• Emerg Med J · Mar 2006

    Case Reports

    Lower limb amputation with CPR in progress: recovery following prolonged cardiac arrest.

    • R Wise, I Higginson, J Benger, and N Rawlinson.
    • Emergency Department, United Bristol Healthcare Trust, Bristol, UK.
    • Emerg Med J. 2006 Mar 1;23(3):e20.

    AbstractIntravenous drug users (IVDUs) often present to the emergency services with the medical complications of drug use. We report a case in which an acutely ischaemic lower limb of one such patient was thought to be the cause of cardiac arrest occurring during treatment in the emergency department (ED). Amputation of the limb was performed with cardiopulmonary resuscitation (CPR) in progress, spontaneous cardiac output was restored, and the patient made an excellent neurological recovery despite a total arrest time of 85 minutes. Possible causes of cardiac arrest, in relation to the release of potassium and metabolic toxins are discussed, as well as the decision making processes of the involved clinicians and other possible management strategies.

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