Trinh, a nurse, was caring for Devon, a 20-year-old college student who experienced cardiac arrest in the hot tub while home visiting his family for the holidays. His mother, Catalina, found him partially submerged and not breathing. She pulled him out, called emergency services, and started cardiopulmonary resuscitation. When the paramedics arrived, Devon was in cardiac arrest with ventricular fibrillation. Spontaneous circulation returned after 4 cycles of cardiopulmonary resuscitation, 4 defibrillations, and 2 doses of epinephrine. He did not regain consciousness after the resuscitation. He was transported to the local community hospital for continued care. He was intubated and received targeted temperature management and vasopressor support. He responded to noxious stimuli with decerebrate posturing but had no cough, gag, or corneal reflexes. His toxicology screen result was negative for drugs. Imaging studies on admission and 7 days later confirmed he had experienced severe anoxic brain injury. His neurologic assessment remained...

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