Let´s suppose that you are a member of a resuscitation team and you are called to a CPR inside the hospital.
When you get to the place, you find several physicians performing advanced life support. According to an accompanying person, the patient was discharged from the department of surgery a few minutes ago – discharging medical report is not available. While the patient was waiting for transport, several people witnessed her collapse and loss of vital functions. Monitor detected asystole.
After suction of vomiting content from her mouth, she was intubated while being resuscitated continuously. At the same time, a peripheral venous catheter was inserted and adrenaline i.v. was given. After approximately 3 minutes, the heart rhythm was restored with pulse palpable over large vessels.
In the corridor, there is a room with an ultrasonographic machine. A cardiologist brought it and performed quick echocardiography – left ventricle is hypertrophic and shows symmetric kinetics, signs of hypovolemia, no significant systolic dysfunction is detected, right ventricle shows borderline size at maximum (no significant dilation is detected). The patient was transferred to the monitored bed, and 1000 ml of pressurised crystalloid were administered i.v. during transport.
First 12-lead ECG: junctional rhythm, sinus bradycardia, ST elevation in III and aVF, ST depression in V2-4, iRBBB.
Bed-side echocardiography was performed: