Wednesday, March 4, 2015

Q: Patient coded in ICU and didn't survive the full ACLS  protocol. How long should you wait before officially declaring patient dead?

Answer: 5 to 10 minutes.

Often after failed ACLS, patient may recover circulation by himself/herself, which has been well described in literature and known as Lazarus syndrome or autoresuscitation. Many theories have been proposed in this regard including rebound potassium or epinephrine in circulation. Another popular theory is the relaxation of pressure in chest after resuscitation efforts have ended which allows the heart to expand, triggering the heart's electrical impulses and restarts the heartbeat.


Ben-David M.D., Bruce; et al. (2001). "Survival After Failed Intraoperative Resuscitation: A Case of "Lazarus Syndrome". Anesthesia & Analgesia 92 (3): 690–692.

Walker, A.; H. McClelland; J. Brenchley (2001). "The Lazarus phenomenon following recreational drug use". Emerg Med J 18 (1): 74–75.

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