a question about cardiac arrest w/asystole!

Nurses General Nursing

Published

let me say,that i am very fascinated with CRP and life/death. my neighbor has been a ER/ICU RN for over 35 years at a major hospital. i have asked him if in his long line of work has he ever seen a patient who presented with an initial rhythm of asystole get discharged from the hospital. he told me that he only remembers one such case and it was a 21 yr. old male who had hyperkalemia and went into asystole,and eventually was able to get a ROSC and get discharged from the hospital. i am curious,have any of you had a patient/patients who presented with asystole and were discharged from the hospital?? thanks very much.

Am I the only one concerned about allnurses.com being a source of information for a layperson "fascinated with life/death"?

Education is a basic function of nursing.

Experienced ROSC with asystole, no survival to discharge however.

Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.
Experienced ROSC with asystole, no survival to discharge however.

Yep, that right there.

Specializes in ICU, Telemetry.

I've only seen one non-trauma adult who went from asystole to a spontaneous rhythm. Unfortunately. The family finally agreed to a terminal extubation a week later, when the patient was declared brain dead. It was horrible going from, "Hey, Yeah, we got him back!" to "oh, God, he's posturing. Pupils fixed and dialated. We brought his body back but his mind didn't come with him..."

Generally, 2/3 of Code Blues don't survive the initial code (that's everybody in the pot, from the Emory, Johns Hopkins, Cook County down to our little mom and pop ER). Of the remaining 1/3, only 1/3 of them are alive 30 days later; my gut feeling is that the ones that come back and do well are the electrolyte imbalance, cold water drownings of children, electrocution, etc., -- something where you can jump in and fix what caused the code in the first place. If the person's coding because of sepsis, respiratory failure d/t end stage COPD, Lung CA, SIRS, ARDS, MODS....if you bring them back, you haven't done them a favor.

Specializes in PICU, ICU, Hospice, Mgmt, DON.

This is one of the things that "gets" me on the TV shows when they all yell something like "he's flat lining...better shock him...POW, again, POW, again, POW.....we got him BACK"!!!!!!!!!!!!!!!!!!!!!!!! Geeezzzzzzzzzzzzzzz...um, no, you probably didn't....and you don't shock asystole...(unless it's very fine vfib)

Specializes in Medical.

I hate, hate, hate that! I withdrew as technical advisor from a (now former) friend's film project because he insisted on defib and wouldn't make his character's arrest be a shockable rhythym. Why? "She has to really be dead." I think you'll find VF is just as dead, just more survivable. Comparatively speaking, that is.

Sorry -whats ROSC? thanks!

Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.
Sorry -whats ROSC? thanks!

Return of spontaneous circulation.

Am I the only one concerned about allnurses.com being a source of information for a layperson "fascinated with life/death"?

I'm quite concerned with that statement as well. As I am a nurse I am more fascinated by life. I will be fascinated by death once they bury me or cremate me (I told my love ones to surprise me with either burial or cremation once I die). As the "Wizard of Id" once stated, "Death is a once in a lifetime experience." :jester:

Specializes in Medical.

I'm fascinated about death - I'm doing a PhD on the topic, or at least deathwork practices.

Statistically, the odds aren't good. The survival to discharge rate for cardiac arrest w/asystole when the event occurs in hospital is less than 10%, and 60% of those will likely suffer significant disabilities as a result of the event. For a patient where the arrest occurs outside the hospital the odds of survival to discharge, with very rare exceptions, are practically non-existent.

Specializes in Neurosciences, cardiac, critical care.

I haven't had it with a patient, but I have a friend who flat-lined 3 times in one day. He was mid 20s when it happened (10 or so years ago), a professional athlete, and has had an AICD ever since. They've never figured out why he had the sudden cardiac death, but he's a spokesperson now for some heart health program at Cedars-Sinai. Pretty interesting.

+ Add a Comment