You are riding along with EMS when you get a call for "difficulty breathing". You enter the house to find fire department on scene already performing CPR on a high school age male. The paramedics 2mg of intranasal Narcan is given without response. The patient is placed on the monitor and the following rhythm strip is obtained:
The patient is defibrillated x 2 with ROSC and his post-defibrillation strip:
After return of pulses, the patient is bagged on transport to the emergency department. An additional 2mg of narcan is given IV without effect. A 12 lead EKG is obtained on ED arrival:
What is your diagnosis?
Read our case conclusion here