Saturday, October 24, 2009

Glyceryl Trinitrate?

Whilst at the scene of an accident a doctor once told me that if your were trying to insert a venous cannula into a patient who,s periferal circulation had shut down,you could achieve a local reaction on a vein by spraying the skin with GTN,Has anyone known this to work?
Answers:
I've heard of nitroglycerin used to dilate veins for venous access, but I've never personally seen it done. In theory, it might work, but I believe the action would be too slow to do much good prehospitally.
Nitroglycerin is often applied topically to achieve systemic results throughout the body, though, and topical nitro can be used to relieve chest pain, i.e nitro paste. It acts fairly quickly, but definitely not as quickly as sublingual nitro. Personally, I'm pretty convinced that nitro won't do much good for venous access (it would work too slowly to do much good in a situation where the peripheral circulation had vasoconstricted to that extent. A better choice for venous access would be an external jugular or femoral vein. These are often even usable during cardiac arrest!
Hope this helps!
Glyceryl Trinitrate is a drug but it's also an explosive.
As a drug it's used to treat heart failure and other things.
As an explosive it's used for demolition and stuff.
glyceryl trinitrate is also known as nitroglycerin. It is a potent vasodilator (is makes the vein or artery dilate or get larger). if someone's peripheral circulation has shut down due to shock, it basically means the body has vasconstricted itself due to insufficient circulatory supply (due to hemorrhage, cardiac arrest, etc.) I don't know if GTN applied topically would be absorbed fast enough to cause this peripheral vasodilatation locally for IV insertion. I have certainly never used it my practice.
Most aerosolized GTN is applied to a mucous membrane, where the blood supply is much more accessable. It is used primarily for chest pain (because it dilates the coronary arteries).
BTW, the vasodilation effects of nitroglycerin were first observed by men manufacturing the product for explosives use.
Its a vasodilator, i.e makes the blood vessels enlarge. Used under the tongue to ease angina. Not sure if it works on the skin though
Glyceryl Trinitrate is used in heart conditions.I have never it to open a vein .I will try it next time I want to insert a cnnnula into a patient who's periferal circulationhas shut down

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