# My First Arrest



## CAR1 (Apr 4, 2012)

This is the scenario:  upon arrival (als & bls pulled up together) find 80y/o male in cardiac arrest. no shock-able rhythm, after 20-30 min of CPR+ meds we get a pulse back, en route we lose it, get it and lose at hospital a couple of times(don't remember how many)   My question is that the last time we lost it, we did  CPR for about 5 min before the doc called it.   Do you think he called it to early?


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## Shishkabob (Apr 4, 2012)

Now ay did he call it too early.  30 minutes is really pushing the envelope as is.  Just because you get a pulse back doesn't 'reset the clock' on death, as the heart beating doesn't instantly fix the acidosis, MODS, etc etc of prolonged arrest.


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## d_miracle36 (Apr 4, 2012)

What was the downtime before effective CPR was started? Mayo Clinic has a article about a prolonged resuscitation guided by capnography that led to discharge with full reovery after 10 days. But you had no shockable rhythm however so I would say it was a good call.


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## Handsome Robb (Apr 4, 2012)

We had a pt with an ETCO2 of 36 this morning that we pronounced. Asystolic throughout the arrest. 

Between prearrival and us he was worked for 52 minutes. Even if we had gotten a pulse back the chances of having anything more than a vegetable were slim to none. 

That mayo clinic story is crazy but truly is one and a million.


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## d_miracle36 (Apr 4, 2012)

Yeah and I believe if the stars line up like they did in that one it can happen. Witnessed arrest, trained responders on scene, refractory v-fib. Then again I may just be young and naive


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