Table 1 Scenario: Acute pulmonary embolism with rapid deterioration and consecutive cardiac arrest

Background

Patient on ward, 3 days after liver-surgery, ASA 2, was moved from intensive care unit to ward yesterday. When the physiotherapist was trying to mobilize the patient for the first time, the patient collapsed and breathing started to get worse. At first, the patient was still responding and moaning about having difficulties to breath. Insufflation of oxygen over a mask was started and an emergency call was made.

Emergency call

“This is ward XY calling. Please come quickly. One of our patients is not breathing properly.”

Situation

On arrival of the emergency team the patient was lying in his bed, breathing fast and noisily, unresponsive, with arterial hypotension and tachycardia and arrhythmia. After handover to the emergency team the patient deteriorated rapidly. Breathing ceases and the heart rhythm quickly changed to pulseless ventricular tachycardia and further to ventricular fibrillation requiring cardiopulmonary resuscitation.

Cause for cardiac arrest

Acute pulmonary embolism