Citation

Hancock J, Huang S, Zavalkoff S. CJEM 2020; 22(2): 155-158.

Copyright

(Copyright © 2020, Canadian Association of Emergency Physicians, Publisher Cambridge University Press)

DOI

10.1017/cem.2019.456

PMID

32209160

Abstract

A 16-year-old female presents to a community emergency room following a suicide attempt by hanging. Prehospital, on arrival of paramedics, the patient was in a pulseless electrical activity rhythm. Paramedics provided advanced cardiac life support for 20 minutes before they obtained return of spontaneous circulation. In the emergency department, she had another 25-minute cardiac arrest with ultimate return of spontaneous circulation. She is now hemodynamically stable on Levophed 0.2 µg/kg/min. Her neurological exam shows pupils to be 3 mm and fixed bilaterally, absent cough and gag, and no response to central or peripheral pain. She occasionally triggers 2-3 spontaneous breaths per minute above the set rate on the ventilator. Her CT head scan shows severe anoxic changes and cerebral edema.

Language: en

Keywords

Humans; Female; Adolescent; Heart Arrest; Emergency Medical Services; Cardiopulmonary Resuscitation; Emergency Service, Hospital; Critical care; emergency medicine; Tissue and Organ Procurement; transplant medicine