ABC: časopis urgentne medicine (Jan 2014)
Cardiopulmonary resuscitation in patient's home: Case report
Abstract
INTRODUCTION: cardiopulmonary resuscitation (CPR) is emergency and lifesaving procedure, done when someone's breathing and/or heartbeat has stopped. It is performed to restore and maintain breathing and circulation and to provide oxygen and blood flow to vital organs. AIM: is to present successful resuscitation of patient in the pre-hospital conditions by ERC's protocols forshockabile rhythms from 2010. MATERIALS AND METHODS: case report of 58 years old male patient, who is presented with repeated collapses and after that with cardiac arrest. RESULTS: Emergency Medical Service was called for conscious man who is allegedly drunk. He collapsed once and hit his head when he fell; then he got conscious but faint again. The first ECG showed R on T phenomena: this was PVC's trigeminy, and PVCs appeared at the end of T wave. Next, patient collapsed again and arrested in front of EMS team. Initial rhythm of cardiac arrest was ventricular fibrillation (VF). We preformed resuscitation procedures by ERC's protocols for shockabile rhythms from 2010. After 6 DC shocks and 16 minutes of CPR we got a pulse and spontaneous respirations. Sinus tachycardia was noted on the defibrillator's monitor as perfused rhythm. When ROSC (Restitution of Spontaneous Circulation) was achieved, we checked blood glucose values; and also monitored the oxygen saturation of arterial blood by pulse oximetry. In hospital, in the reanimation room, patient became aware. During hospitalization, acute coronary syndrome and acute neurological event were excluded; the real reason for cardiac arrest remains unknown. Patient left home without any sequelae. CONCLUSION: indicates importance of fast rejection differential diagnosis and recognition cardiac problem as cause of repeated collapses. Thanks to teamwork of EMS, knowledge and application of Protocols, restitution was fast and successful. Result was patient's full recovery, without any neurological sequelae.
