We were called to a male in cardiac arrest.
On arrival, patient was found in PEA arrest @ 40, no CPR done. Down time of 5minutes.
Daughter stated she found her father on lounge struggling to breathe holding his chest. Was not unwell earlier. Vomit around mouth and on floor.
PMHX - Hypertension.
We did 2 rounds of CPR with a ROSC.
Initial observations post ROSC.
Heart rate = 44 followed by a run of self terminating SVT then into a NSR @ 95bpm. Slight ST depression V4, v5, v6 - 1mm, normal t wave morphology.
BP = 240/130 then dropping to 130/99.
RR = 4 poor tidal volume prior to intubation.
Post intubation: sp02 96%, etco2 60, good AE bilaterally.
GCS 3
Pupils - 2mm sluggish bilaterally.
Temperature = 36.7 c / 98f
BGL = 10.1
Our treatment:
IPPV > guedel airway followed by intubation 8mm - 24lips. No RSI needed.
IV access = 16g
Post intubation sedation with M&M mix due to grimacing but no limb movement/speech/eye opening.
Ringers lactate TKVO.
No changes en route. Maintained ROSC and observations.
Via ISTAT - All ions within normal ranges. Lactate = 2.5, pH 7.29.
Any ideas at this point?