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Comment by bedobi | Hacker News Reader

pretty sure at least in Sweden they use EpiPens for a bunch of stuff, including heart attacks already?

Ahh yes, nothing treats heart hypo perfusion quite like forcing the heart into overdrive and massive vasoconstriction. Why is the US so far behind on this???

Edit: sorry I was getting technical. Yes it absolutely has a role in cardiac arrest and it's used for this the world over.

It would be very detrimental in a patient with a heart attack without arrest though due to increasing cardiac demand when cardiac supply is already highly limited

> Ahh yes, nothing treats heart hypo perfusion quite like forcing the heart into overdrive and massive vasoconstriction. Why is the US so far behind on this???

This is actually quite reasonable, especially if it’s paired with an existing defibrillator. Epinephrine is part of the advanced, cardiac life support algorithm, but it’s just not used in a pen format, since ACLS is typically performed in the hospital setting.

https://cpr.heart.org/-/media/CPR-Images/CPR-Guidelines-Imag...

Edit:

Recently, in the news, there was a discussion of using ECMO in the setting of patients who would require CPR. Take a look at this article for more: https://www.nytimes.com/2024/03/27/magazine/what-to-know-ecp...

Cardiac arrest is not the same as cardiac hypoperfusion (what people commonly call a heart attack), but it can a be a consequence of it.

Heart attacks are due to blockage of blood flow to the heart. That can cause the heart to stop (cardiac arrest) but not always.

Aren't epipens used sometimes to restart the heart after cardiac arrest, though?

I don't think it's the first tool from the toolbox, but I'm pretty sure epinephrine has use here.

I'm not a doctor or in the medical field but I've read injected lidocaine is used to treat ventricular fibrillation.

I don't know if it's true but I am sure I also once read that lidocaine can cause a heart attack but if having one can help stop the heart attack.

It's not often used for what's classically considered heart attacks, but it's a fun drug that can both cause and fix certain arrhythmias!

Ventricular Fibrillation is not a heart attack (heart attack is already an imprecise lay term) but I don't think encouraging it's use for anything other than acute myocardial ischemia is a good idea. In that sense, lidocaine doesn't stop a heart attack. A heart attack may lead to arrhythmias like VF. But VF is not a heart attack.

Lidocaine is a sodium channel blocker, it controls arrhythmias by blocking or diminishing the disorganized electrical activity going on in heart while hopefully not squelching whatever remaining dominant organized pacemaker activity there is. It is not the only antiarrhythmic though and relatively not a common one even for VF, it is not generally first line in its class. It's role in life support is a complicated subject but it is an optional drug for use in in-hospital CPR (ACLS) for VT/VF. High quality CPR and defibrillation are far more important though.

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