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Cardiovascular Issues in Critical Care: Robyn Peters and Mary Boyde Improving Survival After In-Hospital Cardiac Arrest: The Australian Experience Am J Crit Care 2007; 16: 240-247 [Abstract] [Full text] [PDF]

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Electronic letters published:

Re: Advanced Life Support

Mary Boyde   (21 August 2007)

Advanced Life Support

J. D. M. Sanderson   (20 August 2007)

Additional Information

Richard W. Herrick   (13 June 2007)

Re: Advanced Life Support 21 August 2007
Mary Boyde, Clinical Lecturer University of Queensland, Princess Alexandra Hospital Send letter to journal: Re: Re: Advanced Life Support m.boyde{at}uq.edu.au Mary Boyde	Many thanks for your positive comments regarding our findings. Our semiautomatics are biphasic. The RNs who are trained and qualified in Advanced Life Support give epinephrine, lidocaine, and atropine sulfate only. Doctors who attend the cardiac arrest can administer other drugs including amiodorone but we do not use vasopressin regularly in Australia for cardiac arrest management at present.
Advanced Life Support 20 August 2007
J. D. M. Sanderson, Registered Nurse Send letter to journal: Re: Advanced Life Support sandersoy{at}hotmail.com J. D. M. Sanderson	Peters and Boyde provide an excellent, clear, and concise summary of their findings with respect to improving survival after in-hospital cardiac arrest in Australia. As a nurse who regularly teaches Advanced Cardiac Life Support (ACLS) in the United States, I was impressed with the researchers' survival to discharge statistics. But were the semiautomatic external defibrillators monophasic or biphasic? Other than the epinephrine, lidocaine, and atropine sulfate the nurses can administer according to the Australian Resuscitation Council, are there other medications that may be given in cardiac arrest (ie, vasopressin, amiodorone)? Each time the new ACLS guidelines come out, there is a struggle for students to relearn what they have been taught for the previous years. One often examines the factors that make a difference in patients' survival to discharge, not to mention patients' neurological status. Kudos, by the way, on that 3-11 PM shift!
Additional Information 13 June 2007
Richard W. Herrick, RN University Hospital, Cincinnati, Ohio Send letter to journal: Re: Additional Information herricrw{at}healthall.com Richard W. Herrick	This article provided a good tool for measuring the effectiveness of response-based code management. However, it would have been helpful to have a note about what the Australian Resuscitation Council guidelines are. And although it may be outside the scope of this study, a brief look at patients' medical conditions with respect to outcomes may have shown medically independent factors. For instance, were there more arrests in the late afternoon and early evening related to operations, procedures, or dialysis that may have been more responsive to ALS measures? It would be interesting to repeat the study now that ACLS is no longer recommending stacked shocks for ventricular fibrillation/ventricular tachycardia to see if overall outcomes changed.