Abstract
Background
Refractory ventricular dysrhythmia, or electrical storm, is a cardiac condition consisting
of three or more episodes of ventricular dysrhythmia resistant to treatment within
a 24-hour period. These dysrhythmias carry high morbidity and mortality if not diagnosed
and abated promptly. When traditional resuscitative algorithms fail to return a patient
to a perfusing rhythm, providers need to consider other, more novel techniques to
terminate these dangerous dysrhythmias. One approach is the use of a stellate ganglion
block, which has been documented in the literature only a handful of times for its
resuscitative use in cardiac arrest.
Case Series
This case series details two cases from an urban emergency department (ED) in a large
metropolitan city, where the use of ultrasound-guided stellate ganglion blocks during
cardiac arrest provided successful ablation of the tachydysrhythmia. The first case
involves a patient who went into cardiac arrest while in the ED and was found to be
in refractory pulseless ventricular tachycardiawhile. The second case describes a
patient who went into a witnessed out-of-hospital cardiac arrest while with emergency
medical services.
Why Should an Emergency Physician Be Aware of This?
The stellate ganglion block is a procedure currently being used as a treatment modality
for a variety of neurologic, psychological, and cardiac conditions. This intervention
may provide a viable and lifesaving option for emergency physicians to adopt when
traditional resuscitative algorithms fail to break resistant ventricular tachydysrhythmias.
Keywords
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Article info
Publication history
Published online: March 13, 2023
Accepted:
March 7,
2023
Received in revised form:
January 29,
2023
Received:
December 7,
2022
Footnotes
RECEIVED: 7 December 2022; FINAL SUBMISSION RECEIVED: 29 January 2023; ACCEPTED: 7 March 2023
Identification
Copyright
© 2023 Elsevier Inc. All rights reserved.
