A 76-year-old patient was admitted to hospital for state after out-of-hospital cardiac arrest. According to witnesses, the patient collapsed and was unconscious. Basic life support had not been performed. After the arrival of an ambulance, cardiac massage and artificial ventilation were started. Quick ECG analysis revealed stimulated ventricular rhythm without a palpable pulse over carotid arteries. CPR continued, after 2 minutes ventricular fibrillation appeared. After one defibrillation, a stimulated ventricular rhythm was restored, and pulse was palpable over carotid arteries. 0.1 mg of adrenalin i.v. was administered. Transfer to hospital.
GCS 3, narrow pupils, hypothermia, circulatory centralization, pulse was palpable at big arteries, blood pressure 85/40 mmHg, 60 bpm, stimulated ventricular rhythm, mechanical ventilation. Quick echocardiography was performed at emergency – dilation and diffuse hypokinesia of left ventricle were revealed. No sign of right ventricular afterload was present. No pericardial effusion was detected. Blood samples (including cardiac enzymes) were taken. Central venous catheter was inserted into the femoral vein – when punctuating femoral artery; we entered the vein; thus, the central venous catheter was inserted here. Administration of dobutamine 20 mg/h = approximately 5 ug/kg/min. Transfer to the ICU.
Admission ultrasonography:
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