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Problem zavajajočih informacij na terenu - prikaz bolnika s sindromom GMAS, ki so ga zdravili zaradi epileptičnih napadov = Problem of misleading information in prehospital setting - presentation of a patient with Stokes-Adams attack treated for epileptic seizures
Petrovič-Koren, Nedeljka
In the year 1998 we have accomplished approximately 2500 emergency interventions using reanimobile in our emergency medical service in Ljubljana.In 8 cases (0,32%) we used transcutaneous pacing.5 of ...these 8 cases were symptomatic bradicardia, respectively third-degree heart block and 3 werecases of cardiopulmonal arrest. ln all 5 casses of symptomatic bradicardia, use of transcutaneous pacing has been successful, but in case of cardiopulmonal arrest the same method was unsuccessful. Examle described belowis a description of a patient, who has been treated for epileptic seizures. At our arrival, we established that the patient has bradicardia. Epileptic seizures were recurrent and the monitor was showing atrial activity without response of the ventricles. After use of the transcutaneous pacing, wemanaged to stop epileptic seizures.Later on we determined, these seizures were result of a low blood-presure along with Stokes-Adams attack.This exampleshows that in prehospital management and in the moment when immediate intervention is required, wg, are also confronted with misleading information which make our work even more difficult. lt is neccessary for us to recognize these misleading informations in order to avoid further complications or even death of the patient. These kind of informations are sometimes given by relatives or eyewitnesses who unintentionally increase difficulties in order to accelerate intervention. They can also misjudge the condition of a patient.As we have seen from the above described example, false information isalso possible from doctors, when they for various reasons incorrectly estimate the condition of a patient.Therefore it is emergent quickly examine breathing, pulse, heart- action (using monitor), blood-sugar, eyepupils and estimate the depth of unconsciousnes in order to be assured about a patient's actual condition.
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