[Therapeutic procedures in patients with acute coronary syndrome and life-threatening arrhythmias in prehospital stage].
The prehospital phase of acute coronary syndrome can be divided into two parts: in the first part laypersons (or nobody), and later on professional medical staff are in contact with the patient. This part is especially important since it is well-known that the mortality rate arising from acute myocardial infarction is highest in the first hour of the disease onset, mostly due to malignant arrhythmias. Apart from calling the doctor, laypersons' help practically comes to resuscitation in case of cardiac arrest. In different regions of the world, there are different programs of interventions that have led to a decline in the mortality rate in this stage of the disease, which is nevertheless higher than in the overall later period (in Zagreb in 2003, 59% : 41%). One of the main reasons for this is late arrival in the hospital where proper help can be given (based on the Registry of Acute Coronary Syndrome of the City of Zagreb in 2003, in the first three hours 26% of women and 33% of men were admitted to the hospital, while figures change to 39% for women and 45% for men in the first six hours). Unfortunately, in Croatia there is no systematic program of prehospital care of patients before the arrival of medical staff although it has been proposed for years. The treatment of certain life-threatening arrhythmias in this phase of the disease depends on the type and level of arrhythmia, hemodynamic status and transportation time. The article provides a summary of different procedures in particular arrhythmias in comparison with the same arrhythmias in other situations and/or other etiologies.
Goldner
Vladimir
V
Salata Polyclinic, Zagreb, Croatia.
D054058:Acute Coronary Syndrome / Q000628:therapy*; D001145:Arrhythmias, Cardiac / Q000209:etiology / Q000628:therapy*; D017523:Croatia; D004632:Emergency Medical Services / Q000458:organization & administration*; D005260:Female; D006801:Humans; D008297:Male