Last updated on: July 13th, 2023

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You’re looking at an interactive case study from Prognosis: Your Diagnosis (one of four distinct learning formats available in Clinical Odyssey). Try it out, and have fun improving your clinical skills.



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A 35-year-old construction worker is brought in 20 minutes after he received a electrical shock from a defective power cord (110 volts / 60 Hz, alternating current). He was thrown from the ladder he was on; and was witnessed landing on his back on the concrete floor six feet below. His co-workers found him to be unconscious and not breathing. They initiated CPR and called in emergency services.

The paramedics arrived 10 minutes later and found him in cardiopulmonary arrest with a ventricular fibrillation ECG pattern. He was defibrillated via a biphasic protocol of 120J, 150J, and 200J, given as single shocks with resumption of CPR between shocks. Intravenous (IV) access was established in parallel and epinephrine administered after the first shock, and lidocaine after the second shock. He returned to sinus rhythm after the third shock. He was subsequently intubated, a cervical collar was placed, and he was immobilized on a spinal board. IV fluids were also commenced. He was then rushed to hospital.

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