Keywords
Out-of hospital
Ventricular fibrillation
Cardiopulmonary resuscitation
ALS
BLS
How to Cite
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).
References
2. Adabag AS, Luepker RV, Roger VL, Gersh BJ. Sudden cardiac death: epidemiology and risk factors. Nat Rev Cardiol. 2010 Apr;7(4): pp 216-25.[PMC free article] [PubMed]
3. Engdahl J, Holmberg M, Karlson BW, Luepker R, Herlitz J. The epidemiology of out-of-hospital ‘sudden’ cardiac arrest. Resuscitation. 2002;52:pp 235–245. [PubMed] [Google Scholar] [Ref list]
4. Nolan JP, Soar J, Zideman D, et al. 2010. European Council Guidelines for Resuscitation 2010. Section 1: Executive Summary. Resuscitation. 2010;81: pp 1219- 1276.
5. Jasmeet Soar, Jerry P. Nolanb, Bernd W. Böttiger, Gavin D. Perkins, Carsten Lott, Pierre Carli, Tommaso Pellis, Claudio Sandroni, Markus B. Skrifvars, Gary B. Smith, Kjetil Sunde, Charles D. Deakin, European Resuscitation Council Guidelines for Resuscitation 2015, Section 3. Adult advanced life support; Resuscitation 95 (2015), pp 100–147.
6. Steven M. Bradley, Erin E. Gabriel, Tom P. Aufderheide, Roxy Barnes, Jim Christenson, Daniel P. Davis, Ian G. Stiell, Graham Nichol, Survival Increases with CPR by Emergency Medical Services before defibrillation of out-of-hospital ventricular fibrillation or ventricular tachycardia: Observations from the Resuscitation Outcomes Consortium, Resuscitation, Volume 81, Issue 2,2010, pp 155-162.
7. Trond Nordseth, Theresa Mariero Olasveengen, Jan Terje Kvaløy, Lars Wik, Petter Andreas Steen, Eirik Skogvoll, Dynamic effects of adrenaline (epinephrine) in out-of-hospital cardiac arrest with initial pulseless electrical activity (PEA), Resuscitation, Volume 83, Issue 8,2012, pp 946-952.
8. Walter Kloeck, Richard O. Cummins, Douglas Chamberlain, Leo Bossaert, Victor Callanan, Pierre Carli, Jim Christenson, Brian Connolly, Joseph P. Ornato, Arthur Sanders, and Petter Steen, An Advisory Statement From the Advanced Life Support Working Group of the International Liaison Committee on Resuscitation, Vol 95, Issue 8, 1997;pp2183–2184.
9. Thomas D. Rea, Mickey S. Eisenberg, Greg Sinibaldi, Roger D. White; Incidence of EMS-treated out-of-hospital cardiac arrest in the United States; Resuscitation; Volume 63, Issue1,2004,pp17-24.
10. Christie Atwood, Mickey S. Eisenberg, Johan Herlitz, Thomas D. Rea; Incidence of EMS-treated out-of-hospital cardiac arrest in Europe; Resuscitation; Volume 67, Issue 1;2005; pp 75-80.
11. Mozaffarian D, Benjamin EJ, Go AS, et al. on behalf of the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics—2015 update: a report from the American Heart Association. Circulation. 2015;131(4):e29–e322. [PubMed] [Google Scholar]
12. https://www.erc.edu/projects/eureka-one
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