Serbian Medical Society, Department of Emergency Medicine, Belgrade
Abstract
INTRODUCTION: According to current recommendations for cardiopulmonary resuscitation (CPR) for OHCA we can distinguish two kinds of rhythms: shockable (VF / VT) and non shockable (asystole / PEA). Drug that is used in both kinds of rhythms is adrenaline, except that with shockable rhythms it is used after the third defibrillation (about 6 minutes after the beginning of CPR), and with non shockable rhythms it is used within the first two minutes and is repeated every 3-5 minutes. Also, the recommendations state that CPR should be performed as long as the shockable rhythm persist, or there is some of the reversible causes of OHCA which we can treat, and in the case of asystole lasting longer than 20 minutes should be decided about the termination of CPR. MATERIAL AND METHODOLOGY: By retrospective analysis we got materials from the register of Emergency Medical Services Sombor in one year period starting from January 1st 2014 until January 1st 2015. RESULTS: During the observed period, our Service has had 63 OHCA when CPR was performed and those cases could be statistically analyzed. From those, shockable rhythms as the initial rhythm were in 21 cases or in 33.3%, and non shocable rhythms in 42 cases or in 66.7%. The average arrival time at the location was 5 minutes and 44 seconds, in case of shockable rhythms 4 minutes and 51 seconds, and in case of non shocable rhythms 6 minutes and 3 seconds. Average duration of CPR was 27 minutes and 12 seconds, as for the shockable rhythms 23 minutes and 45 seconds, and for non shocable rhythms 28 minutes and 56 seconds. In total was given 210 ampoules of adrenaline, with average of 3.33 ampoules of adrenaline per one CPR. Depending on the initial rhythm, for shockable rhythms was given an average of 2.05 ampoules of adrenaline (every 11 minutes and 35 seconds), and for non shocable rhythms 3.98 ampoules of adrenaline (every 7 minutes and 12 seconds). CONCLUSION: If by the use of adrenaline can be assessed whether the teams of our Services work under the recommendations and if this small sample can be considered statistically significant (percentage of the patients with established circulation (ROSC) 34.9%), we must be realistic and admit that we do not apply recommendations enough, and that the strict application of recommendations would bring even better results and greater survival rate
