Sudden Deterioration in the Intensive Care Unit

You arrive as the code leader in the intensive care unit. A 58-year-old woman was alert and hemodynamically stable before a right subclavian central venous catheter was placed approximately 10 minutes ago. Shortly afterward, she developed sudden shortness of breath, became hypotensive, and lost consciousness.

The bedside nurse found no normal breathing and could not feel a carotid pulse within 10 seconds. The resuscitation response was activated, and CPR is already in progress. A respiratory therapist is providing bag-mask ventilation with oxygen, and the monitor/defibrillator is being attached.