Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 2020. Autoresuscitation (Lazarus phenomenon) after termination of cardiopulmonary resuscitation – a scoping review. Gordon L, Pasquier M, Brugger H and Paal P. Journal of the Royal Society of Medicine, 2007. woman found alive by funeral home staff after FD medics declared her dead Referencesġ. Once CPR has stopped, monitor the patient for 10 minutes to confirm they haven’t auto resuscitated after you have declared them deceased.Remember the reversible causes of cardiac arrest and ensure that you are treating for them.Ensure that you are ventilating appropriately, not hyperventilating your patient.Here are three ways EMS providers can ensure they are not surprised by the Lazarus syndrome: Therefore, many recommend monitoring a patient for 10 minutes after CPR is stopped to ensure that they are truly deceased. The Lazarus syndrome usually occurs within 10 minutes of CPR cessation. For EMS, it is usually defined as the cessation of respiration and circulation. Transient asystole can happen after defibrillation, which is why it’s important to continue resuscitation after defibrillation.Īs weird as it sounds, death is often defined differently in the medical field. Myocardial dysfunction following myocardial ischemia can last several hours before normal heart function returns. Inadequately treated reversible causes of cardiac arrest such as acidosis or hyperkalemia could resolve, leading to restored circulation. Syndromes: Rapid Recognition and Perioperative Implications Bissonnette B, Luginbuehl I, Marciniak B, Dalens BJ. The plaque in the coronary artery may dislodge spontaneously after CPR is stopped, leading to restored circulation. Additionally, there could be a delay in drug effect in a severely acidotic patient.
Once PPV is stopped, intrathoracic pressure decreases, which could allow the drugs to reach the heart. Drugs injected through a peripheral line may not be able to reach the heart because of high intrathoracic pressure that occurs with positive pressure ventilation. Once ventilation is stopped, venous return may be restored, leading to spontaneous circulation. This is believed to be more common in those with pre-existing airway disease. Rapid ventilation rates lead to lung hyperinflation and air trapping, which decreases venous return.
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