What Do you Think Happened?
http://news.aol.com/health/article/man-r…
I was Thinking a Scenario may Have Involved this:
http://en.wikipedia.org/wiki/Pulseless_e…
Answers:
Don't know, but hopefully not PEA. The article said they shocked him 8 times. PEA is not an indication for defibrillation; so if that's what he had, the doctors really screwed up.
Addendum: First, indications for shocking are VTach, VFib, and unstable AFib. With unstable AFib, you use synchronized cardioversion. I think as not long as a few years ago, the shocking algorithm was still shock-shock-shock, then CPR. Now, it's shock once, then 2 mins of CPR, later shock again as needed, then CPR, etc.
Ideas about this guy-- given the indications for cardioversion and the fact that he seem to recover after getting anticoagulated, that suggests s few possibilities. A pulmonary embolism can cause AFib. But if a PE was huge enough to cause this, I would think you would have need of a focused thrombolysis to fix it within 45 mins. The other possibility is that he had an ischemic event that sent him into an arrhythmia. If it was a vessel that hit a small nouns in the subendocardium (where the main parts of the conduction system lay), that might have be enough to throw him into VTach/Fib. Heparin, ASA, or a GP IIb-IIIa inhibitor might have been plenty to open up flow. I would think 45 mins would be a long time for a nerve to survive lacking blood flow though. Don't know. Not a cardiologist.
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I was Thinking a Scenario may Have Involved this:
http://en.wikipedia.org/wiki/Pulseless_e…
Answers:
Don't know, but hopefully not PEA. The article said they shocked him 8 times. PEA is not an indication for defibrillation; so if that's what he had, the doctors really screwed up.
Addendum: First, indications for shocking are VTach, VFib, and unstable AFib. With unstable AFib, you use synchronized cardioversion. I think as not long as a few years ago, the shocking algorithm was still shock-shock-shock, then CPR. Now, it's shock once, then 2 mins of CPR, later shock again as needed, then CPR, etc.
Ideas about this guy-- given the indications for cardioversion and the fact that he seem to recover after getting anticoagulated, that suggests s few possibilities. A pulmonary embolism can cause AFib. But if a PE was huge enough to cause this, I would think you would have need of a focused thrombolysis to fix it within 45 mins. The other possibility is that he had an ischemic event that sent him into an arrhythmia. If it was a vessel that hit a small nouns in the subendocardium (where the main parts of the conduction system lay), that might have be enough to throw him into VTach/Fib. Heparin, ASA, or a GP IIb-IIIa inhibitor might have been plenty to open up flow. I would think 45 mins would be a long time for a nerve to survive lacking blood flow though. Don't know. Not a cardiologist.
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