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Myocardial stunning

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Immediately following a DC shock, the rhythm may change to asystole or PEA.

This rhythm lasts for more than one sweep of the monitor and is not associated with cardiac output.

The myocardium may be temporarily stunned and given time will generate cardiac output.

This is called myocardial stunning.

Basic life support should be performed for one minute. All drugs should be withheld as should intubation. Otherwise, arrhythmias may be precipitated..

If after this one minute:

  • the rhythm is still non-VF/VT:
    • CPR is continued for two minutes
    • 1mg adrenaline is given
    • 3mg atropine is given if the rhythm is PEA with a rate less than 60, or is asystole, and atropine has not been given already
    • the non-VF/VT protocol is entered
  • the rhythm is VF/VT then the original VF/VT protocol is rejoined

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