title: Digoxin levels in prehospital sudden-death syndrome.
abstract: Digitalis toxicity is common and has been associated with ventricular dysrhythmias. Digoxin levels in patients who suffer prehospital sudden death have never been studied. This study measured digoxin levels in a population of sudden-death patients. During the 15-week study period, 252 patients in cardiac arrest were seen by an urban paramedic system. During daytime hours, paramedics were requested to obtain a blood sample from sudden-death patients; the samples were subsequently analyzed for digoxin by means of radioimmunoassay. Thirty-nine patients had measured digoxin levels drawn; 28 (71.8%) were in the therapeutic range (0.5-2.1 ng/mL), and four (10.2%) were in the toxic range (greater than 2.1 ng/mL). The patients with toxic dogoxin levels and those with nontoxic levels had similar resuscitation rates (50.0% vs. 34.3%, P = NS), but none were found in ventricular fibrillation. Emergency medical services personnel should consider digoxin toxicity as a potential etiology of arrest.
authors: Medical College of Wisconsin, Department of Trauma and Emergency Medicine, Milwaukee.
authors: D S
authors: DS
authors: Olson
authors: H A
authors: HA
authors: Stueven
authors: J L
authors: JL
authors: Teresi
authors: B M
authors: BM
authors: Thompson
authors: A S
authors: AS
authors: Yee
mesh_terms: D000368:Aged; D003645:Death, Sudden; D004077:Digoxin / Q000097:blood*; D006801:Humans; D011863:Radioimmunoassay
chemical_list: D004077:Digoxin