mycrofft
Still crazy but elsewhere
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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.
instantaneous rigor
- Thread starter blindsideflank
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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.
d_miracle36
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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.
blindsideflank
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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
And to someone above. There was no trismus prior to the code
mycrofft
Still crazy but elsewhere
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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.
mycrofft
Still crazy but elsewhere
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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.
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.
jefftherealmccoy
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In this situation would a depolarizing agent such as Sux be useful?
Not a bad idea, i'd say a non-depol would be a better idea due to the competitive antagonism preventing AcH binding leading to the flaccidity.
mycrofft
Still crazy but elsewhere
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" 'Maybe some sux. Maybe some potassium. Maybe some Max'. Sometimes, 'dead' is DEAD. Now, how about some nice MLT sandwiches? Hmmm?".
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blindsideflank
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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)
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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.
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.
jefftherealmccoy
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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.