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A 40 yo in cardiac arrest

9/7/2022

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A 40 yo male is brought in by ambulance following a collapse
His GCS at the scene was 3
Paramedics found his rhythm to be VT? and he was given 11 shocks and 5mg of Adrenaline in total.
On arrival he has an undetectable BP. He is maxed out on an adrenaline infusion.
He has an LMA and has spontaneous assisted respirations
The ECG is shown below. What do you think are the important changes
Picture
What would you treat this patient with, acutely? He is maxed out on an adrenaline infusion.
(a)Adrenaline
(b)
Calcium Gluconate
(c)Amiodarone
(d)Potassium
(e)Atropine

ANSWER
The answer is d. This is the ECG of hypokalaemia.
Notice the PR prolongation, ST depression and U waves.
See the ECG changes below.
.
.
.
.
​.
Picture

What are the causes of this condition?
What is the treatment?
Was it really VT or something else?
​What is the issue with Adrenaline in this case?
Cardiac Bootcamp Members go to the Hypokalaemia section for answers and for another case.
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    Author

    Dr Peter Kas
    ​Emergency Physician

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