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shaldna
11-07-2011, 02:55 PM
I have a patient in a coma without any major complications. I need her to go into a cardiac arrest, but what could trigger that? A new medication or something would be ideal, but I'm open to anything that would cause her to need to be resusitated.

thothguard51
11-07-2011, 04:45 PM
No one knows what, if anything, goes on in the minds of someone in a coma.

Perhaps someone comes into the room and starts talking. Someone the person fears. This triggers an increased activity in the brains electrical system which triggers a cardiac arrest.

Sometimes, there is just no known reason, (at the time). It does not always have to be a drug or medication, which is the easy way out...for a writer, IMHO.

areteus
11-07-2011, 06:07 PM
An inept doctor giving the wrong dose of something could do it - anything which increases heart rate (or otherwise increases blood pressure) in a patient who is already at risk of heart attack will do the job. Perhaps the patient notes got mixed up (I've seen how some hospitals transport patient records around... a trolley full of overfull cardboard files randomly stuffed into it... it is easy for this to happen in that situation...) and the junior doctor on duty is too overworked and lacking in sleep to realise the mistake and gives the wrong medication? There are also situations where unknown reactions to drugs can cause heart problems. A drug which is ok for 90% of the population might give the remaining 10% a bit of a bad headache and 1% severe high blood pressure and in some cases that may be enough to kill. If the patient has not had the drug before no one will know which category they fall in and it may be considered an acceptable risk (especially if the patient is monitored so they can be resucitated from any severe side effects). Medical science actually knows very little about many drug effects, partly because drug companies keep a lot of data under wraps to prevent patent steals and partly because the minimum required testing for drug use is nowhere near enough to work out all the possible effects. This is why you have schemes like the one we have in the UK (the Yellowcard scheme) where patients can write down any symptoms they have which are not listed in the documentation on a yellowcard form and send it to the NHS who evaluate the claims and update their information on the drug if necessary.

MTaillard
11-14-2011, 09:14 PM
Even a small overdose of general anesthetic will put a person into analphylactic shock which can cause cardiac arrest (hence the reason why anesthesiologists get paid so damn much).

A large air bubble in the arteries, called an air embolism, can get lodged in the heart's ventricle causing heart attack that will be otherwise completely non-symptomatic in a coma patient.

Heart attack is the ultimate cause of death from cocaine overdose.

waylander
11-14-2011, 10:23 PM
Overdose of a Potassium salt giving hyperkalemia
http://www.nlm.nih.gov/medlineplus/ency/article/001179.htm

cbenoi1
11-14-2011, 11:53 PM
> I have a patient in a coma without any major complications.

Coma (unless induced medically) is a symptom of something major such as a head trauma. One doesn't just 'fall into a coma' without consequences or cause. So there is no such thing as "coma without major complications".


> I need her to go into a cardiac arrest, but what could trigger that?

Depending on what caused the coma, there could be a few things that could go wrong. If you are looking for a helping hand, then anything goes. Potassium chloride (as noted above) is a good way to stop the heart cold in a way that it can be restarted - open heart surgeries often require the hart be stopped.

-cb

nikkidj
11-15-2011, 02:37 AM
An overdose of any cardiac medication could cause cardiac arrest. Digoxin, Epinephrine, Norepinephrine, Dopamine, Dobutamine. Any of those, given at a large enough dose "fast push" could do it.

The above mentioned air embolism and potassium chloride are also good choices.

Any electrolyte abnormality could cause it. Specifically, hyper- or hypokalemia (high or low potassium), hypoglycemia (low sugar, could be caused by an overdose of insulin), hypomagnesemia (low magnesium can cause arrhythmias), hyper- or hypocalcemia (calcium abnormalities).

If the person is in a coma because of head trauma, brain herniation from swelling could cause sudden cardiac arrest.

Fluid around the heart (pericardial tamponade) could cause it. Things that cause PT are cancer, kidney failure, and trauma.

HTH