I have responded to a cardiac arrest call in a DGH. On arrival I found 65 year old male with GCS of 3/15, maintaining his airway, spontaneously breathing and pulse present. He has had a background of grade IV glioblastoma diagnosed 2 months prior this incident, diagnosis was followed by tumour debulking surgery and radiotherapy. He has been gradually deterioration over past 24 hours with fluctuating GCS. During resuscitation prior the cardiac arrest call he was given by accident a 500ml bag of 0.2% Lidocaine in 5% Glucose instead of Gelofusine to treat his hypotension. This error has been noticed after the whole amount of 500mls was given. We have consulted the Toxbase centre as the clinical picture wasn’t quite clear. The recommendation was to give the Intralipid bolus followed by the infusion. I have given the bolus and infusion according to AAGBI guidelines. Patient consciousness level has slightly improved even before the bolus was started but his GCS after the infusion was 11/15. It is very difficult to judge whether this improvement was due to the Intralipid given his background history.
This case is currently undergoing further investigations on a local level.
He has had a background of grade IV glioblastoma diagnosed 2 months prior this incident, diagnosis was followed by tumour debulking surgery and radiotherapy. He has been gradually deterioration over past 24 hours with fluctuating GCS.
During resuscitation prior the cardiac arrest call he was given by accident a 500ml bag of 0.2% Lidocaine in 5% Glucose instead of Gelofusine to treat his hypotension. This error has been noticed after the whole amount of 500mls was given.
We have consulted the Toxbase centre as the clinical picture wasn’t quite clear. The recommendation was to give the Intralipid bolus followed by the infusion. I have given the bolus and infusion according to AAGBI guidelines. Patient consciousness level has slightly improved even before the bolus was started but his GCS after the infusion was 11/15. It is very difficult to judge whether this improvement was due to the Intralipid given his background history.
This case is currently undergoing further investigations on a local level.