The acquisition cost of isoproterenol (Isuprel®) has dramatically increased from approximately $60 per vial in 2012 to over $2,150 per vial today, a nearly 4000% increase. In order to minimize costs associated with therapy, the following represents alternative agents that may be utilized in the management of bradyarrhythmia:Recommendations for the management of bradyarrhythmia based on the Advanced Cardiovasular Life Support guidelines are as follows (1):Patients who are asymptomatic from their bradycardia typically do not need aggressive [...]

There are two kinds of people in the emergency department: those who are advocates of intravenous tPA for the treatment of acute ischemic stroke, and those who aren’t. Among twelve large clinical trials, only two have demonstrated statistically beneficial results of systemic thrombolytics in the setting of acute ischemic stroke: NINDS and ECASS III [1,2,3]. Despite the lack of robust high quality evidence, current American Heart Association/American Stroke Association guidelines recommend the administration of intravenous [...]

There are two kinds of people in the emergency department: those who are advocates of intravenous tPA for the treatment of acute ischemic stroke, and those who aren’t. Among twelve large clinical trials, only two have demonstrated statistically beneficial results of systemic thrombolytics in the setting of acute ischemic stroke: NINDS and ECASS III [1,2,3]. Despite the lack of robust high quality evidence, current American Heart Association/American Stroke Association guidelines recommend the administration of intravenous [...]