Your opinions on a strange development in a case would be welcome:
Teenage boy, previously healthy, sickle cell trait, playing basketball collapses
Found to be pulseless.
Police on scene apply AED and patient is shocked and remains pulseless
(I do not know if AED found shockable rhythm)
EMS arrives documents asystole, secures airway, I/O started, CPR is given, 6 rounds of Epi en route, Amiodarone
Arrives at hospital approx. 30 minutes of down-time.
Compressions held to check for rhythm--asystole, ultrasound of heart shows no activity:
Patient postures (arms extend and turn inward) and takes a breath (inhale/exhale...not stacked breath release)
CPR and medications continue. Again, stop to check rhythm:
Patient postures and takes breath
Pupils sluggishly reactive
Continues for a total of 30 more minutes, and is ultimately pronounced.
Autopsy not yet available.
Do you think that it is possible with effective CPR to have a somewhat functioning brainstem/respiratory drive? Is this some sort of reflex? Any other explanation?
Also, with no electrical cardiac activity for a prolonged time, would you continue once you saw these movements?
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