Miracle or to be Expected? ROSC after 45 minutes is a post from: Everyday EMS Tips Everyday EMS Tips reader Marty from Connecticut sent me this article about a Brooklyn NY man who arrested at the hospital and was successfully resuscitated and discharged neurologically intact. The patient and his doctor’s call this a miracle. Certainly it is a noteworthy event because of the time length and interventions involve but I wonder if we should expect a positive outcome. As you read the article keep in mind these important factors: the patient arrested in the emergency department surrounded by action oriented professionals it was a witnessed arrest shocks were delivered quickly the rhythm is not explicitly stated but since eight shocks were delivered I am assuming persistent V-Fib “staffers” gave him chest compressions. Likely following AHA guidelines to rotate in a new staffer every two minutes or less the patient was given a clot busting drug, type not listed. Compressions must have been effective enough to circulate the drug as soon as ROSC was achieved induced hypothermia began immediately the patient was transferred to a cath lab in the same hospital. Door to balloon time of zero Should we expect patient’s that have cardiac arrest witnessed by BLS and ALS professionals should survive? I think we should especially when the presenting rhythm is v-fib. The theoretical survival threshold of witnessed v-fib could be as high as 60-70% ( EMSEduCast episode 27 ). Read related posts and tips: Team Approach to Cardiac Arrest Patients Inducing Hypothermia for ROSC Patients (#31daysofCE) Video About Medic One History

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