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Zapleti po kardiopulmonalni reanimaciji - posledice zunanje masaže srca - prikaz primera = Complications after cardiopulmonary resuscitation - consequences of external chest massage
Merela, Irena
Introduction: External cardiac massage is simple and usually a safe procedure for cardiopulmonary resuscitation. However, it is not innocuous and is occasionally associated with serious and even ...fatal complications. Case report: 43- years old man collapsed and stoped breathing infront of the witnesses. A bystander performed basic life support with external cardiac massage and mouth-to-mouth breathing. First arrived two medical technicians byan ambulance and continued cardiopulmonary resuscitation, including chest compression. When prehospital emergency team with doctor had arrived ( at the time of call they had another intervention ), on the monitor was asystole. Patient was further resuscitated by chest compression, endotracheal intubation, artificial ventilation, epinephrine by the tracheal and intravenous route. At the onset of ventricular fibrillation he was twice defibrillated. When spontaneous rhythm had been established, patient was transported to the hospital to intesive care internal medicine department. ECGhad shown posterior myocardial infarction. Serial rib fractures and tensionpneumothorax were found on the left hemithorax. Patient was resuscitated again because of ventricular fibrillation, and spontaneous rhythmwas established. Ultrasonography showed free fluid in abdominal cavity. At emergency laparotomy hepatic laceration was found. Rhythm turned to asystole again, patient died. Discussion: We were thinking about whether to the'complications after cardiopulmonary resuscitation contributed bystanders external chest massage, use of ACD device or patients anatomical abnormalities. It is impossible to define exactly when individual injuries turned up because external chest massage was performed by bystander, two prehospital emergency teams, team at intensive care internal medicine department and team at the operation. In the case described external chest massage was performed by physicaly strong bystander. (Abstract truncated at 2000 char
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