Successful Treatment and Transport of a Prolonged Cardiac Arrest from the Antarctic Continent with Full Neurological Recovery

We describe full neurologic recovery from an out-of-hospital cardiac arrest with a prolonged arrest time (35 min) and prehospital interval (12 h) from the Antarctic continent after the use of standard advanced cardiac life support (ACLS) protocols and thrombolytic therapy. A 61-year-old male had a witnessed collapse in the dining facility at McMurdo Station, Antarctica, resulting in prompt activation of emergency services. The responding firefighter team found the patient in ventricular fibrillation and administered defibrillations. After the defibrillations, the responding team transported the patient to the base clinic. Clinic staff in the resuscitation bay achieved return of spontaneous circulation (ROSC) after successful defibrillation and medication administration. The postarrest electrocardiogram (EKG) showed that an anterior ST-elevation myocardial infarction was the cause of the ventricular fibrillation. Clinic staff administered tenecteplase, and the patient was prepared for transport to New Zealand. The patient was transported aboard an LC-130 aircraft with a transport time of 7 h. The total time from cardiac arrest to arrival at the receiving hospital was 12 h. On arrival to definitive care, the patient underwent percutaneous coronary intervention revealing 100% occlusion of the left anterior descending artery. The vessel was opened and 2 drug-eluting stents were placed. Remarkably, the patient survived the arrest completely neurologically intact. This case highlights the effectiveness of the current ACLS algorithms and chain of survival despite austere locales and long transport times.