Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Pitfalls with the “chest compression-only” approach: the challenge of an unusual cause | Reid and Skogvoll Scandinavian Journal of Trauma Resuscitation and Emergency Medicine 2010 18 45 http content 18 1 45 SCANDINAVIAN JOURNAL OF Et emergency medicine CASE REPORT Open Access Pitfalls with the chest compression-only approach the challenge of an unusual cause Bj0rn Ole Reid 1 Eirik Skogvoll1 2 3 Abstract Chest compression-only CC-only is now incorporated in the Norwegian protocol for dispatch guided CPR cardiopulmonary resuscitation in cardiac arrest of presumed cardiac aetiology. We present a case that is unique and instructive as well as unusual. It reminds us of the challenges that face bystanders dispatch centres and ambulance services when faced with possible cardiac arrest. This case report describes a 50 year old man in a rural community. He had suffered a heart attack 8 months previously and was found unconscious with respiratory arrest in his garden one morning. Due to the proximity to the ambulance station the paramedics were on the scene within three minutes. A chain-saw was lying beside him but no external injuries were seen. The patient had no radial pulse central cyanosis and respiratory gasps approximately every 30 seconds. Ventilation with bag and mask was given and soon a femoral pulse could be palpated. Blood sugar was elevated and ECG electrocardiogram was normal. GCS Glasgow Coma Scale was 3. Upon arrival of the physician staffed air ambulance further examination revealed bilateral miosis of the pupils and continuing bradypnoea. Naloxone was given with an immediate effect and the patient woke up. The patient denied intake of narcotics but additional information from the dispatch centre revealed that he was hepatitis C positive. After a few hours the patient admitted to have obtained a fentanyl transdermal patch from an acquaintance having chewed it before falling unconscious. This case report shows the importance as well as the challenges of identifying a non-cardiac cause of possible cardiac arrest and the value of .
