Author/Editor		Kovač, M; Žnidaršič, M
Title		Fibrilacija prekatov in pomen zgodnje defibrilacije
Translated title		Ventricular fibrillation and importance of early defibrillation
Type		članek
Source		In: Bručan A, Gričar M, editors. Urgentna medicina: izbrana poglavja 2. Zbornik 3. mednarodni simpozij o urgentni medicini; 1996 jun 26-29; Portorož. Ljubljana: Slovensko združenje za urgentno medicino,
Publication year		1996
Volume		str. 219-22
Language		slo
Abstract		On July 23rd 1995, the prehospital unit intervened at home of a 84-year-old patient suffering from anterior wall acute myocardial infarction. During ECG recording a ventricular fibrillation occurred. In the first two attempts to deliver electrical shocks of 200 J the defibrillator didn't discharge. It did in the third attempt but only the fourth converted the ventricular fibrillation to a sinus rhythm. Peripheral pulses were palpable again, the patient restarted to breathe and recovered consciousness. Mechanical ventilation and external heart massage were not performed. On the way to the hospital the patient was given lidocaine (100 mg), morphine (5+5 mg) with thyethylperazinum, oxygen and an infusion of Ringer lactate. In the hospital he was given streptokinase. He was sent home after 8 days showing no signs of heart weakening. There were no signs of myocardial infarction on teh ECG. We believe: MD intervened in the best manner for the patient due to experience in recieving urgent telephone calls. In the case of an individual intervention, where no defibrillator was available, the patient would have died due to a long arrival time of the prehospital unit (19 minutes). A precordial thump is generally ineffective for termination of prehospital ventricular fibrillation (1). In our case the defibrillation was succesful, thus the precordial thump was not necessary. In the first two attempts the defibrillator didn't discharge. There was a very coarse fibrillation curve on the monitor which dictated a synchronized mode of operation. Manual switching to unsynchronized shocks is not possible. The patient looses his consciousness in 8 to 10 seconds from the beginning of the heart arrest (3). Coughing may raise intracerebral blood flow due to a greater intrathoracic pressure and thus preserve consciousness longer (2). (Abstract truncated at 2000 characters.)
Descriptors		VENTRICULAR FIBRILLATION ELECTRIC COUNTERSHOCK EMERGENCY MEDICAL SERVICES