• Der Anaesthesist · Apr 2019

    Case Reports

    Cardiopulmonary resuscitation: when guidelines provide no answers.

    • M-M Ventzke and G I Kemming.
    • Klinik für Anästhesiologie, Intensivmedizin, Notfallmedizin und Schmerztherapie, Sektion Notfallmedizin, Bundeswehrkrankenhaus Ulm, Oberer Eselsberg 40, 89070, Ulm (Donau), Germany. marcmichaelventzke@bundeswehr.org.
    • Anaesthesist. 2019 Apr 1; 68 (4): 239-244.

    AbstractOut of hospital cardiac arrest (OHCA) is encountered on a regular basis in prehospital care. Specific guidelines exist for cardiopulmonary resuscitation. Guidelines cover most related situations but cannot cover all of them. This article reports on a 71-year-old man who suffered an OHCA. Persisting gasping and recurrent ventricular fibrillation made the prehospital management difficult and imposed challenges on the whole team. The guidelines provided no answers to this specific situation. Wittingly, the emergency physician decided to abandon the standard approach. Based on this case, this article discusses the pathophysiological considerations and an approach deviating from the standard approach, which could have led to a positive patient outcome without casting doubt on the current resuscitation guidelines.

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