Robert Johnson is a 60-year-old man who is experiencing severe pain and numbness in his left leg. After tests and examinations, he went through spine surgery. During post-surgical procedures, the patient suddenly lost consciousness after complaining of chest pain. He is unresponsive to stimuli, his pulse is not palpable and after basic life support was initiated his rhythm shows to be irregular. This paper will explain his condition, as well as describe the immediate emergency treatment, tests that need to be conducted, and the plan of care for the patient after he is transferred to the ICU.
Rhythm and Assessment Findings
The rhythm of the patient can be directly connected to the assessment of MR. Johnson. Specific elements like circumoral and peripheral cyanosis, cold sweat, unresponsiveness, and lack of breathing suggest that the patient experienced cardiopulmonary arrest. The unusual rhythm of the heart suggests that the patient is likely experiencing fibrillation of the ventricles which confirms this condition. Despite the patient not experiencing any shortness of breath during the physical examination, his respiratory rate suggests that it could develop and it would also put the person at risk of cardiopulmonary arrest (“How is cardiogenic shock treated?” 2017).
Immediate Emergency Treatment
The immediate emergency treatment is focused on oxygenating the blood of the patient. His heart is not pumping blood to his organs, and his lungs are not breathing. Therefore the patient requires a ventilator to provide the missing oxygen and resume proper work of the heart. The patient also requires additional fluids to be applied through the veins. However, this should only be done when the heart resumes its operation. Thrombolytic medicine should be applied to prevent clots from developing (“Cardiogenic shock,” 2014).
Diagnostic Tests
After the patient successfully responds to the treatment and management of his rhythm two tests would need to be performed. The first is the troponin test to determine the level of damage to the muscle of the heart. Due to heart damage, large amounts of troponin often excrete into the bloodstream, and through this test, the presence of damage could be seen. The second is the ALT test, also known as the alanine aminotransferase test. Just as the troponin test is used to measure the presence of damage to the heart but unlike the specific damage that can be measured through the troponin test, it applies to more conditions but could also be important to the examination (Mangla, Daya, & Gupta, 2014).
Plan of Care
During the patient’s stay, it is important to determine the true cause of the cardiopulmonary arrest and whether it is related to the issues with cholesterol that is noted in the patient’s history. The work of his lungs and heart need to be supported during his treatment and thrombotic, pain relief, and the previously prescribed medication should be applied. Any vascular and metabolic issues should receive additional attention (Mangla et al., 2014).
Conclusion
The case of Robert Johnson is relatively common among people at risk of heart failure. His history of coronary artery disease, hypertension and hypercholesterolemia can be seen in his history suggest that they could have caused cardiopulmonary arrest after the surgery. However, if proper measures are undertaken after the emergency treatment, there is a chance of recovery in the ICU. It is possible that the heart of the patient was damaged by the arrest, but the troponin and ALT tests would need to be done to confirm it.
References
Cardiogenic shock: A serious heart attack complication. (2014). Web.
How is cardiogenic shock treated? (2017). Web.
Mangla, A., Daya, M. R., & Gupta, S. (2014). Post-resuscitation care for survivors of cardiac arrest. Indian Heart Journal, 66,105–112. Web.