Middle Aged Woman with Asystolic Cardiac Arrest, Resuscitated: Cath Lab?

Conclusions: Head CT is common in NT-OHCA.  Cerebral edema is more common in patients presenting with an initial rhythm of PEA/asystole than in VT/VF and is associated with higher mortality.  Management is rarely affected by routine use of early head CT. In those who required urgent PCI, CT was associated with a (non-statistically significant) 21 minute longer mean DBT. Kurkciyan et al., abstracthttp://www.sciencedirect.com/science/article/pii/S0300957201003811Objective: Spontaneous subarachnoid haemorrhage as a cause of out-of-hospital cardiac arrest is poorly evaluated. We analyse disease-specific and emergency care data in order to improve the recognition of subarachnoid haemorrhage as a cause of cardiac arrest. Design: We searched a registry of cardiac arrest patients admitted after primarily successful resuscitation to an emergency department retrospectively and analysed the records of subarachnoid haemorrhage patients for predictive features. Results: Over 8.5 years, spontaneous subarachnoidal haemorrhage was identified as the immediate cause in 27 (4%) of 765 out-of-hospital cardiac arrests. Of these 27 patients, 24 (89%) presented with at least three or more of the following common features: female gender (63%), age under 40 years (44%), lack of co-morbidity (70%), headache prior to cardiac arrest (39%), asystole or pulseless electric activity as the initial cardiac rhythm (93%), and no recovery of brain stem reflexes (89%). In six patients (22...

Source: Dr. Smith's ECG Blog - October 20, 2013 Category: Cardiology Authors: Steve Smith Source Type: blogs