58yF w/ unknown PMHx arrives via EMS in cardiac arrest. Per EMS, patient called 911 stating that she wanted to kill herself. When they arrived they found her pulseless on the floor with a bag of medications beside her, all containing at least some pills. No drugs, liquids, alcohol or other items found strewn beside her. Medications found in her bag her bag, some in multiples, listed alphabetical order: Baclofen, Gabapentin, Hydromorphone, Hydroxyzine, Ibuprofen, Methocarbamol, Simvastatin
EMS initiated ACLS, placing an ETT and a L tibial IO, w/ 2 rounds of epinephrine and 2mg Narcan administered, with a total of 15-25 mins of prearrival CPR.
On arrival to ED in persistent PEA arrest, ACLS was continued with adjunct medications given as deemed appropriate. Approximately 5-10 minutes after arrival, after several rounds of ACLS, ROSC was achieved. Hypothermia protocol started, epinephrine drip started for persistent hypotension, and an ECG was obtained.