Table of Contents Author Guidelines Submit a Manuscript
Case Reports in Emergency Medicine
Volume 2017, Article ID 4071531, 3 pages
https://doi.org/10.1155/2017/4071531
Case Report

Unilateral Dilated Pupil and Spontaneous Cardiac Arrest with Successful Bystander Resuscitation

1Midlands Air Ambulance, Hawthorn House, Dudley Rd, Stourbridge DY9 8BQ, UK
2NIHR Surgical Reconstruction and Microbiology Research Centre, Queen Elizabeth Hospital, Birmingham B15 2TH, UK

Correspondence should be addressed to David N. Naumann; ten.shn@nnamuan.divad

Received 3 April 2017; Accepted 3 May 2017; Published 17 May 2017

Academic Editor: Ching H. Loh

Copyright © 2017 James M. Hancox et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A 75-year-old man collapsed on a golf course and received cardiopulmonary resuscitation from a bystander, including the use of a public automated external defibrillator (AED). The AED was discharged once, with return of spontaneous circulation. An air ambulance crew found the patient haemodynamically stable, with no acute abnormalities on a 12-lead ECG. He had reduced consciousness and a dilated left pupil. On contacting the patient’s wife by telephone, she said that he had fallen and hit his head earlier that day. The crew decided to convey the patient to a Major Trauma Centre that had both neurosurgical and cardiology specialist services (rather than the nearest hospital) so that both traumatic brain injury and cardiac pathologies could be addressed if required. A head CT was normal, but coronary angiography demonstrated occlusion of two coronary arteries. These were successfully treated with stenting, and the patient went home two weeks later. He informed medical staff that his left pupil has been permanently dilated since he was a boy following a traumatic ocular injury. This case illustrates the utility of early deployment of an AED as well as the importance of an accurate history and emergency decision-making by prehospital personnel.