What cardiac arrest looks like

wanderingmedic

RN, Paramedic
448
61
28
Anyone understand the physiology behind the seizure-like activity following a cardiac arrest?
 

Ewok Jerky

PA-C
1,401
738
113
Just a guess but its probably nonfunctional misfiring of irritable hypoxic peripheral nerves. I wouldn't think it would be from a central (CNS) cause.
 

Carlos Danger

Forum Deputy Chief
Premium Member
4,510
3,234
113
http://www.ems12lead.com/2014/11/11/sudden-cardiac-arrest/

Interesting article/videos about sudden cardiac arrest with pts having tachypneic agonal respirations and posturing while in cardiac arrest. Some videos are painful to watch because of care or lack there of but good info

Excellent article, thanks for posting it.

I remember as a new EMT, being a little freaked out at how people looked and acted immediately before and after a cardiac arrest. Very different than I had imagined as a layperson.
 

Carlos Danger

Forum Deputy Chief
Premium Member
4,510
3,234
113
Anyone understand the physiology behind the seizure-like activity following a cardiac arrest?

Good question, my guess is one or a combination of:
  • Subcortical disinhibition due to hypoxia, similar to the myoclonic movements you see after etomidate is given
  • Anoxic depolarization due to cerebral hypoxia; basically a hypoxic seizure
 

zzyzx

Forum Captain
428
90
28
The first video is most interesting. I honestly would not have thought that she was in cardiac arrest if I had been there. Her "agonal" breathing wasn't really agonal at first. In fact her deep breathing was keeping some blood flow going to her brain, which is likely why she was able to keep breathing for so long. I suppose this is similar to cough CPR.
 

Shishkabob

Forum Chief
8,264
32
48
Anyone understand the physiology behind the seizure-like activity following a cardiac arrest?

Arrhythmia causing decreased blood flow to the brain which causes hypoxia which causes the brain to ''freak out'' and have seizure-like activity, much like a syncopal episode can sometimes present with / as a seizure.
 

Brandon O

Puzzled by facies
1,718
337
83
Thanks for the endorsement! IMO this is an important one (ie not just a curiosity) due to the frequent failure to recognize SCA in a timely manner... in laypersons and providers alike.
 

FltMedicRob

Forum Crew Member
30
2
8
Wow, that's a fantastic article. Just forwarded it to our Opps Director and will use it as a training hour for our new medics (and the old ones if I get my way).
 
Top