Pulseless Electrical Activity

“…the surgeon requested that the head of the bed be raised another 20° for improved access. Sometime later, the end-tidal CO₂ was noted to drop suddenly from 30 to 26 mmHg…”

Case Context   Provider Narrative   Lessons Learned

Case Context

Patient: elderly female
Presenting diagnosis: bilateral subdural hematomas s/p ground level fall
Planned procedure: craniotomy, evacuation of hematoma, burr holes
Past medical history: mild hypertension, well-controlled with hydrochlorothiazide
Anesthetic plan: general endotracheal anesthesia, preoperative placement of arterial line and left internal jugular triple lumen catheter