Work

Utilising a refractory ventricular fibrillation bundle to improve outcome in out of hospital cardiac arrest: A case report

Year: 2025

Type: article

Abstract: Cardiac arrest secondary to persistent ventricular fibrillation or ventricular tachycardia (pVF/VT) is challenging to manage, particularly in the prehospital setting. This report, prepared in keeping with CARE guidelines, discusses a 70-year-old male who survived to discharge with pre-morbid neurological function after a prolonged cardiac arrest with pVF. Clinical interventions included mechanical CPR, vector change defibrillation, de-emphasised adrenaline and intravenous esmolol. We believe this may be the first reported case of a paramedic-led team providing this care bundle in the UK outside of a research setting. In this case a refractory pVF/VT bundle appeared to be associated with terminating pVF. This report may be of use to other pre-hospital services considering introducing specialised care bundles for this case type, as well as adding to the body of evidence for the complex pharmacological relationship between adrenergic agonists, antagonists and persistent shockable rhythms.

Source: Resuscitation Plus

DOI: 10.1016/j.resplu.2025.101063

Authors: Isabel Horne, Thomas Gleeson-Hammerton, James Plumb, John Pike

Institutions: Isle of Wight NHS Trust, St Mary's Hospital, University of South Australia, University of Southampton

Language: English

Topic: Cardiac Arrest and Resuscitation

Subfield: Emergency Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,450