Could you have prevented this young man ' s cardiac arrest?

Written by Pendell MeyersWe received a call from an outside hospital asking to transfer a " traumatic post arrest " patient. We were told that a young patient was brought in with altered mental status but complaining of right hip and/or leg pain after being found by his mother at the bottom of the stairs into the basement. His history was significant only for IV heroin abuse, but he denied any recent use. Apparently he had been confused about why he was at the bottom of the stairs, unsure if he had fallen, unsure whether there was any specific traumatic mechanism.The practitioner on the phone stated that he suddenly developed a wide complex PEA arrest just after he came back from CT scan (pan scan performed looking for traumatic injury). The official read was not back yet, but initial view of CT scans did not show any clear injuries in the head, chest, or abdomen per report. They stated that the patient was coded for 20 minutes, including multiple doses of epinephrine, and they also gave glucose, calcium, and bicarb. They achieved ROSC and wanted to transfer to our institution for post-arrest care.We asked for the ECGs to be faxed over while they prepared to transfer him.We received 4 ECGs, including his baseline on file, and three from today, including triage, peri-arrest, and post-ROSC (sorry for the poor quality due to scanning).Prior ECG on file:Sinus tachycardia, imperfect baseline, otherwise unremarkable.Triage ECG, with patient awake and complaining of right lower extr...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs