Document Detail


The prohibition on shocking apparent asystole: a history and critique of the argument.
MedLine Citation:
PMID:  18534295     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A recommendation against shocking asystole has been part of the American Heart Association's Emergency Cardiovascular Care (ECC) Guidelines since 1992. The principal rationale offered then for the prohibition on shocking apparent asystole (PSAA) has since been refuted and has gradually been dropped, but the recommendation itself remains in the 2005 Guidelines. The PSAA now rests mainly on the lack of solid evidence of a survival benefit--a curious criterion given the lack of such evidence for most ECC treatment recommendations. "Occult" ventricular fibrillation and problems with distinguishing between fine ventricular fibrillation and asystole may lead to delays and omissions of potentially lifesaving shocks. No studies on the subject have been conducted since the PSAA first appeared. Removal of the PSAA from the ECC Guidelines is warranted to reopen research on this topic and support the goal of early defibrillation.
Authors:
John A Stewart
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of emergency medicine     Volume:  26     ISSN:  1532-8171     ISO Abbreviation:  Am J Emerg Med     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-06-06     Completed Date:  2008-07-01     Revised Date:  2009-01-08    
Medline Journal Info:
Nlm Unique ID:  8309942     Medline TA:  Am J Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  618-22     Citation Subset:  IM    
Affiliation:
Virginia Mason Medical Center, Seattle, WA 98101, USA. john.stewart@vmmc.org
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MeSH Terms
Descriptor/Qualifier:
Cardiology / standards*
Death, Sudden, Cardiac / prevention & control
Defibrillators
Electric Countershock* / contraindications
Heart Arrest / therapy*
Humans
Practice Guidelines as Topic*
Ventricular Fibrillation / therapy
Comments/Corrections
Comment In:
Am J Emerg Med. 2008 Nov;26(9):1057   [PMID:  19091271 ]

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


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