Intramuscular XXXX for prevention of lethal arrhythmias in the prehospitalization phase of @entity583 .

@entity1 @entity662 @entity1165 @entity3303 @entity1188 @entity2224 @entity583
In a randomized controlled study examining the value of an intramuscular injection of @entity3303 in the prehospitalization phase of suspected @entity583 , paramedics used an automatic injector to administer 400 mg of the drug into the @entity1 's deltoid muscle before transport to the hospital. In a 33-month period, 7026 @entity1 with acute @entity662 were seen. Of the 6024 @entity1 randomized (2987 to the @entity3303 group and 3037 to the control group), 1935 (32 per cent) proved to have an @entity583 . In the entire 60-minute period of observation by continuous electrocardiography, primary @entity2224 was observed in 8 treated and 17 control @entity1 (P = 0.08). However, from 15 minutes after randomization onward, when plasma @entity3303 levels were in the therapeutic range, only 2 cases of @entity2224 occurred in the treated group, as compared with 12 in the control group (P less than 0.01). @entity1165 terminated a mean of 10 minutes after injection in six of nine @entity3303 -treated @entity1 with @entity583 but in none of five control @entity1 with @entity1188 (P less than 0.02). Mean plasma @entity3303 levels were 3 micrograms per milliliter 11 to 20 minutes after injection in 369 consecutive @entity1 . In 65 @entity1 , levels were below 2 micrograms per milliliter, and in 15 @entity1 , levels were above 6 micrograms per milliliter. Side effects were rare and did not contribute to mortality. We conclude that intramuscular @entity3303 may be useful if given by a paramedic, another @entity1 , or the @entity1 himself when @entity583 is suspected outside the hospital.
