CPR-Induced Consciousness – do you stay or do you go?
It’s a warm summer afternoon when the MDT notifies you of a Category 3, 88-year-old male, abdominal pain. You are 30 miles away and the MDT updates to a Category 2, chest pain. On arrival you find an elderly patient clutching his chest, as you begin your assessment he collapses, and you commence CPR, but you start to realise this is far from straightforward…
The incidence of CPR-induced consciousness (CPR-IC) is relatively uncommon. It is described as an emerging phenomenon where signs of consciousness present in the absence of ROSC. This article discusses the pathophysiology of CPR-IC and the clinical signs and symptoms that might be present. It will also help you with assessment and management of a very challenging situation where the patient can become very agitated and where difficult decisions will have to be made. Finally, the article offers guidance on how to learn from very challenging calls through well structured and careful debrief.
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