My First Arrest

CAR1

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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?
 
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.
 
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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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.
 
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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