3 thoughts on “Can you administer NEAL down the ETT during resuscitation?”
But do any of them do anything….. I wonder aural administration of Neil Young would have a similar effect.
Hi Col and Johnny, just seeing how this thing works.
Thank you Dr.PB.The post is under the mnemonics category and hence is intended to be taken that way.Within the limits of the post, I would not like to go into the usefulness/futility of the medications in a resuscitation scenario.
There is good evidence out there that intranasal naloxone works for heroin / other opiate toxicity and in the USA there’s a big public health program where they encourage families of heroin users or pubs / clubs where they tend to use to keep naloxone + atomiser and use it if needed – http://intranasal.net/OpiateOverdose/
I don’t think there’s much evidence about giving it via ETT though, but the nasal mucosa is quite diferent to the mucosa of the lower airway so it might not be as effective.
As for adrenaline and the rest… you know how you become a believer after something works even once. I had a patient in PEA arrest secondary to septic shock (urosepsis) and gave adrenaline via the ETT till we managed to get IO access. He had ROSC before the IO was in, so all he had was good CPR, ETT + bagging + O2 and 2 x 10 mg adrenaline via the ETT.
That’s the other think you have to remember, the dose is much higher if you give anything via the ETT, it’s 10 x the iv dose.
But do any of them do anything….. I wonder aural administration of Neil Young would have a similar effect.
Hi Col and Johnny, just seeing how this thing works.
Thank you Dr.PB.The post is under the mnemonics category and hence is intended to be taken that way.Within the limits of the post, I would not like to go into the usefulness/futility of the medications in a resuscitation scenario.
There is good evidence out there that intranasal naloxone works for heroin / other opiate toxicity and in the USA there’s a big public health program where they encourage families of heroin users or pubs / clubs where they tend to use to keep naloxone + atomiser and use it if needed – http://intranasal.net/OpiateOverdose/
I don’t think there’s much evidence about giving it via ETT though, but the nasal mucosa is quite diferent to the mucosa of the lower airway so it might not be as effective.
As for adrenaline and the rest… you know how you become a believer after something works even once. I had a patient in PEA arrest secondary to septic shock (urosepsis) and gave adrenaline via the ETT till we managed to get IO access. He had ROSC before the IO was in, so all he had was good CPR, ETT + bagging + O2 and 2 x 10 mg adrenaline via the ETT.
That’s the other think you have to remember, the dose is much higher if you give anything via the ETT, it’s 10 x the iv dose.