The case

A 54-year-old man assessed at the hospital after cardiac arrest associated with ventricular fibrillation.

Until mid-day on the day of admission, the patient had been in usual condition of health. HE gasped suddenly at a fast-food restaurant, with full-body shaking and loss of consciousness.

The shaking movements ceased rapidly, but he remained unresponsive.

He was given cardiopulmonary resuscitation (CPR) within 4 minutes. His heart rhythm was detected as ventricular fibrillation. He was given IV naloxone, amiodarone and a bolus of epinephrine, followed by a continuous infusion.

Pulselessness recurred, and he had to be given CPR again.

The patient arrived at this hospital 30 minutes after the initial arrest. The patient was an unresponsive, middle-aged man who had undergone mechanical CPR and had no external signs of trauma. Empirical IV calcium chloride, dextrose and insulin, and sodium bicarbonate were administered. Also, vasopressin, norepinephrine, rocuronium and ketamine were administered intravenously, and aspirin was administered rectally. Emergency intubation of the trachea was performed, and an orogastric tube, a femoral arterial catheter and a femoral central venous catheter were placed.

Questions:

1. What do you suspect happened to him?
2. Do you suspect any potassium involvement here?

Read the complete case report here

Source

Edelman ER, et al. Case 30-2020: A 54-year-old man with sudden cardiac arrest. N EnglJMed. 2020;383(13):1263-75.