The Rational Clinical Examination
David L. Simel, Drummond Rennie
Christopher Booth, David L. Simel
cardiac arrest, coma, death
"A 26-year-old woman presented to the emergency department with
severe pleuritic chest pain and dyspnea. While waiting for a computed
tomographic scan in the radiology department, she had an asystolic
cardiac arrest. The resuscitation lasted 20 minutes, after which
she had reactive pupils. You have been asked to see her 3 days later
for prognosis because the family is considering withdrawing care.
On examination, her pupils are now unreactive, and she has no motor
response or brainstem reflexes. The nurse tells you she had myoclonus
12 hours ago...."
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