EARLY DEFIBRIATION IN A PATIENT WITH VENTRICULAR FIBRILLATION IN THE PRE-HOSPITAL AREA: CASE REPORT

Öz

Case 112 applied to 112 with complaints of chest pain and sweating. The aim of the study was to emphasize the importance of ventricular fibrillation management and early defibrillation in the prehospital area. When the patient was reached, it was observed that his skin was pale and sweaty, and he held the chest area with his hand. When the patient was taken to the stretcher to have an electrocardiogram, the patient became unconscious and the pulse could not be taken. Cardio Pulmonary Resuscitation was started, and when the rhythm of the patient was controlled, it was understood that the patient was in Ventricular Fibrillation. Defibrillation was applied by adjusting to 200 joules. After defibrillation, it was returned with a glaskow coma score of 15. It is vital that paramedics undergo early diagnosis and provide effective advanced life support in patients with fatal arrhythmias.

Anahtar Kelimeler

• Cardiac arrest
• early defibrillation
• ventricular fibrillation

Hastane Öncesi Alanda Ventriküler Fibrilasyonu Olan Hastada Erken Defibrilasyon: Olgu Sunumu

Öz

Olgu 112’ye göğüs ağrısı ve terleme şikayeti ile başvurmuştur. Çalışmada hastane öncesi alanda ventriküler fibrilasyon yönetimi ve erken defibrilasyonun öneminin vurgulanması amaçlandı. Hastaya ulaşıldığında cilt rengi soluk ve terli, eliyle ise göğüs bölgesini tuttuğu gözlemlenmiştir. Hasta, elektrokardiyografi çekebilmek için sedyeye alındığı sırada hastanın bilinci kapanmış ve nabız alınamamıştır. Kardiyo Pulmoner Resüsitasyon’a başlanılmış, hastanın ritmi kontrol edildiğinde hastanın Ventriküler Fibrilasyon’da olduğu anlaşılmıştır. 200 joule ayarlanarak defibrilasyon uygulanmıştır. Defibrilasyondan sonra glaskow koma skoru 15 olacak şekilde geri dönüşü sağlanılmıştır. Paramediklerin, ölümcül aritmisi olan hastalarda erken ön tanıya gitmeleri ve etkin ileri yaşam desteğini sağlamaları hayati öneme sahiptir.

Anahtar Kelimeler

• Erken defibrilasyon
• kardiyak arrest
• ventriküler fibrilasyon

Kaynakça

1. BAKER, P. W., CONWAY, J., COTTON, C., ASHBY, D. T., SMYTH, J., WOODMAN, R. J., & GRANTHAM, H. (2008, 12). Defibrillation or cardiopulmonary resuscitation first for patients with out-of-hospital cardiac arrests found by paramedics to be in ventricular fibrillation? A randomised control trial. Resuscitation, 79(3), 424-431.
2. CHENG, A., MAGID, D. J., AUERBACH, M., BHANJI, F., BIGHAM, B. L., BLEWER, A. L., . . . DONOGHUE, A. (2020, 10 21). Part 6: Resuscitation Education Science: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation, 142(16), 551-579.
3. DURUSU TANRIÖVER, M. (2011). Kardiyak Arrest Öncesinde Kötüleşen Hastayı Tanımak: Öngörü Kriterleri ve Risk Faktörleri. Yoğun Bakım Dergisi, 1, 16-20.
4. JOHNSTON, M., CHESKES, S., ROSS, G., & VERBEEK, R. P. (2016). Double Sequential External Defibrillation and Survival from Out-of-Hospital Cardiac Arrest: A Case Report. Prehospital Emergency Care Journal, 20(5), 662-666.
5. KO, P. C.-I., CHEN, W.-J., LIN, C.-H., MA, M. H.-M., & LIN, F.-Y. (2005). Evaluating the quality of prehospital cardiopulmonary resuscitation by reviewing automated external defibrillator records and survival for out-of-hospital witnessed arrests. Resuscitation, 64(2), 163-169.
6. LUDWHANI, D., GOYAL, A., & JAGTAP, M. (2020). Ventricular Fibrillation.
7. Majewski, D., Ball, S., Bailey, P., Bray, J., & Finn, J. (2021). Long-Term Survival Among Ohca Patients Who Survive To 30 Days: Does İnitial Arrest Rhythm Remain A Prognostic Determinant? Resuscitation, 162, 128-134.
8. NICHOL, G., THOMAS, E., CALLAWAY, C. W., HEDGES, J., POWELL, J. L., AUFDERHEIDE, T. P., . . . STIELL, I. (2008). Regional Variation in Out-of-Hospital Cardiac Arrest Incidence and Outcome. JAMA, 300(12), 1423-1431.

9. PANCHAL, A., BARTOS, J. A., CABANAS, J. G., DONNINO, M. W., DRENNAN, I. R., HIRSCH, K. G., . . . CHAIR, V. (2020). Part 3: Adult Basic and Advanced Life Support: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Cieculation, 142(16), 366-468.
10. SHARABI, A. F., & SİNGH, A. (2020). Cardiopulmonary Arrest In Adults.
11. STEEN-HANSEN, J. E. (2010). Favourable outcome after 26 minutes of "Compression only" resuscitation: a case report. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 18(19).