A female patient with a neurodegenerative disorder and severe dystonia is brought in by ambulance from a nursing home to your emergency department. She is neurologically severely impaired; she is non-ambulatory, non-verbal with preserved consciousness and social non-verbal communication. The ECG-strip shows a heartrate of 230/min with a fibrillation-like pattern. Defibrillation pads were applied and the heart rhythm was double checked by switching to pad-leads.
Blue rectangles: location of defibrillator pads
A- implanted neurostimulator
B- Baclofen pump
C- gastrostomy tube.
Along the red dotted line you palpate a subcutaneous wire.