07-10-2008, 11:25 PM
A 58-year-old man had a cardiac arrest at home. His daughter, who was a nurse, administered cardiopulmonary resuscitation until the paramedics arrived. The paramedics documented ventricular fibrillation and were able to resuscitate the patient.
Physical examination in the emergency room shows a blood pressure of 120/80 mm Hg and a heart rate of 88/min. His electrocardiogram does not show ST elevation in any lead. Despite his normal vital signs, he remains in a coma an hour after he has been stabilized. He does not respond to verbal commands or painful stimuli and shows no movements.
What is the most appropriate next step to improve this patient's chance of surviving the hospitalization?
A Cardiac catheterization and revascularization
B Induction of mild hypothermia
C Intra-aortic balloon counterpulsation
D Dobutamine to enhance cardiac contractility
E Placement of an implantable cardioverter-defibrillator
Physical examination in the emergency room shows a blood pressure of 120/80 mm Hg and a heart rate of 88/min. His electrocardiogram does not show ST elevation in any lead. Despite his normal vital signs, he remains in a coma an hour after he has been stabilized. He does not respond to verbal commands or painful stimuli and shows no movements.
What is the most appropriate next step to improve this patient's chance of surviving the hospitalization?
A Cardiac catheterization and revascularization
B Induction of mild hypothermia
C Intra-aortic balloon counterpulsation
D Dobutamine to enhance cardiac contractility
E Placement of an implantable cardioverter-defibrillator