Horne Isabel, Gleeson-Hammerton Thomas, Plumb James, Pike John
Isle of Wight NHS Trust Ambulance Service, Ambulance Station, St Mary's Hospital, Parkhurst Road, Newport, Isle of Wight PO30 5TG, United Kingdom.
University of South Australia, Uni SA Clinical and Health Sciences, Rosemary Bryant AO Research Centre, Adelaide, SA, Australia.
Resusc Plus. 2025 Aug 14;26:101063. doi: 10.1016/j.resplu.2025.101063. eCollection 2025 Nov.
Cardiac arrest secondary to persistent ventricular fibrillation or ventricular tachycardia (pVF/VT) is challenging to manage, particularly in the prehospital setting. This report, prepared in keeping with CARE guidelines, discusses a 70-year-old male who survived to discharge with pre-morbid neurological function after a prolonged cardiac arrest with pVF. Clinical interventions included mechanical CPR, vector change defibrillation, de-emphasised adrenaline and intravenous esmolol. We believe this may be the first reported case of a paramedic-led team providing this care bundle in the UK outside of a research setting. In this case a refractory pVF/VT bundle appeared to be associated with terminating pVF. This report may be of use to other pre-hospital services considering introducing specialised care bundles for this case type, as well as adding to the body of evidence for the complex pharmacological relationship between adrenergic agonists, antagonists and persistent shockable rhythms.
继发于持续性室颤或室性心动过速（pVF/VT）的心脏骤停难以处理，尤其是在院前环境中。本报告按照CARE指南编写，讨论了一名70岁男性，他在长时间心脏骤停伴pVF后存活出院，且病前神经功能正常。临床干预措施包括机械心肺复苏、向量改变除颤、减少肾上腺素使用以及静脉注射艾司洛尔。我们认为这可能是英国首例在非研究环境下由护理人员主导的团队提供此护理方案的报告病例。在该病例中，难治性pVF/VT方案似乎与终止pVF有关。本报告可能对其他考虑为这类病例引入专门护理方案的院前服务机构有用，同时也为肾上腺素能激动剂、拮抗剂与持续性可电击心律之间复杂的药理关系增添了证据。
