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Asthma cardiac arrest — DipIMC MCQ

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HardResuscitationAsthma cardiac arrestDipIMC

A 42-year-old woman with severe asthma becomes exhausted, then loses consciousness and pulses during transfer. The monitor shows PEA and bag-mask ventilation is difficult with high resistance. What is the most appropriate management?

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Correct answer: E — Continue ALS while treating dynamic hyperinflation and ensuring effective ventilation

Asthma arrest is commonly due to hypoxia and dynamic hyperinflation, so ventilation must be controlled to avoid breath stacking while ALS and bronchodilator therapy continue. Very rapid ventilation worsens air trapping and venous return. Defibrillation is not indicated for PEA. The pearl is that in obstructive lung disease, ventilation strategy can either treat or worsen the arrest physiology.

Reference: Resuscitation Council UK Special Circumstances Guidelines 2025; JRCALC Guidelines 2025