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DOI: 10.1055/s-2005-861032
Frühdefibrillation im Gletscherskigebiet: übertrieben oder Überleben? 3 Fallberichte und eine Standortbestimmung
Public Access Defibrillation in Alpine Skiing Areas: Three Case Reports and a Brief Survey of the LiteraturePublication History
Publication Date:
16 March 2005 (online)
Zusammenfassung
In den Wintermonaten der Jahre 2002 - 2004 erleiden drei Menschen im Skigebiet der Stubaier Gletscherbahnen in Tirol (Österreich) einen Herz-Kreislauf-Stillstand aus nicht-traumatologischer Ursache. Sie werden vom Personal des Pistenrettungsdienstes mit Hilfe des Einsatzes von halbautomatischen Defibrillatoren (AED) wiederbelebt. Zwei der drei Patienten überleben das Ereignis primär; in einem Fall bis zur Krankenhausentlassung ohne neurologische Folgeschäden. Der Artikel beschreibt am Beispiel dieser Notfallsituationen die Rettungskette bei einem vital bedrohlichen Zwischenfall in einer hochalpinen Region, die Implementierung eines modifizierten Public-Access-Defibrillation-Systems in einem Gletscherskigebiet, sowie die Voraussetzungen für eine sinnvolle Anwendung der Frühdefibrillation außerhalb des professionellen Rettungsdienstes.
Abstract
In the months of winter 2002-2004, three cases of non-traumatic cardiac arrest occurred in the skiing area of the Stubaier Gletscher in Tyrol, Austria. All patients were initially resuscitated by ski patrol members, including the use of an automated external defibrillator (AED). Two of the patients were alive at hospital admission, one patient was discharged from hospital without neurological damage. The article describes the chain of survival in a high-alpine area, the installation of a modified public-access-defibrillation (PAD) system in a skiing area, and the prerequisites necessary for a successful PAD-program far away from an organized emergency medical system.
Schlüsselwörter
Frühdefibrillation - AED - kardiopulmonale Reanimation - Laienhelfer - alpine Region
Key words
Public Access Defibrillation - AED - cardiopulmonary resuscitation - lay rescuers - alpine area
Literatur
- 1 Burtscher M, Philadelphy R, Likar P. Sudden cardiac death during mountain hiking and downhill skiing. N Engl J Med. 1993; 329 1738-1739
- 2 Siskovic D S, Weiss N S, Fletcher R H, Lasky T. The incident of primary cardiac arrest during vigorous exercise. N Engl J Med. 1984; 311 874-877
- 3 DeLuna A B, Coumel P, Leclercq J F. Ambulatory sudden cardiac death: Mechanisms of production of fatal arrhythmia on the basis of data from 157 cases. Am Heart J. 1989; 117 151-159
- 4 Handley A J, Bahr J, Baskett P, Bossaert L, Chamberlain D, Dick W, Ekstrom L, Juchems R, Kettler D, Marsden A, Moeschler O, Monsieurs K, Parr M, Petit P, van Drenth A. The 1998 European Resuscitation Council guidelines for adult single rescuer basic life support: A statement from the Working Group on Basic Life Support, and approved by the executive committee. Resuscitation. 1998; 37 67-80
- 5 Cummins R O, Ornato J P, Thies W H. AHA Medical/Scientific Statement. Improving survival from sudden cardiac arrest: the chain of survival concept. Circulation. 1991; 83 1832-1847
- 6 Cummins R O, Eisenberg M S, Hallstrom A P, Litwin P E. Survival of out-of-hospital cardiac arrest with early initiation of cardiopulmonary resuscitation. Am J Emerg Med. 1985; 3 14-119
- 7 Carrington D J. Proceedings of the 6th World Congress on Disaster and Emergency Medicine. Hong Kong; Excerpta Medica 1989: 66
- 8 Cummins R O, Eisenberg M S, Hallstrom A P. Prehospital cardiopulmonary resuscitation: Is it effective?. JAMA. 1985; 253 2408-2412
- 9 Lewi P J, Mullie A, Quets A. Relevance and significance of pre-CPR-conditions in cardiopulmonary resuscitation: A graphic analysis by means of Spectramap. Resuscitation. 1989; 17(Suppl) S35-S44
- 10 The American Heart Association in Collaboration With the International Liaison Committee on Resuscitation (ILCOR). Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care - An International Consensus on Science. Part 4: The automated external defibrillator: key link in the chain of survival. Resuscitation. 2000; 46 73-91
- 11 Larsen E, Cummins R O, Hallstrom A P. Predicting survival from out-of-hospital cardiac arrest: a guide graphic model. Ann Emerg Med. 1993; 22 1652-1658
- 12 Caffrey S L, Willoughby P J, Pepe P E, Becker L B. Public use of automated external defibrillators. N Engl J Med. 2002; 347 1242-1247
- 13 Capucci A, Aschieri D. Results of early defibrillation program in Piacenza. Minerva Anesthesiol. 2003; 69 353-356
- 14 Capucci A, Aschieri D, Piepoli M F, Bardy G H, Iconomu E, Arvedi M. Tripling survival from sudden cardiac arrest via early defibrillation without traditional education in cardiopulmonary resuscitation. Circulation. 2002; 106 1065-1070
- 15 Valenzuela T D, Roe D J, Nichol G, Clark L L, Spaite D W, Hardman R G. Outcome of rapid defibrillation by security officers after cardiac arrest in casinos. N Engl J Med. 2000; 343 1206-1209
-
16 Breitfeld L, Voelckel W.
Der plötzliche Herztod im Gebirge und halbautomatische Defibrillatoren - grundsätzliche Überlegungen. In: Sumann G, Schobersberger W, Mair P, Berghold F ÖGAHM Jahrbuch. 2002: 55-66 - 17 The Public Access Defibrillation Trial Investigators . Public-access defibrillation and survival in out-of-hospital cardiac arrest. N Engl J Med. 2004; 351 637-646
- 18 Cobb L A, Fahrenbruch C E, Walsh T R, Copass M K, Olsufka M, Hallstrom A P. Influence of cardiopulmonary resuscitation prior to defibrillation in patients with out-of-hospital ventricular fibrillation. JAMA. 1999; 281 1182-1188
- 19 Wik L, Hansen T B, Fylling F, Steen T, Vaagenes P, Auestad B H, Steen P A. Delaying defibrillation to give cardiopulmonary resuscitation to patients with out-of-hospital ventricular fibrillation: a randomized trial. JAMA. 2003; 289 1434-1436
- 20 Gundry J W, Comess K A, DeRook F A, Jorgensen D, Bardy G H. Comparison of naive sixth-grade children with trained professionals in the use of an automated external defibrillator. Circulation. 2000; 100 1703-1707
Dr. Hannes Lienhart
Univ.-Klinik für Anästhesie und Allg. Intensivmedizin
Anichstraße 35 · A-6020 Innsbruck
Email: hannes.lienhart@uibk.ac.at