1. Special Circumstances Workshops Cardiac arrest due to hypovolaemia Key teaching objectives By the end of this session the candidate will: Understand the treatment of the patient with cardiac arrest caused by hypovolaemia Know the likely causes and signs of life-threatening hypovolaemia Understand the need to control haemorrhage and infuse fluids Know the different actions needed in addition to standard ALS

2. Scenario A 75 year old man has had a partial gastrectomy for a large bleeding gastric ulcer. Two hours after arriving back on the surgical ward his abdomen is grossly distended. Vital signs: AClear BRR 30 min-1, SpO2 unrecordable on 4 l min -1 oxygen via a Hudson mask CP 140 min-1 sinus tachycardia – femoral pulses just palpable, BP 60/40 mmHg DGCS 12 (E3, V4, M5), pupils equal and reactive to light EVery pale What action will you take?

3. Scenario (continued) He loses consciousness and becomes apnoeic. The ECG monitor displays sinus tachycardia. There are no palpable pulses. What will you do now?