Virginia Research Day 2025

Medical Student Research Case Reports

06 A Prehospital Case of CPR-Induced Consciousness

Nicholas A. Wright, OMS-III, NR-P; John B. Patterson, MD; William S. Cox, DO Corresponding author: nwright@vt.vcom.edu

Edward Via College of Osteopathic Medicine

answer questions and hold meaningful discussion. She was transported directly to the cardiac catheterization lab (CCL), where she underwent percutaneous coronary intervention (PCI) that reversed a 100% occlusive in-stent thrombosis of the mid-left anterior descending artery (LAD). Conclusions: This case describes challenges that might be faced by healthcare professionals when CPRIC is encountered. While sedation was considered by medical direction, widespread protocols for sedation in CPRIC patients should be considered for the safety of both patient and healthcare professionals. More research is needed to determine the prevalence of CPRIC in the United States, as well as best practices for management of this rare phenomenon.

Background: Cardiopulmonary resuscitation induced consciousness (CPRIC) is an extremely rare phenomenon in which patients in cardiac arrest demonstrate signs of consciousness while undergoing cardiopulmonary resuscitation (CPR). While there are only a few cases of this phenomenon reported in the literature, it seems as though its prevalence has increased in recent years. Objectives: The goal of this report is to highlight the challenges healthcare professionals might encounter when caring for a patient with CPRIC. The importance of awareness of the phenomenon and potential treatment options are also discussed.

Case Report: This case involves a 52-year-old female who presented as a witnessed out-of-hospital cardiac arrest (OHCA) after a bout of ischemic chest pain. During CPR, resuscitation was stopped multiple times due to signs of consciousness despite the patient being in ventricular fibrillation (VF). Throughout the resuscitation attempt, the patient grunted, yelled, demonstrated purposeful movements, and opened her eyes. These actions resulted in considerable pauses in chest compressions, delays and omissions in routine advanced cardiac life support interventions, and psychological distress to the emergency medical services (EMS) providers. After multiple defibrillations, the patient was successfully resuscitated and became alert and oriented enough to

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