Zastosowanie automatycznego defibrylatora zewnętrznego w warunkach górskich

Sylweriusz Kosiński, Zdzisław Trella, Dariusz Kałuża

Summary
Background. Automated external defibrillators (AEDs) have been designed for use by non-medical rescuers and laypersons in cases of unexpected cardiac arrest. Medical professionals may also use these light and easy to operate devices. We describe two cases of resuscitation of avalanche victims during which the AED was used. Case report 1. A 21-year-old male was caught in an avalanche and was dug out after app. 50 minutes. Presence of an air pocket indicated the possibility of breathing after the accident. Cardiopulmonary resuscitation was initiated during the extrication and because of ventricular fibrillation, three unsuccessful shocks were delivered. Because of the failure of a conventional defibrillator, an AED was used and, after delivering the three further shocks, spontaneous circulation was restored. The core temperature measured rectally on arrival at hospital was 28.7°C. The patient did not regain consciousness and has remained in a vegetative state. Case report 2. A 22-year-old male climber was caught in an avalanche and remained under the snow for 45 minutes, with an air pocket around his face. The patient was found asystolic, but after 3 min of CPR his heart began to fibrillate. After 16 minutes of resuscitation and two defibrillations from the AED, spontaneous circulation was restored. Core temperature on hospital arrival was 31.2°C. The patient did not regain consciousness and died after 30 days. Discussion and conclusions. This is the first report on the use of AEDs during rescue operations in mountain terrain of limited accessibility. We did not encounter any technical problems while defibrillating. In both cases, spontaneous circulation was restored despite the deep hypothermia. Light, rugged and reliable AEDs can be used instead traditional defibrillators during mountain rescue.

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