Case Report: Code Blue and Leg Edema

History: You respond to a code blue for a man in his 70’s who is waiting for SNF placement after recent admission for COVID-19. His COVID tests are now negative and his symptoms have resolved. The nurses were readjusting his position in bed when he suddenly collapsed and became unresponsive. An AED was attached and read “No Shock Advised”.

A monitor was attached about two minutes later and showed asystole. CPR is in progress and 2 rounds of Epi have been given. You ask the nurse if anything has been different today prior to the arrest and she mentions that his legs look a bit swollen today and his urine output has decreased.

Exam: GCS = 3, minimal respiratory effort being bagged. You call for a pulse check and note a rhythm in the 30’s with a decent pulse. BP is measured and is 95/55.

You request a 12-lead ECG:

Computer Read: Atrial fibrillation with slow ventricular response, RBBB, rate = 30, QTc = 332.