Case No. 95

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Case No. 95


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Chief Complaint:

Found down at home

Published: Aug. 29, 2017
Author: jason.lopez

A patient is rushed to the Emergency Department by EMS in cardiac arrest after a neighbor found her down at home. EMS states they arrived to the scene to find the patient lying on a carpet without pulses. The patient was bagged and CPR was started. The responding EMS crew was BLS (basic life support) so the patient is being bagged and no medications were given during this time. In the Emergency Department the patient is pulseless. CPR is again initiated and defibrillator pads are placed on the patient. She is rapidly intubated and an IO is placed in her right tibia. You obtain a fingerstick that shows a blood glucose of 200. On a quick physical exam you appreciated bilateral breath sounds, left upper extremity AV fistula, and no evidence of trauma. Repeat pulse check after 2 mins shows an organized slow wide complex rhythm on the cardiac monitor but no pulses. CPR is again initiated.


In addition to epinephrine, what is the next best step in management?

  • immediately defibrillate the patient
  • administer calcium chloride
  • administer an amiodarone bolus
  • administer atropine bolus
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