“Give me the Class IIa drug!”
A middle age lady was found collapsed in the toilet. She has no significant past medical history. Her family did not notice anything unusual preceding the collapse. Upon arrival at the A&E, the 1st first Pulse-Rhythm-Echo check revealed pseudo-PEA:
While CPR is ongoing, the Emergency Physician screened for reversible causes of cardiac arrest using the mnemonic D HI MAP protocol (a slight variation of the Original RUSH protocol (click to view) and found this in the left common femoral vein. No other abnormality was found clinically or sonographically:
There was no physical sign of DVT. Her legs were symmetrical in terms of size, shape and warmth. What drug should the Emergency Physician give now?
IV Adrenaline 1mg
IV Alteplase 50mg
IV Amiodarone 300mg
IV Atropine 2.4mg