Importance of the early defibrillation: CPR in the ambulance vehicle

• Main Author: Uzelac Bojana
• Format: Article
• Language: English
• Published: Serbian Medical Society, Department of Emergency Medicine, Belgrade 2014-01-01
• Series: ABC: časopis urgentne medicine
• Subjects: cpr; ami; defibrillation; vf; ambulance vehicle
• Online Access: https://scindeks-clanci.ceon.rs/data/pdf/1451-1053/2014/1451-10531403014U.pdf

INTODUCTION: 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. Defibrillation is the passage of an electrical current across the myocardium of sufficient magnitude to depolarize a critical mass of myocardium and enable restore of coordinated electrical activity. This is definitive treatment of life treating arrhythmias ventricular fibrillation (VF) and ventricular tachycardia (VT) without pulse. AIM: is to indicate the importance of an early defibrillation for success of CPR. MATERIALS AND METHODS: is case report of 64 year old male, who is suffered acute myocardial infarction (AMI), arrested in ambulance vehicle and successfully resuscitated. RESULTS: Patient clinically presented like acute coronary syndrome (ACS). On the ECG tracing we recorded STEMI of infero-posterior left ventricle's wall, complicated with lots of premature beats. We called cardiology on duty, and prepared patient for the PCI. 15 minutes after first ECG, patient fainted in the ambulance; had spasms of whole body; made bizarre grimace and arrested. We stopped vehicle and started CPR. This was witnessed VF cardiac arrest; patient was already connected to a manual defibrillator; so we decided to provide three- DC shock strategy. The rhythm of cardiac arrest was VF and we shocked it with 200J DC shock. After first, we immediately preformed the second DC shock ( 300J). Patient suddenly awaked, pushed away medical technician and set down. Sinus rhythm was recorded on monitor; and patient's vitals were stable. At first, patient was agitated and confuse, but gradually he became completely aware and sane. Sinus tachycardia was cardiac rhythm during transport and stay so until we arrived at the hospital. Patient was successfully stented; without further complications during hospitalization. CONCLUSION: Thanks to an early defibrillation and being priority over other resuscitation measurements, we successfully resuscitated patient in the ambulance vehicle.