Cardiac arrest is the sudden termination of the heart’s ejection function. It is often the direct cause of sudden cardiac death. Cardiac arrest occurs in patients with organic heart disease. Coronary atherosclerotic heart disease and its complications are currently the main cause of cardiac arrest. The optimal time for resuscitation of cardiac arrest is within 4 h of its occurrence, which is known as the golden hour. The key to successful resuscitation is to perform cardiac resuscitation as early as possible, if not resuscitated in time will cause irreversible damage to the brain and systemic organs and tissues, ultimately leading to death. The success rate of cardiac arrest resuscitation is relatively low, after resuscitation of patients who survive, about 20% to 40% left with permanent neurological disability, serious cases can become vegetative. Successful resuscitation of cardiac arrest for 45 min and recovery without any neurological disability after 30 hours of loss of consciousness is rare. It is reported as follows. 1, case summary patient male 54 years old working farmer. Previous history of hypertension for 5 years, self medication (specific drugs and dosage is not known), usually do not detect blood pressure. In the past week, the work is tiring, often working night shifts, today a small amount of alcohol before the lunch break, after waking up consciously heart anterior drive discomfort, pressure-like pain, persistent unrelieved, accompanied by nausea, irritability. No sweating. No treatment was done. Lasted 1 hour after the symptoms are not relieved in 2009-3-5 17:50 emergency to our hospital emergency department. At that time, the examination: T 36 ℃ P 86 times M minutes R 25 times M minutes Bp160M80mmHg, mood, irritability, restlessness, clear breath sounds in both lungs, knocking the heart is not big, rhythmic heart sound is strong, the heart rate is 86 times M minutes, and no murmur is heard in each valve auscultation area. The electrocardiogram showed extensive anterior wall and lateral wall ST-segment elevation, and the ST-segment of the lower wall was correspondingly shifted downward. Clinical diagnosis Acute myocardial infarction (extensive anterior wall and lateral wall). Immediately into the emergency room, oxygen, cardiac monitoring, the establishment of intravenous fluid pathway, nitroglycerin 5mg static, pantoprazole 40mg into the pot, aspirin 300mg sublingual sublingual, dulcolax 100mg intramuscular, to carry out the green channel, urgent check blood routine, blood coagulation four, cardiac enzymes, troponin I to do the preparations for thrombolysis. At 18:10, the patient suddenly vomited stomach contents, about 200ml, followed by cyanosis, loss of consciousness, cardiac monitoring showed a straight line. Consider cardiac arrest. Immediately given to clean the airway, tracheal intubation, airbag mask assisted respiration, chest cardiac compression, electric defibrillation, after 3 consecutive electric shock defibrillation, the monitoring showed ventricular fibrillation, continue to give chest cardiac compression, assisted respiration, epinephrine 1mgiv every 3 minutes, lidocaine 100mg iv, continue defibrillation. At the 6th defibrillation, the electrocardiographic monitoring showed ventricular tachycardia, and ethylaminolevulinone 150mg iv was defibrillated again, and sinus rhythm was restored after the 7th defibrillation, and the patient’s spontaneous heartbeat was restored and respiration was restored at 18:55 after about 45 minutes of resuscitation. However, the patient’s consciousness was still not restored, bilateral pupils were dilated and fixed, and light reflex disappeared. ECG monitoring showed sinus rhythm, ventricular premature, short bursts of ventricular tachycardia, and continued to give ethambutol brain resuscitation drug treatment. At 19:40, he was thrombolized with 1.5 million U of urokinetic acid, and cardiac arrest occurred again during thrombolysis, which was successful. However, the patient’s consciousness was not recovered. Thereafter, the patient developed acute left heart failure and high fever. Until 30 hours after the loss of consciousness in 2009-3-6 22:30 patient consciousness recovery. However, the patient had no memory of the first 2 hours of the disease. Neurological examination showed no abnormality, and cranial CT showed multiple cavernous hypodense areas in the right basal ganglia region and in the center of both hemi-ovarian zones. Consider cavernous cerebral infarction. After 1 week of hospitalization, the patient was basically in good condition and returned home to continue treatment. 2, Discussion There are several elements in the diagnosis of cardiac arrest: (1) ventricular fibrillation or flutter, ECG shows vf. (2) cardiac arrest, ECG shows straight line. (3) myocardial electromechanical separation, ECG shows wide QRS. there is no effective mechanical contraction of the myocardium, and the following symptoms appear: fainting, intermittent respiration, sighing-like, and later cessation, disappearance of large artery pulsation, disappearance of heart sounds, pulse is not palpable, and the blood pressure is not measurable, the clinical manifestations and ECG of this case are in line with the diagnostic elements of the cardiac arrest described above, and the success of the rescue of the patient is now analyzed as follows. 2.1 The patient in this case is a middle-aged or elderly male, with risk factors such as smoking and high blood pressure, as well as triggers such as fatigue and emotional stress. Therefore, it is very necessary to remove the triggers and eliminate the risk factors for cardiac patients. 2,2 Once cardiac arrest occurs, standardized cardiopulmonary and cerebral resuscitation is extremely important. Early defibrillation is especially important. Our hospital has conducted annual cardiopulmonary resuscitation training for the past three years, and everyone passes the test, which improves the success rate of cardiopulmonary resuscitation. 2,3 Time is life, and cardiopulmonary resuscitation should be performed as early as possible. The earlier the resuscitation starts, the higher the survival rate. 2,4 Firm conviction, do not give up on the patient, insist on the last second. The patient is in good physical condition, the onset time is short, and timely resuscitation is also the key to success.