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Table 2 Scenario: Acute cardiac arrest resulting from hyperkalemia

From: Real-time tablet-based resuscitation documentation by the team leader: evaluating documentation quality and clinical performance

Background

Patient on ward, 1 day after surgical debridement of chronic wound, ASA 3, nephropathy requiring renal dialysis. Dialysis was paused yesterday because scheduling for surgery. Patient was found unresponsive, not breathing by ward staff. Emergency trolley was obtained and emergency call was made.

Emergency call

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

Situation

On arrival of the emergency team the patient was lying on the floor besides his bed. He was unconscious, pulseless and not breathing. Cardiopulmonary resuscitation had been started. The paddles of the ward’s automated external defibrillator were already placed on the chest, but the device was still turned off and no defibrillation has been performed so far. The patient has not been ventilated. The heart rhythm was a ventricular fibrillation.

Cause for cardiac arrest

Hyperkalemia