Out of Hospital Cardiac Arrest: A Case Report

Abstract

Introduction: Sudden OHCA (Out of hospital cardiac arrest) is the third leading cause of death in industrialized nations. With more than 60% of cardiovascular deaths resulting from cardiac arrest, it remains the leading cause of death worldwide. Heart rhythms associated with cardiac arrest are divided into two groups: shockable rhythms (ventricular fibrillation/pulseless ventricular tachycardia (VF/pVT) and non-shockable rhythms (asystole and pulseless electrical activity (PEA)). VF is the most commonly identified arrhythmia in cardiac arrest patients. Urgent medical treatment includes cardiopulmonary resuscitation and early defibrillation. Material and Methods: Materials for this case report are data collected from the medical records of the Emergency Medical Center of Sarajevo protocol of patients. Case report: Our case report is presented with 59 years old man who had OHCA in his apartment. The initial rhythm was VF, and cardiopulmonary resuscitation was provided due to the Advanced life support guidelines to shockable rhythms. It was delivered 3 DC Shock-s (200J, 300J, 360 J) with the biphasic defibrillator, it was administered 1mg Adrenalin and performed endotracheal intubation. After the third DC shock, we got the return of spontaneous circulation ROSC. The patient was transferred to the University hospital, were he was stabile, and PCI of the LAD was performed as per the standard protocol. Echocardiography performed in the CCU revealed hypokinesia of RV, with preserved systolic function. On hospital day 7 he had a full neurological recovery. He was conscious, oriented, with normal breathing, blood pressure 125/79mmHg, sPO2 99, ECG: sinus rhythm, fr 87/min, without pathological signs. Echocardiography revealed the reduced systolic function of the left ventricle, with mitral regurgitation MR+2. Discussion: Out-of-hospital cardiac arrest (OHCA) is a major health problem in Europe and in the United States. The numbers of patients who have OHCA annually in these two parts of the world have traditionally been reported to be 275,000 and 420,000 respectively. The success of resuscitation depends on many factors: well-organized health care, organization of outpatient emergency services, but primarily when it comes to OHCA, education of the population on Basic life support, and early Cardiopulmonary resuscitation and use of AED (automated external defibrillator).

Keywords

• cardiac arrest
• Out-of hospital
• Ventricular fibrillation
• Cardiopulmonary resuscitation
• ALS
• BLS