Case 2

It is 02:00. A 56-year-old man has called an ambulance because of central chest pain. He collapsed in VF soon after their arrival.

En route to hospital he has had excellent CPR, 3 mg of adrenaline, 300 mg of amiodarone and 6 shocks but is still in VF. He is intubated.

Your team take over CPR, attach a defibrillator, give adrenaline and a further DC shock and his rhythm changes to sinus rhythm, with a rate of 70.

A pulse is palpable. He is making no respiratory effort, and there are no other signs of life.

Your patient is now intubated, ventilated, and cautiously sedated. His blood pressure and heart rate seem reasonably stable after 2 x 250 ml fluid challenges with normal saline.