# Patient awareness during CPR



## Stretcher Jockey (Jun 5, 2018)

I was reading the news when I stumbled across this gem. Apparently, a man was in the hospital when he suffered from an aortic dissection. Went into cardiac arrest, but was still somehow awake/aware during CPR. It was reported that he got multiple doses of epinephrine, so Im assuming full ACLS type care for 90 minutes before they terminated the code and the patient died. 

How is it even possible that someone would be aware during CPR? And for 90 minutes no less. I guess we cant ask the guy since he ended up passing away.....

Doctors report strange case of man who stayed awake during cardiac arrest


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## snapt (Jun 5, 2018)

That's some high quality CPR! There are anecdotes of Lucas devices keeping people perfusing and somewhat responsive during codes, not sure how much I believe that but it's out there.


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## Stretcher Jockey (Jun 5, 2018)

Thats what I thought too, but with an aortic dissection I just cant see it. BP would drop so low that theres no way you could have a decent CPP. Right?


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## snapt (Jun 5, 2018)

Aortic Aneurysm covers such a broad spectrum its near impossible to surmise all the factors that went into this. It did strike me as odd that they called the code with the guy still responsive, perhaps a small facility without surgical capabilities? 

The more time I spend in this business the less I'm surprised by the crazy things the human body can endure at times.


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## Devildoc (Jun 5, 2018)

We have seen people die from things they should have lived from. We have seen people live when they should have died. I have been in the medical field in some capacity since 1990, and I am always amazed at the things I have seen and heard.

I agree with @Paramagician , no way I can imagine a CPP high enough when your whole blood supply is laying around in the chest not going anywhere, but who knows?


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## medicchick (Jun 5, 2018)

snapt said:


> Aortic Aneurysm covers such a broad spectrum its near impossible to surmise all the factors that went into this. It did strike me as odd that they called the code with the guy still responsive, perhaps a small facility without surgical capabilities?
> 
> The more time I spend in this business the less I'm surprised by the crazy things the human body can endure at times.



I was taught if they are responsive to use altered ACLU measures (had one pt with a wonky pace maker, they were in and out).  I had an instructor who as a noob did a quick look, saw v-fib and went to shock even though the patient was fighting him.  His own hands were shaking enough to cause a false reading.


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## BigGian (Sep 11, 2018)

Im an EMT -B in the civi world, performed CPR on a Triple A patient; we had no idea. CPR is contradictory to a Triple A from what I was taught. Patient was successfully resuscitated, and survived. As a new emt at the time my mind was blown


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## Muppet (Sep 11, 2018)

Since the addition of "pit crew CPR", updated CPR standards a while back, I have seen ROSC in many folks, alot of them being either neuro intact in my care, at the ED or in ICU. I've had a few open their eyes and stare at me, while they are intubated, corresponding EtCo2 numbers improving, a couple requiring sedation post assuring that they displayed a stable pressure/rhythm. 

Add an automated CPR machine of your liking, the better the perfusion. I'm sure, brothers and sisters like @policemedic, @Devildoc and @medicchick can attest to the abhorrent CPR we all did 20 years ago, to standard at that time. It's a wonder, some family member has not sued under the basis of malpractice, for the way stuff was done back then.


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## policemedic (Sep 11, 2018)

Muppet said:


> Since the addition of "pit crew CPR", updated CPR standards a while back, I have seen ROSC in many folks, alot of them being either neuro intact in my care, at the ED or in ICU. I've had a few open their eyes and stare at me, while they are intubated, corresponding EtCo2 numbers improving, a couple requiring sedation post assuring that they displayed a stable pressure/rhythm.
> 
> Add an automated CPR machine of your liking, the better the perfusion. I'm sure, brothers and sisters like @policemedic, @Devildoc and @medicchick can attest to the abhorrent CPR we all did 20 years ago, to standard at that time. It's a wonder, some family member has not sued under the basis of malpractice, for the way stuff was done back then.



Speak for yourself. My intracardiac epi jab was always perfect—Rampart said so.


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## Muppet (Sep 11, 2018)

policemedic said:


> Speak for yourself. My intracardiac epi jab was always perfect—Rampart said so.



Well, that emergent c section I did with my Leatherman Wave in an overturned car on 95 under command line was epic. Lol


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## Stretcher Jockey (Sep 11, 2018)

One time, I correctly diagnosed sepsis.....


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## medicchick (Sep 11, 2018)

Running a code through an IO and ET tube...woohoo those were the days.

Those 20 minute transport times with no room to change out the compression person was always grand.


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