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O2 not req'd...

PostPosted: Thu Jun 28, 2012 5:25 pm
by sharperblue
Super-oxygenating injection drug. Hmmm..

Not so pie-in-the-sky technology: could conceivably be a life-saver or at least a time-buyer for avy victims (if they could reach a port to inject themselves) and victims of AMS

http://gizmodo.com/5921868/scientists-i ... -breathing

Re: O2 not req'd...

PostPosted: Tue Jul 17, 2012 5:46 am
by tigerlilly
Interesting.

Re: O2 not req'd...

PostPosted: Tue Jul 17, 2012 6:07 am
by POLUKO
Could have amazing consequences for mountain people, wow. Finding a vein could be a challenge in the cold but that's probably why you used the word port.

Re: O2 not req'd...

PostPosted: Wed Jul 25, 2012 7:58 am
by philoparts
There is one problem to this; metabolic waste. If you can't breath or urinate, you have no way to get rid of metabolic waste buildup. Lack of oxygen isn't the only thing that kills you, after so many minutes (depending on temperature) serum blood potassium starts to shoot up. In the range of 8-10mEq/L, there isn't much hope of survival. They are working on a field serum potassium test for avalanche victims to determine viability after burials lasting 10+ minutes with cardiac or respiratory arrest. Still cool stuff, though. Plenty of other possible applications.

Re: O2 not req'd...

PostPosted: Mon Nov 19, 2012 2:46 am
by mroutdoorsman
philoparts wrote:There is one problem to this; metabolic waste. If you can't breath or urinate, you have no way to get rid of metabolic waste buildup. Lack of oxygen isn't the only thing that kills you, after so many minutes (depending on temperature) serum blood potassium starts to shoot up. In the range of 8-10mEq/L, there isn't much hope of survival. They are working on a field serum potassium test for avalanche victims to determine viability after burials lasting 10+ minutes with cardiac or respiratory arrest. Still cool stuff, though. Plenty of other possible applications.


Elevated Potassium = Hyperkalemia
Low Potassium = Hypokalemia

In field or on medical helicopter testing CAN be done on a device such as the Piccolo Xpress which some air medical companies and the military have started to use but as it stands there are no "quick and easy" ways to diagnose hyper/hypokalemia. As far as treatment for an avalanche victim that is suffering from hyperkalemia due metabolic waste buildup or hypokalemia due to hypothermia there are various and fairly effect means to counter the elevated or decreased potassium levels. For hyperkalemia a patient can be given calcium, sodium bicarbonate, insulin + glucose, nebulized albuterol, or some other not so popular treatments. For Hypokalemia the treatment is pretty simple as you can generally just give potassium to raise the blood serum levels. Hyperkalemia is more difficult to treat due to problems with facilitated diffusion in the cellular membrane at times. The sodium bicarb, insulin + glucose, and nebulized albuterol all cause a redistribution and intracellular shift causing more potassium to be forced into the cell. The other treatments not listed treat hyperkalemia by removing potassium from the body, which doesn't work very well in cold wilderness emergencies due to vasoconstriction.

I have most likely go too far in depth to this but if you have any questions or want more explanation please feel free to ask. By the way the majority of what I stated is based off of the current Advanced Cardiac Life Support (ACLS) guidelines. These are only suggested or recommended by the AHA and not always adopted or used in all situations or all patients. MOST emergency medical cardiac protocols are based off of ACLS guidelines though.

EDIT: sorry this is a bit off topic from the original post but was more in reply to the quoted post

Re: O2 not req'd...

PostPosted: Mon Nov 19, 2012 6:33 am
by philoparts
I was quoting off the Wilderness Medical Society handbook about avalanche burial. What I was getting at is that unless interventions are performed within 30 minutes of burial, viability decreases to almost nothing. The odds of getting an ALS team on scene within that amount of time is not very realistic. The odds of also having a 12-lead on scene to see a peaked T wave, prolongation of the PR interval and absent P waves besides a field test for Hyperkalemia and then having everything needed to shift the potassium into the cells....... And none of this accounts for trauma from the initial event.

Re: O2 not req'd...

PostPosted: Mon Nov 19, 2012 7:54 am
by mroutdoorsman
philoparts wrote:I was quoting off the Wilderness Medical Society handbook about avalanche burial. What I was getting at is that unless interventions are performed within 30 minutes of burial, viability decreases to almost nothing. The odds of getting an ALS team on scene within that amount of time is not very realistic. The odds of also having a 12-lead on scene to see a peaked T wave, prolongation of the PR interval and absent P waves besides a field test for Hyperkalemia and then having everything needed to shift the potassium into the cells....... And none of this accounts for trauma from the initial event.


True. Whenever I go out in a non-SAR status I do usually bring my jump bag drug box with many of the drugs capable of treating hyperkalemia. I know I am part of a VERY small percentage of people qualified to do so that go in a wilderness setting. I think i go pretty overboard in what I normally carry in my pack medical wise but I rather be prepared and carry the extra weight than see someone I know or be near someone that may need my help die because I didn't have the stuff to save their life.

Re: O2 not req'd...

PostPosted: Mon Nov 19, 2012 3:26 pm
by philoparts
People ask me at times why I carry a larger first aid kit in the backcountry . I tell them its not for me, its for the other people I might run into who need help. Being an EMT basic with no ACLS certs (and I volunteer for a BLS rural agency), my meds resources are more limited, but if I'm close enough to help in an emergency situation I want to have at least "something" in my pack. Then I can back that up with the WEMT training for "make due with what you have".

I can imagine at current research prices, this new super oxygenating drug is probably worth more than most luxury cars cost per dose, but it is an interesting concept.