Monday, November 5, 2012
You arrival on scene of a 81 y/o M supine on the ground. Pt's daughter is doing CPR. You and your partner take over. You place the pt on the monitor, and you notice asystole. No vital signs. Family stated that the pt was having chest pain that started around 1420 hrs. He went to lay down on the couch, when they realized he was not breathing nor had a pulse. The daughter started CPR about 4 minutes prior to your arrival (she started CPR as they were calling 911).
You give two minutes of CPR. You attempt and are successful at an advanced airway with an ET Tube. As your partner is on the chest, you attempt an IV. You successfully obtain an 18 gage in the left AC. You and your partner switch places. Your partner draws up 1mg of Epi 1:10,000 (prefilled syringe). Your partner pushes the first dose at 1432 hrs. You continue with CPR. It has now been 4 minutes, and you draw up another 1mg of Epi 1:10,000 and push it at 1436 hrs. You patient continues to show asystole on the monitor.
You now start going over your H's and T's. Pt's sugar is 103. No other H's and T's are noted in the hx of the pt, according to his wife.
You continue to work him for an additional 5 minutes. You push 1 mg Epi 1:10,000. Pt's still showing asystole. You load the pt on a backboard and put him on the stretcher. You move to the truck and transport emergency (lights/sirens) to the closest hospital, which is 4 minutes away. While enroute, you focus on chest compressions and airway management.
Your partner calls the hospital for you, and they advice you that you are going to the resuscitation room.
You give report to the hospital doctor and RN in the room. You advice them that you have given three doses of Epi with no response. Pt's is still showing asystole on the monitor. You continue to advice them that the pt has been down for about 20+ minutes, starting from time of call to now.
The ED works the pt for an additional 20 minutes. Despite all of your partner and yours best efforts. and the hospitals efforts, the ED doctor calls the code. The doctor stated to you that you guys did everything that you could and you did a fantastic job.