I wondered if anyone could help me understand my title. I’m a junior doctor, not yet completed a speciality (but interested in ITU maybe).
I was involved in a cardiac arrest secondary to a patient who self-tied ligature around the neck as a suicide attempt. It is unknown exactly when they tied the ligature but they had not been seen for about 30 minutes. It could be 20 minutes before they were found or even 20 seconds.
When they were discovered, they were in cardiac arrest and their face and lips were discoloured with a blue tint. We regained ROSC after 20 minutes, 1mg adrenaline and 1 shock. They made no respiratory effort.
The paramedics intubated them on the scene and transferred them to a medical hospital.
The paramedics have since said that they: 1) started breathing at 8 breaths per minute 2) moved her head and hand ‘occasionally’ 3) started tearing (i.e tears were seen coming from her eyes) 4) blood pressure increasing
They said the latter three were signs of “awareness” so they sedated her with morphine and midaz.
I’ve tried to do some research but I’m not really getting anywhere. Is it possible that in the ambulance they regained consciousness then? Is it possible to for this to happen immediately after a hypoxic brain injury? Would it be meaningful consciousness i.e would they feel pain, fear, confusion?
A CT head later showed severe hypoxic brain injury and they died 48 hours after this event.
This was quite a traumatic event and I’m trying to make sense of it the best I can.
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