Primum Non Nocere: Complementary Medicine for Curable Cancers and Epinephrine in Out-of-Hospital Cardiac Arrest
Katie Wiskar and Samanatha Young, both GIM fellows at the University of British Columbia, host this week’s episode of The Rounds Table! Together they review survival among patients with curable cancers receiving complementary medicine and epinephrine in out-of-hospital cardiac arrest.
Complementary and alternative medicine are frequently used by patients in conjunction or as an alternative to medically recommended treatment. Sam walks listeners through a study using data from the National Cancer Database in the United States on treatment outcomes and the risk of death in patients with potentially treatable cancers who use complementary medicine and have refused conventional cancer therapy.
Early cardiopulmonary resuscitation and defibrillation reduce the rate of death and disability in cardiac arrests. What about medications such as epinephrine? Katie covers the PARAMEDIC2 trial which analyzes the use of epinephrine in sustained out-of-hospital cardiac arrest and how it contributes to the rate of return of spontaneous circulation, survival to hospital discharge, and survival with a favourable neurological outcome.
Finally, the Good Stuff segment. Sam highlights an article that looks at psilocybin, a psychedelic, for aiding smoking cessation. Katie reviews a perspective piece in which a physician reflects on a heroic resuscitation of an infant.
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1. Complementary Medicine: https://jamanetwork.com/journals/jamaoncology/article-abstract/2687972
2. PARAMEDIC2 Trial: https://www.nejm.org/doi/full/10.1056/NEJMoa1806842
1. Magic Mushrooms: https://www.ncbi.nlm.nih.gov/pubmed/27441452
2. Heroic Resuscitations: https://www.nejm.org/doi/full/10.1056/NEJMp1804030
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