustained ventricular tachycardia and/or multiple and complex ventricular ectopic activity (8 of 30 patients) of 33% (total 35 of 106 patients). In another 9%, those arrhythmias were slowed markedly. The remaining 31 cases were eventually interpreted as being of supraventricular origin. No complications attributed to the use of the injector were reported and its use was found to be both feasible and effective in the prehospital setting.
Authors:
A Roth; N Malov; Y Bloch; Z Schlesinger; S Laniado; E Kaplinski
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of cardiology     Volume:  79     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1997 Mar 
Date Detail:
Created Date:  1997-04-08     Completed Date:  1997-04-08     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  611-4     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiology, Tel-Aviv Sourasky Medical Center, Israel.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Ambulances
Angina Pectoris / drug therapy
Anti-Arrhythmia Agents / administration & dosage*
Electrocardiography, Ambulatory
Emergency Service, Hospital
Feasibility Studies
Female
First Aid*
Humans
Injections, Intramuscular
Intensive Care
Israel
Lidocaine / administration & dosage*
Male
Middle Aged
Myocardial Infarction
Safety
Self Administration
Tachycardia, Supraventricular / drug therapy
Tachycardia, Ventricular / drug therapy*
Treatment Outcome
Ventricular Premature Complexes / drug therapy
Chemical
Reg. No./Substance:
0/Anti-Arrhythmia Agents; 137-58-6/Lidocaine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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