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Out of curiosity any reported elbows or trauma to the chest in the moments
prior to the collapse?

Musab Al-Yahia,  MD
Panama City, Florida
On Feb 26, 2015 10:24 AM, "Baxter, Amy" <[log in to unmask]> wrote:

> I had a similar case about two years ago.  Tall thin 14 year old playing
> basketball all day, collapsed with frothy pink material in the mouth.
> Asystole, compressions in the field, EF 15% when we got him back briefly a
> few times.  Amiodarone, multiple rounds epi, etc. etc. then completely no
> electrical activity. pH was 6.4 when we got him, sats came up to 90 with
> good CPR. I brought parents in to watch us as we withdrew support, and the
> mom exhorted her little athlete to fight, fight, "OPEN YOUR EYES!" she
> screamed.... and he did.  Still had no electrical activity, we shocked him
> once more for good measure with no response, kept going another 5 minutes
> or so then I stopped the code.
>
> Autopsy only showed pulmonary edema.  I suspect WPW, and subsequently read
> that isoproteronol is the drug to given in that situation, not amiodarone.
>
> I've heard one similar story vis a vis the eyes opening with compressions
> in progress, ultimately leading to withdrawal also.  Creepy.
>
> -Amy
>
> On Thu, Feb 26, 2015 at 8:54 AM, Marty Herman <[log in to unmask]>
> wrote:
>
> > Dying myocytes contract?
> > Heard of bodies in a morgue seem to sit up.
> > Perhaps the exercise left the muscles in an excitable state and with lack
> > of blood flow etc they contracted.
> > No evidence just a guess
> >
> >
> > Marty, (Dad, Bro etc.)
> > Martin Herman , M.D.
> > Sent from my iPhone
> >
> >
> > > On Feb 26, 2015, at 5:58 AM, kplatt6 <[log in to unmask]> wrote:
> > >
> > > I had a very similar case, maybe 12 years or so ago.  Very memorable.
> > Also a teenage boy, sudden collapse while cheering his sports team (post
> > showed myocarditis, presumed viral. He had not complained of anything, so
> > it was unrecognized). I don't recall the details of the EMS actions and
> our
> > code, but just as you described, we had just pronounced him when he
> took a
> > breath and moved.
> > >
> > > The family was in the room, and for their peace of mind, I restarted
> the
> > code and ran it for another 10 minutes or so. My case did not have a
> second
> > such event, though. There was never any ROSC or cardiac electrical
> activity
> > (at any point during the code including after the breath and movement).
> We
> > re-pronounced him (there's an unusual phrase for you!).
> > >
> > > As to explanations, I haven't a clue. Damndest thing.
> > >
> > > Ken Platt
> > >
> > >
> > >> On 2/25/2015 7:05 PM, Niel Miele wrote:
> > >> Group:
> > >>      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?
> > >>  Niel
> > >>
> > >>
> > >> For more information, send mail to [log in to unmask] with
> > the message: info PED-EM-L
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> > >>
> > >
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> >
> > For more information, send mail to [log in to unmask] with the
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> >
>
>
>
> --
> Amy Baxter MD FAAP FACEP
> Director of Emergency Research, Scottish Rite
> Children's Healthcare of Atlanta
>
> For more information, send mail to [log in to unmask] with the
> message: info PED-EM-L
> The URL for the PED-EM-L Web Page is:
>                  http://listserv.brown.edu/ped-em-l.html
>

For more information, send mail to [log in to unmask] with the message: info PED-EM-L
The URL for the PED-EM-L Web Page is:
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