In response to The Parachute Study as an Objection to Studying Ventilations in Cardiac Arrest, Can’t say, clowns will eat me writes –
But my why not is based upon things that we know do work vs things(drugs/IVs/advanced airways) that we know don’t help.
Actually, we do not know if epinephrine is harmful. The lack of evidence of benefit is also a lack of unambiguous evidence of harm.
We just don’t know.
We are practicing alternative medicine.
We are too dumb and/or too arrogant to realize how little we know.
There probably are some patients who do benefit from epinephrine, but I suspect that it would be at lower doses, perhaps much lower doses, and combined with medications to decrease the brain damage that seems to be caused by epinephrine. Nitroprusside, nitroglycerin, adenosine, and others have been used with some success.
Again, we do not know.
We have been too reckless with our patients’ lives to bother to find out. It is all just a big bet with not enough information for anyone to know what is right. And that’s not good.
So is that really unethical if you get the em PHA sis on the right SYL lable?
We have no idea what emphasis is right, or what syllable is right, because we refuse to turn the light on and look at what we are doing.
We are not ethical.
Ethics would require a respect for our patients.
Finding out if a treatment actually works would be something we would insist on – if we actually had any respect for our patients.
If we were ethical, we would tell our patients the truth.
Something like this –
We do not know if this treatment leads to improved outcomes, worse outcomes, if there is any benefit, or if there are equal amounts of harm and benefit.
It is reasonable to assume that all treatments cause some harm, but without any good evidence, there is no way we can honestly tell you if this treatment is likely to cause you more harm than benefit.
Some day someone will be able to find out, but that will probably still be years away.
You just are not important enough to get a treatment that works.
For how many EMS treatments is this the truth?
Cardiac arrest treatments except compressions and defibrillation, spinal immobilization, . . . .