I saw something this week in a code that is truly unique and a bit disturbing. We were doing CPR on a pt that coded and he started moving his arms purposefully. We stopped chest compressions and he was asystole and without a pulse. The ED doc that was running the code stated that he probably had enough cerebral perfusion during CPR to allow him to be responsive. I have seen this one other time (in my 14 years of critical care) but not as pronounced as in this case. Moral of the story, just because the pt is moving doesn't mean that spontaneous circulation has been restored.
See link to abstract for more information: http://www.ncbi.nlm.nih.gov/pubmed/18483881
Has anyone else experienced this?
I have actually called 2 codes on pts that were AAO! One was about to go into anaphylactic shock - and would need to be intubated, the other was severely fluid overloaded and drowning. Both survived. In the first case, a doctor told me to just call the anesthesia office, to get someone to come up, but they wouldn't answer. The doc was pi$$ed when I called the code, but the code team was impressed that we didn't wait.
The second person had rec'd 2 units of RBCs and plenty of saline, needed a diuretic and then more extreme measures.
Too often, we do too little until it becomes a true emergency. I like the idea of a 'fast response' team, makes it easier to call prior to an arrest.
Last edit by merlee on Sep 30, '13
: Reason: sp