MedBugs: SAQ #511

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Case: Cardiac arrest on a beach

You are working at a regional hospital in a coastal city in northern Australia. You are pre-alerted that the ambulance is 5 minutes away with an 11-year-old, 30kg boy who has suffered a cardiac arrest on a nearby beach and is coming with CPR in progress.

1. Outline (4) key team members and (4) drugs/pieces of equipment you need in preparing for his arrival. 8 marks

Paramedics report he was heard to scream and lost consciousness on entering the water. His head went below the surface briefly and he was dragged out by his parents. Immediate CPR was commenced by lifeguards and continued by paramedics a few minutes later. CPR continued en route with a non-shockable rhythm. One dose of adrenaline has been given. On handover, your team continues CPR and you notice the below appearance of his legs .

2. Describe the findings. 1 mark

3. What is the most likely diagnosis AND pathophysiology of the arrest? 2 marks

4. What is the critical management priority and how is this done? 2 marks

5. Give (5) subsequent management considerations. 5 marks

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