Document Detail


Advanced cardiac life support and defibrillation in severe hypothermic cardiac arrest.
MedLine Citation:
PMID:  19145531     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The application of Advanced Cardiac Life Support (ACLS) in severe hypothermic cardiac arrest remains controversial. While the induction of mild hypothermia has been shown to improve outcomes in patients already resuscitated from cardiac arrest, it is unknown whether ACLS protocols are effective during the resuscitation of the severely hypothermic cardiac arrest patient. We describe a case of a 47-year-old man who was successfully resuscitated from a ventricular fibrillation (VF) arrest with a core body temperature of 26.4 degrees C. The patient had been found unresponsive in a bathtub of cold water following an apparent suicide attempt. An incorrect pronouncement of death by the fire department delayed his transport to the hospital by more than four hours. Once in the emergency department (ED), the patient sustained a VF cardiac arrest and was successfully defibrillated using ACLS protocols. He ultimately survived his hospitalization with near-complete neurologic recovery. In this case report, we discuss the application of ACLS to the resuscitation of the hypothermic cardiac arrest patient as well as the issues involved in the prehospital determination of death.
Authors:
Christopher H Lee; Carin Van Gelder; Kevin Burns; David C Cone
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors     Volume:  13     ISSN:  1545-0066     ISO Abbreviation:  Prehosp Emerg Care     Publication Date:    2009 Jan-Mar
Date Detail:
Created Date:  2009-01-15     Completed Date:  2009-05-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9703530     Medline TA:  Prehosp Emerg Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  85-9     Citation Subset:  IM    
Affiliation:
Yale-New Haven Medical Center, Emergency Medicine Residency Program, New Haven, Connecticut 06519, USA. c.lee@yale.edu
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MeSH Terms
Descriptor/Qualifier:
Advanced Cardiac Life Support / methods*
Electric Countershock
Heart Arrest / complications,  therapy*
Humans
Hypothermia / complications,  therapy*
Male
Middle Aged
Positive-Pressure Respiration
Rewarming*
Suicide, Attempted
Ventricular Fibrillation / therapy*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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