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- May 11, 2008
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41 YO M brought in by EMS. Found down on the ground by coworkers who started CPR. Medics coded him for 25 minutes PTA. Vfib as initial presenting rhythm and throughout. Medics tell us patient had a heart cath with stent placement 1 mo prior. He gets to us and is still warm. Doesn't have that grey/mottled look that a true dead dead person looks like. Continue coding him. Checked with ultrasound, heart definitely still fibrillating. Tubed, EtCO2 of 35. We code and code and code. Epi, bicarb, amio, lido, calcium, mag, tPA, many shocks. Vfib -> Vfib -> Vfib. Eventually the vfib starts getting more and more fine until nothing is moving.
I've done plenty of codes before and usually don't have any problems calling it. But then again, rarely do I encounter someone I'm coding who is still warm, still apparently perfusing, and who has a damn good EtCO2 and heart motion on ultrasound. Not to mention much younger than many of the people I code. I just remember thinking "****, if this was 10-15 years from now, maybe I'd be able to put this guy on ECMO". I didn't want to give up.
Looked up his past records from our computer system after the fact. First MI at 33. This guy really drew the genetic short straw.
I've done plenty of codes before and usually don't have any problems calling it. But then again, rarely do I encounter someone I'm coding who is still warm, still apparently perfusing, and who has a damn good EtCO2 and heart motion on ultrasound. Not to mention much younger than many of the people I code. I just remember thinking "****, if this was 10-15 years from now, maybe I'd be able to put this guy on ECMO". I didn't want to give up.
Looked up his past records from our computer system after the fact. First MI at 33. This guy really drew the genetic short straw.