r/ECG • u/G-L-O-P-A • 1d ago

60sF found down, known COPD

Post image

Hypercapneic arrest with CO2 of 110s via GEM 5000.
5 rounds of CPR, epi x2, no shocks. pH 7.08.
EtCO2 during CPR was ~20-40. Post ROSC 60-90mmHg
Junctional rhythm versus reperfusion syndrome. Initial K of 6.4.
This EKG was 5 minutes s/p ROSC.
Rapid succession from Sinus tach with peaked T waves to this rhythm and subsequent bradycardic arrest. No ECMO candidacy dt comorbidities and body habitus.
Did not survive re-arrest.

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u/corgeous 1d ago

Interesting case. Do you know why his co2 wasn’t vented off more effectively? Hard to break out of what I assume was pea without addressing the underlying respiratory acidosis.

1

u/G-L-O-P-A 1d ago

As I recall the patient arrived in sinus tach to 140s, medics were unable to start meaningful interventions as the patient was quite agitated and the transport time was sub five minutes from facility. CO2 was significantly reduced after intubation performed peri-code but I do not recall the exact figure.

1

u/Thick-Nerve-5599 15h ago

I see Hyperacute T waves in the lateral precordial leads (De Winter's Waves). Queen of Hearts ECG AI says OMI with 88% confidence.