{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T06:40:17Z","timestamp":1756363217520,"version":"3.44.0"},"reference-count":30,"publisher":"BMJ","issue":"10","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2023,10,2]]},"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:p>A boy in early childhood presented in cardiac arrest. Care was provided out of hospital and in the emergency department as per standard paediatric resuscitation guidelines. Despite initial return of spontaneous circulation following cardiopulmonary resuscitation, two defibrillation shocks and epinephrine via intraosseous access, he had recurrent episodes of pulseless ventricular tachycardia and ventricular fibrillation. In total, 40 defibrillation shocks were administered, and he subsequently stabilised on combined treatment with intravenous esmolol, amiodarone and milrinone. He was transferred to the paediatric intensive care unit and had an automated implantable cardioverter\u2013defibrillator inserted prior to discharge. Genetic testing has confirmed a diagnosis of catecholaminergic polymorphic ventricular tachycardia and it is hypothesised that the childhood excitement at a popular time of year, combined with caffeinated drinks, instigated his initial cardiac arrest which was propagated with iatrogenic epinephrine. He has remained stable since, with no neurological sequelae thus far from a significantly prolonged downtime.<\/jats:p>","DOI":"10.1136\/bcr-2023-255729","type":"journal-article","created":{"date-parts":[[2023,10,18]],"date-time":"2023-10-18T13:11:24Z","timestamp":1697634684000},"page":"e255729","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Survival in a young child with out-of-hospital cardiac arrest: diagnostic dilemma and when to deviate from standard resuscitation guidelines"],"prefix":"10.1136","volume":"16","author":[{"given":"Neil John","family":"Collins","sequence":"first","affiliation":[{"name":"Cardiac Services, The Royal Children's Hospital, Melbourne, Victoria, Australia"},{"name":"Paediatrics, Cork University Hospital, Cork, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daragh","family":"Finn","sequence":"additional","affiliation":[{"name":"Paediatrics, Cork University Hospital, Cork, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olivia","family":"O'Mahony","sequence":"additional","affiliation":[{"name":"Paediatrics, Cork University Hospital, Cork, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Walsh","sequence":"additional","affiliation":[{"name":"Paediatric Cardiology, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,10,18]]},"reference":[{"key":"2025082723012603000_16.10.e255729.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199611143352001"},{"key":"2025082723012603000_16.10.e255729.2","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0b013e31829763e2"},{"key":"2025082723012603000_16.10.e255729.3","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0b013e31827129b3"},{"key":"2025082723012603000_16.10.e255729.4","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2017-2741","article-title":"Cardiac arrest survival in pediatric and general emergency departments","volume":"141","author":"Michelson","year":"2018","journal-title":"Pediatrics"},{"key":"2025082723012603000_16.10.e255729.5","unstructured":"Napolitano C , Priori S . 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