Journal of Regional Section of Serbian Medical Association in Zajecar

Year 2011     Vol 36     No 3
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      UDK 616.12-008.315-083.98

ISSN 0350-2899, 36(2011) br.3 p.166-69

Case report

Chain of survival – does it realy work? Case report
(Lanac preživljavanja – da li to zaista funkcioniše? Prikaz slučaja)
Marina Milenković, Dušica Janković
Zavod za hitnu medicinsku pomoć Niš


The actions linking the victim of sudden cardiac arrest with survival are called the Chain of Survival. The central links depict the integration of CPR and defibrillation. The aim of the research is to show how synchronized functioning of all four links of the Chain of Survival improve chances of survival in victims of sudden cardiac arrest. The method of the research is descriptive data display. NN female, aged fifty, found unconscious in a public place. The patient was found unconscious, no breathing and pulse of the carotid arteries, a bystander providing CPR. Before the arrival of defibrillator, the patient was first intubated. On checking through the pedal of defibrillator, the first recorded rhythm was asystole. The patient receives the amp. Adrenalin 1 mg as a bolus, chest compression continued. The second rhythm check showed ventricular fibrillation. Delivered shock 200 J with biphasic defibrillator, chest compression continued. The next rhythm analysis showed the presence of atrial fibrillation, palpable pulse over the carotid arteries. The patient receives also amp. Cordarone until the heart rhythm was slowed down. Transported to the Coronary Unit of the Cardiology Clinic where it is continued with post-resuscitation care. In most communities, the median time from ambulance call to ambulance arrival is 5-8 min, or 11 min to the first shock. Immediate CPR initiated by bystanders can double the survival rate in victims from sudden cardiac arrest. The goal of shock delivery is to restore an organised rhythm and spontaneous circulation. The post-resuscitation phase starts at the location where the return of spontaneous circulation is achieved and it continues in Intensive Care Unit. When all four links of the Chain of Survival function synchronised, the chance of survival in victims of sudden cardiac arrest is improved.
Key words: Chain of survival, sudden cardiac arrest, CPR, defibrillation

Napomena: kompletan tekst rada na srpskom jeziku
Note: full text in Serbian

      Corresponding Address:
Milenković Marina
Zavod za hitnu medicinsku pomoć Niš
Vojislava Ilića bb, 18000 Niš
Paper received: 08.04.2011
Paper accepted: 12.04.2011
Paper Internet issues: 17.12.2011
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Journal of Regional section of Serbian medical association in Zajecar
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