A 71-year-old male with significant medical history underwent a routine colonoscopy during which he suffered a cardiac event. Emergency protocols were initiated, including CPR and administration of medications like epinephrine and amiodarone, leading to stabilization. The patient was then intubated and transported to the emergency room for further care and received an AICD.

1. Mock Code
March 19 2014

2. Patient
71 year old male with history of 40 pack year smoking,
quit 10 years ago, hypertension, and known history of
benign occasional PVCs
Presents for routine screening colonoscopy

3. Course
Normal progression of case until splenic flexure. Pt
coughs and strains against colonoscope advance. 20mg
propofol IV administered

4. Course
Pt relaxes. Moments later, the pulse oximeter alarms,
as no tracing is seen. On ECG, the following is noted:

5. What do you do?

6. What do you do?
1. Send Circulator for help
2. Activate EMS
3. Code Cart / Defibrillator
4. Supine then chest compressions
5. Airway Management
6. Medications

7. V-Fib Arrest
1. CPR – 2 minute cycles 100/min
2. Shock 120-200 biphasic
3. CONTINUOUS CPR

8. V-Fib Arrest
1. CPR
2. Shock
3. Epinephrine Q3-5min
4. Amiodarone – 300mg, then
150mg

9. V-Fib Arrest

10. Case
After 3 shocks and 2 rounds of
epinephrine, a dose of Amiodarone
300mg is administered & a 4th
shock is given.

11. Course
On ECG, the following is noted:

12. Course
The intubated patient is
transported to the ER. He is
admitted and furnished with an
AICD