MR. S, 57, EXPERIENCED a foreign body
airway obstruction and subsequent car-
diac arrest while eating lunch at work.
His coworkers called 911 and began
CPR; an automated external defibrilla-
tor (AED) wasn’t available. Paramedics
responded to the scene, found Mr. S in
pulseless ventricular tachycardia (VT),
symptoms within 1 hour of arrest.
Fewer than 25% of EMS-treated
out-of-hospital cardiac arrest vic-
tims have an initial rhythm of
ventricular fibrillation (VF) or
VT or have a shockable rhythm
analyzed by an AED.2
30 l Nursing2013 l January
performed rapid defibrillation, ensured
continued high-quality CPR, established
peripheral venous access, administered
I.V. epinephrine, and intubated him.
Return of spontaneous circulation
(ROSC) occurred after an estimated
code time of 16 minutes. He arrived at
the ED unresponsive in sinus bradycar-
dia. His medical history includes hyper-
tension and type 2 diabetes.
Mr. S may be a candidate for
therapeutic hypothermia. Prompt
intervention could help to reduce
the potential for further neurologic
decline. Understanding the link
between the pathophysiology of
cardiac arrest and the physiology
underlying therapeutic hypothermia
can facilitate the nursing manage-
ment of this challenging patient.
Each year, nearly 383,000 out-
of-hospital sudden cardiac arrests
occur, and 88% of these occur at
home.1 Only about 33% of those
who experience an emergency
medical services (EMS)-treated
out-of-hospital cardiac arrest report