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Case #68 "The Sleeping Baby Doll
Angel"
by Charlene Babcock Irvin, MD, FACEP
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A two month old infant is brought in by
EMS in full cardiac arrest. The initial
rhythm they found was asystole (flat line).
According to EMS, the baby was a premature
infant, born at 25 weeks, and was recently
discharged with a monitor. Paramedics
arrived to find the baby on the bed, without
a pulse, and no bystander CPR. Mom (16 y/o)
was hysterical and could not provide any
additional information, except the baby was
fine two hours ago when she put her to sleep
after feeding.
Primary survey reveals an uncuffed
endotracheal tube orally placed, with equal
breath sounds. Initial rhythm in the ED is
also asystole. There is no IV access. As CPR
is continued, an IO is quickly obtained (no
obvious other IV access).
1. Should you give high dose epinephrine?
2. Should you give atropine?
3. Is 2 thumb-encircling hands versus 2
finger chest compressions better in infants?
4. When can you consider using a cuffed ET
tube?
5. Are lay people doing CPR in the field
supposed to check for a pulse?
Click here for answers and to respond
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Previous Articles
Cardiology (02/08/09)
Trauma (02/08/09)
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Pediatric and Trauma (01/25/09)
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