The Alpha and the Beta of Vasopressors

Alpha- primarily affects vessels

Beta- Primarily works on the heart ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ Vasopressors are commonly talked of as having Alpha and Beta properties. What does this mean, and how to keep it straight? I like to remember Alpha properties by envisioning a blood vessel end-on. To me, it looks a lot like the big loop in the Greek symbol for Alpha. This is a good thing, because the Alpha properties of vasopressors primarily serve to constrict peripheral vessels, thereby "shunting" blood to the core organs, heart and brain (although they also tend to constrict micro-circulation there as well) and thereby increasing blood pressure. The Greek symbol Beta looks a heck of a lot like a stylized heart turned sideways, and the Beta properties of pressors generally work there as well, increasing heart rate (chronotropy) and force of contraction (inotropy). Pressors can work primarily in one way or the other, or both. Epinephrine has about equivalent properties for both Alpha and Beta. Dopamine is interesting, because at low doses it has primarily Beta properties, whereas at higher doses, the Alpha predominates. Another drug that we used to use in the ACLS algorithms, Isoproterenol, is basically all Beta.

Ticks Suck (Literally)!!

ahhh, summer time! Baseball, hikes, beer, ticks. Ticks in and of themselves don't really create a problem. They don't cause pain, only take a tiny amount of blood, then they leave. Problem is, ticks carry and transmit a fair amount of nasty dieases, like Lyme and Rocky Mountain Spotted Fever. These diseases can be a nightmare to diagnose and treat because they have a dizzying constellation of symptoms, including potential neurological complications, malaise, and fever. Best to avoid being bitten if possible, and do frequent tick checks. DEET is still the repellent of choice, placed at the cuffs of pants, long sleeved shirts, and even on hats. If a tick is found attached, the recommendation is removal right away with tweezers placed really close to the person's skin. Continued, even pressure applied straight up is the way to go. Experts do not recommend burning them off, or putting any lotions or petroleum jelly on them to loosen them first, as this can make them regurgitate into their host. Don't twist the tick out!. If any jaw parts are left in, these can be removed with a needle or by scraping. Ticks can be saved for identification, and possible testing if needed. Lyme disease, the biggest risk in the U.S. for "vector-borne" disease, (a disease transmitted to humans through an animal host) is an east coast disease primarily transmitted by very small deer ticks, and actually takes at least 24 hours of the tick being attached to transmit it to a human. Some say it takes 48 hours or more. Unfortunately, it does have a high prevalence due to the fact that the ticks are so small and hard to see, which means they can remain on longer undetected. Rocky Mountain Spotted Fever can be transmitted in just an hour or two. Don't be misled by the name, this disease is prevalent on the east coast as well.

our real home page!

Check out the source of this blog at our website: http://www.carpentercprsolutions.com/-blog.html

SIDS reduction

The first step in the AHA's Pediatric Chain of Survival is prevention and safety. With that in mind, and the fact that everyone I know is having a baby, let's talk a little about SIDS. Sudden Infant Death Syndrome is a fairly poorly understood mechanism of "crib death" usually seen in infants two to four months of age. Statistics show that there are many modifiable things that can be done to reduce SIDS death rates. Among them are: Placing the baby on the back to sleep. Not smoking during pregnancy, and keeping smoke out of the home. Keeping the environment cool. (In other words, don't let the baby get too warm). Minimize blankets and stuffed animals, (and anything else) in the crib to make sure the baby can't suffocate. Maintaining a good flow of fresh air in the room. Use a breathable, mesh type crib bumper. The research and thinking points to SIDS related deaths being caused by a few factors. Rooms with minimal air flow, or lots of blankets, heavy bumpers, and stuffed animals can create dead spaces, where the carbon dioxide can build up, ultimately causing respiratory failure due to the baby's own exhalations. A warm room also can contribute to this due to creating less of a buoyant quality on the exhaled air. Placing a fan in the room can help circulate air. (Of course, don't blow the air directly on the baby!) Other factors that may contribute to SIDS deaths are less clear, but the numbers point to actions that can reduce risk. Breastfeeding reduces SIDS deaths by up to 50%. . Keeping your baby in the room with you during this time (NOT in the same bed!) has been shown to reduce SIDS deaths. Baby sleeping with a pacifier may reduce SIDS. The recommendation is NOT to replace it if it falls out of the baby's mouth while sleeping. For some reason, children with up to date immunizations have a lower SIDS rate. This may be reflective also of up to date pediatrician visits. Congratulations to all of the new mothers out there, and here's to safe sleep and healthy kids!