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Hugo Keszler, MD; Gilbert C. Carroll, MD
University of Pittsburgh School of Medicine

JAMA. 1981;246(2):123.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

Davison et al (1980; 244:1110) recommend intracardiac injections (ICI) in cardiopulmonary resuscitation (CPR) as a safe alternative to intravenous (IV) administration of emergency drugs when other sites are not readily available. Although the subxyphoid approach is preferable to the anterior intercostal approach, we believe the article suffers from a number of serious deficiencies.

There is no mention of the most important issue in this context, and that is how long CPR was interrupted during the injection. Obviously interrupting cardiac compression for more than a few seconds is highly undesirable and may adversely affect the outcome. Second, we are struck by a strange statement in the fourth paragraph under "Comment" from which it appears that positive pressure breathing was continued during cardiac puncture. Does that mean that ventilation was continued while artificial circulation was stopped? There is also no listing of which drugs were given by intracardiac route, . . . [Full Text PDF of this Article]

Footnotes
Edited by John D. Archer, MD, Senior Editor.

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