instantaneous rigor

d_miracle36 said:
I had a patient like this once but it remained after he was resuscitated. Thought that could have been a seizure but later found Cadaveric spasm's. I tried to explain to my director that I could not intubate because the patients mouth would not open. I was able to insert a king airway in shortly after though.
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Rhetorically: how can so-called cadaveric spasm be equated with (mistaken for) a seizure?

OP's pt was in trismus then died. "Cadaveric spasm" may apply.
 
mycrofft said:
Rhetorically: how can so-called cadaveric spasm be equated with (mistaken for) a seizure?

OP's pt was in trismus then died. "Cadaveric spasm" may apply.
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Immediately after the patient arrested he was clinched during that period and it remained after rosc. I equated the trimsus with the seizure because I did not know any other reason. After researching on the Internet cadaveric spasm seemed more feasible. I thought I said that before but I may not understand your rhetoric.
 
I don't want to say too much about the call in terms of specifics but we were actually backing up another ALS crew. We suggested a cric but the attendant was happy with npa's and bagging for our short transport. I disagree and it was brought up later

And to someone above. There was no trismus prior to the code
 
d_miracle36 said:
Immediately after the patient arrested he was clinched during that period and it remained after rosc. I equated the trimsus with the seizure because I did not know any other reason. After researching on the Internet cadaveric spasm seemed more feasible. I thought I said that before but I may not understand your rhetoric.
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You got it right.

It was "rhetorical" because I figured you had it right but not quite sure and didn't want to seem to say you had it wrong.

They aren't equated, but sometimes related.;)
 
blindsideflank said:
I don't want to say too much about the call in terms of specifics but we were actually backing up another ALS crew. We suggested a cric but the attendant was happy with npa's and bagging for our short transport. I disagree and it was brought up later

And to someone above. There was no trismus prior to the code
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I quote:

" 5 mins of code and an attempt to intubate is thwarted by trismus/rigor mortis?!?!"..but bagged well with 2 npa's.

So the trismus set in during resuscitation effort. Got it.:cool: Could be related to the drugs too, as someone mentioned above....

Cric unnecessary if "bagging well", and by that I assume we are talking about no clinical signs of asphyxia, chest rises and falls, breath sounds bilat in lungs, maybe even (wince) good pulse oximetry. Without additional spit and blood and stuff, teeth aren't airtight either. Sounds like the field crew "done good". Any implication by ER folks can't be related to this unless they're just pissy.
 
miraclemax.jpg
" 'Maybe some sux. Maybe some potassium. Maybe some Max'. Sometimes, 'dead' is DEAD. Now, how about some nice MLT sandwiches? Hmmm?".​
 
Doc tried sux and it did nothing. we also carry Roc, but im trying to wrap my head around it working and I don't believe there is any way either paralytic would work, (based on the theory of how this happens)
 
Not an appropriate crich scenario, at all. Crichs are only indicated in a cannot oxygenate/cannot ventilate situation and you stated you were getting good compliance with the BVM and NPAs.

I had a suicide do this a ways back. Was flaccid when I dropped the OPA then totally rigid when I went back to pull the OPA and put in the king.
 
According to the Wiki article it mostly happens to groups of muscles rather than a the whole body. Any ideas why?
 
jefftherealmccoy said:
According to the Wiki article it mostly happens to groups of muscles rather than a the whole body. Any ideas why?
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Can't comment as to why but I will say in my case I briefly described above it was only his neck and jaw, nothing else.
 
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