Yes, this is E.M.K.'s best case ever mini podcast series, and I'm your host, Dr. Anton Helman.

In anticipation of our upcoming episode on pediatric advance life support with Dr. Alan DeKahn, the lead author of The Pals Guidelines, and Dr. Anthony Croco, better known as Rantany, I had the honor of introducing Dr. DeKan to you so he can tell you his best case ever. Dr. DeCon welcome to EM cases. Thanks, Anton. Well, you know, this is a this is a case I dealt with about

15 to 20 years ago at Janus General Hospital. It was an 11-month-old boy, and basically the story ends up being

is that cold February night, and what happened was that this 11-month-old managed to

crawl out of the house unwitnessed and actually was found sometime later in the middle of the night

by a family member encased an ice

in the backyard, starting CPR, called 911. EMS arrived on scene, and the paramedics ended up

recognizing that this child was pulseless, continued CPR, tried to intubate the child.

Needless to say, the child was encased in ice crystals

around the mouth. The mouth was frozen shut, but they did manage to get an airway in, and rushed

into Janus General Emergency Department. And upon arrival, the child was in VF, cardiac arrest.

For those of us in our center, it was an amazing experience.

It was an example of how teams working together can truly make a difference.

A pre-hospital team that provided excellent care in terms of both BLS and ALS care.

A emergency department that had physicians and nurses and respiratory

therapists that when the child arrived, they'd already given the pediatric ICU at Janice General

a heads up and the pediatric intensifist. That was me down in the emergency department upon arrival

of the patient. Rapid identification that this kid

had a temperature of 16 degrees Celsius refractory VF cardiac arrest and that we all in that

emergency department recognized that what we needed to do is get the cardiac surgeons in to get

this kid rewarmed and with a circulation on ECMO.

So 90 minutes of CPR, both pre-hospital and in hospital,

...