Remove Epinephrine Remove Overdose Remove STEMI
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Resuscitated from ventricular fibrillation. Should the cath lab be activated?

Dr. Smith's ECG Blog

After 1 mg of epinephrine they achieved ROSC. Total prehospital meds were epinephrine 1 mg x 3, amiodarone 300 mg and 100 mL of 8.4% Cardiac arrest #3: ST depression, Is it STEMI? EMS arrived and found him in Ventricular Fibrillation (VF). He was defibrillated into VT. sodium bicarbonate.

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2023 AHA Update on ACLS

EMDocs

Calcium is associated with harm but is still necessary in certain situations (hyperkalemia, calcium channel blocker overdose) (Level 3 recommendation: no benefit). Vasopressor medications during cardiac arrest We recommend that epinephrine be administered for patients in cardiac arrest. COR 1, LOE B-R. COR 2a, LOE B-R. COR 2b, LOE B-R.

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What are treatment options for this rhythm, when all else fails?

Dr. Smith's ECG Blog

The ECG shows obvious STEMI(+) OMI due to probable proximal LAD occlusion. Epinephrine infusion was begun. These are also the most commonly reported findings in toxic overdoses with ventricular arrhythmias being reported as the leading cause of death. The below ECG was recorded. Subsequent PCI of the LMCA and LAD was performed.