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A 63-year-old man collapsed, unresponsive and pulseless, at his workplace. Security guards, using an automated external defibrillator, delivered two shocks to his chest and performed cardiopulmonary resuscitation (CPR) until paramedics arrived and intubated the patient. After the return of spontaneous circulation, he was transported to the hospital. A high-resolution computed tomographic (CT) scan confirmed the diagnosis of pulmonary embolism. The patient, whose condition by this time was hemodynamically stable, was treated without thrombolytic agents; he received unfractionated heparin and oxygen and underwent mechanical ventilation overnight. Thirty minutes after self-extubation, the patient reported dyspnea, and subcutaneous emphysema developed, which was especially . . . [Full Text of this Article] |
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