Diagnostic and therapeutic dilemma

62 year old Caucasian woman with a history of  diabetes on oral hypoglycemics,active smoker; hospitalized in the recent past for congestive heart failure came in with pulseless electrical activity(PEA) arrest.Ejection fraction (EF) on recent echo done 1 week prior was 65% with mildinferolateral wall hypokinesis. She is admitted this time with respiratory failure leading to intubation in the field, followed by PEA arrest on arrival in the emergency. Resuscitated after 4-5 minutes of cardio-pulmonary resuscitation-no purposeful movements noted, but patient opens eyes spontaneously.Electrocardiogram after resuscitation as attached. Questions- 1. Should this patient undergo cardiac catheterization emergently? 2. Should hypothermia be considered, especially in light of the new evidence from the TTM (Targeted Temperature Management) trial?   3. If hypothermia is considered-what should be the target temperature?
Source: Doc2Doc BMJ Cardiology - Category: Cardiology Authors: Source Type: forums