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He was defibrillated, but they also noticed that he was being internally defibrillated and then found that he had an implantable ICD. He was unidentified and there were no records available After 7 shocks, he was successfully defibrillated and brought to the ED. There was no bystander CPR. Cardiology agreed.
Attention was turned to the consideration of severe coronary vasospasm as the inciting event for cardiopulmonary arrest and the nidus for refractory ventricular fibrillation. After the fourth defibrillation attempt, 200 mcg IV NTG was administered, resulting in immediate return of spontaneous circulation with a junctional bradycardia rhythm.
CPR is taken over by responding crews, and he is placed on a cardiac monitor/defibrillator. After several cycles of defibrillation, epinephrine, and amiodarone, the patient remains in cardiac arrest. Calcium Chloride Is Given to Sicker Patients During Cardiopulmonary Resuscitation Events. Sanchez, G., Venkataraman, P.,
Let me preface this by saying that these are my opinions which are based on my review of the medical literature and my real life experiences using mechanical CPR at the system level, including post-event analysis of resuscitations in which mechanical CPR was used. Start an IV and give epinephrine? The take-home message is this.
I B ECG monitoring should start immediately and a defibrillator must be ready. IIa B In STEMI patients with stent implantation and an indication for oral anticoagulation, triple therapyd should be considered for 1–6 months (according to a balance between the estimated risk of recurrent coronary events and bleeding).
Resuscitated with chest compressions, epinephrine. Here is the written paramedic report available after all the events were over: Patient was seen by witnesses to become unresponsive. including epinephrine, and there was ROSC. Mistaking such cases as an acute cardiac event is not uncommon because of these ECG changes.
He was defibrillated twice and received two doses of epinephrine, with return of spontaneous circulation. He underwent placement of a dual chamber, implantable, cardioverter-defibrillator (ICD) placement on hospital day 5. There was no family history of syncope or sudden death. Figure 1: The EMS rhythm strip. Click to enlarge.)
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