I’m afraid this is a bit of a less cheery post than usual and it goes against the FOAMed grain of resuscitating everything regardless of likely outcome. But hey, my post on breaking bad news seems to have become a late hit so perhaps cheery is not in this season.
So, it is late February, the temperature outside is 39 degrees Celsius, (for our northern colleagues, that is summertime down here and hot) and your ED is full of bruised cricketers, boozy barbequers, overheated grandmothers and sunburnt teenagers when the ambulance deliver you an 18 month old baby girl in cardiac arrest. She was not seen by anyone for perhaps an hour until a family member spotted her in the family swimming pool.
On arrival in ED the patient is in PEA arrest with no spontaneous respiratory activity and an initial temperature of 25.7 degrees.
Because of the tender age of the victim you continue to cycle through your arrest protocol for 60 minutes at the end of which the child is asystolic.
You are about to call it a day when someone pipes up with the old chestnut “you’re not dead until you’re warm and dead”.