Author/Editor		Kovačič, Bojan; Marčič, Boštjan; Grmec, Štefek
Title		Reševanje obešenca - predstavitev primera
Translated title		Rescuing the patient after suicide attempt by hanging - a case report
Type		članek
Source		In: Bručan A, Gričar M, Vajd R, editors. Urgentna medicina: izbrana poglavja. Zbornik 10. mednarodni simpozij o urgentni medicini; 2003 jun 11-14; Portorož. Ljubljana: Slovensko združenje za urgentno medicino,
Publication year		2003
Volume		str. 339-41
Language		slo
Abstract		In our report we present a case of a 72- year old patient who tried to commit suicide by hanging. Before our arrival his relatives released him from the suspension and started with the basic life support (BLS). At the time of the arrival of the prehospital team (a doctor and two medical technicians) we found the patient unresponsive, without breathing and without palpable pulse: We started with cardiopulmonary resuscitation (CPR) immediately and considered the possibility of the cervical spine injury all the time. The initial electrocardiogram (ECG) showed sinus heart rhythm with bradycardia but the patient had no palpable pulse so we faced the case of the pulseless electrical activity (PEA). We procedeed with the in-line orotracheal intubation and artificial respiration, continued with ihe CPR and intravenouos application of medications according to the PEA protocol. The initial preintubation oxygen saturation, provided by the pulse oxymetre, was 60 % and the initial postintubation capnometric value (petCO2) was 70 mmHg. After few minutes of the CPR the return of the spontaneous circulation (ROSC) was established and the patient started to breathe on his own. We had no difficulties during the transportation of the patient to the hospital and after two days he was transferred to the psychiatric department without any consequences. With this case report we would like to stress: the meaning of correct and in-time CPR, the meaning of short arrival time of the prehospital unit, the meaning of in-line intubation when the trauma of the cervical spine is suspected, high end-tidal COz (petCO2) in the beginning of the CPR after releasing the airway in the case of asphyxia.
Descriptors		EMERGENCY MEDICAL SERVICES SUICIDE, ATTEMPTED CARDIOPULMONARY RESUSCITATION AGED