ALS-2 Cardiac Arrest — ROSC Achieved, Intubated, Defibrillated ×2

Clinical Narrative

Unit dispatched emergent to a 58-year-old male found unresponsive and pulseless by family members. Bystander CPR was in progress on EMS arrival. Patient was placed in full cardiac arrest protocol. CPR was continued with mechanical compressions. Advanced airway management was performed with successful King LTS-D airway insertion with confirmation via waveform capnography at ETCO2 of 38 mmHg. IV access was established bilateral antecubital with 16-gauge catheters. Epinephrine 1 mg IV was administered three times per ACLS protocol at appropriate intervals. Amiodarone 300 mg IV was administered following the second defibrillation. Cardiac rhythm identified as ventricular fibrillation; defibrillation was performed twice at 200 joules each. Return of spontaneous circulation was achieved approximately 22 minutes into resuscitation. Post-ROSC systolic blood pressure 74/42. Patient was manually ventilated via BVM attached to King airway throughout transport. Transported emergently to St. Catherine Cardiac Center with full resuscitation report provided en route.

Vitals

Procedures

• CPR — mechanical and manual compressions
• King LTS-D advanced airway insertion with waveform capnography confirmation
• IV access bilateral antecubital (16g)
• Defibrillation ×2 at 200J
• Manual ventilation via BVM
• Post-ROSC monitoring

Medications

• Epinephrine — 1 mg ×3 IV
• Amiodarone — 300 mg IV

Crew & Logistics

Crew

2 personnel, Paramedic

Loaded miles

12

Origin → Dest

S → H

Disposition

transported