Successful resuscitation using external cardiac pacing in beta adrenergic antagonist-induced bradyasystolic arrest
Annals of Emergency MedicinePublished 1 July 1988
Carolyn J Kenyon, Glenn Aldinger, Premal Joshipura, Gary J Zaid
Citations32
SJR quartileQ1
SJR score0.84
SNIP1.55
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TL;DR
A case of attempted suicide by propranolol overdose presenting as convulsions followed by bradyasystolic cardiopulmonary arrest successfully managed by external transcutaneous pacing is presented, the first report of successful trans cutaneous pacing for beta adrenergic antagonist poisoning.
Abstract
We present a case of attempted suicide by propranolol overdose presenting as convulsions followed by bradyasystolic cardiopulmonary arrest successfully managed by external transcutaneous pacing. Inotropic support and the resulting clinical improvement permitted discontinuation of cardiac pacing after 75 minutes. Pharmacologic management included glucagon late in the patient's management when the persistent hypotension was established to be due to beta adrenergic blockade. A serum propranolol level of 2,331 ng/mL verified the overdose. This is the first report of successful transcutaneous pacing for beta adrenergic antagonist poisoning.
Keywords
Medicine
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In sympathectomised hands, which are typically warm, dry, and swollen, the tissue turgor is too great to allow the swelling of the epidermis to lead to wrinkling.
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A 14‐year‐old boy who ingested 8000 mg of propranolol developed sudden onset of arrhythmias, cardiac failure and convulsions, and responded to ventilator support, transvenous pacing, and massive dosage of isoprenaline.
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I have not come across this practice before in patients with such minor psychiatric histories as these two had and it would be useful to know which prognostic criteria are being used by the insurance companies in the assessment of psychiatric illness.