If you had a Mount Rushmore of Emergency Department drugs fentanyl would make a pretty solid case for its inclusion. This synthetic opioid is roughly 100x more potent than morphine. The onset is rapid – two to three minutes. This is in contrast to morphine, which can take up to 20 minutes. The duration of action is relatively short – 30 to 60 minutes. Again, for purpose of comparison, the duration of action of morphine is up to 4 hours. As opposed to other opioids (namely morphine) there is no histamine release.
Bottom Line: In spite of over 50 years of application, there is minimal evidence to either the pathophysiologic basis or clinical utility of CP. CP also appears to decrease the likelihood for 1st pass success. CP should not be performed routinely. External laryngeal manipulation, either by the operator or an assistant, may improve an otherwise suboptimal laryngeal view.
On October 15, the new American Heart Association Guidelines for CPR and ECG will be published. Then we will get the answers to the big questions many of us have wondered about?
- Has epinephrine in cardiac arrest seen its last days?
- Should paramedics continue to intubate cardiac arrest patients?
- Will traditional CPR be abandoned for cardiocerebral Resuscitation (CCR)?