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-h 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.
This case series details two cases from an urban emergency department in a large metropolitan city, when 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 emergency department and was found to be in refractory pulseless ventricular tachycardia, and 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.
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Published online: March 13, 2023
Accepted: March 7, 2023
Received in revised form: January 29, 2023
Received: December 7, 2022
Publication stageIn Press Uncorrected Proof
RECEIVED: 7 December 2022; FINAL SUBMISSION RECEIVED: 29 January 2023; ACCEPTED: 7 March 2023
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