A 74-year-old male with a history of hypertension and transient ischemic attack 6 months ago.
In usual treatment with anti-hypertensive drugs.
She was attended by a primary care physician due to coronary pain and vegetative cut.
ECG confirmed ST-segment elevation coronary syndrome (STEACS) in the lower face.
The patient was treated with clopidogrel (300 mg vo), metclopramide and hemodynamic chloride protocol, and angioplasty was performed. At the same time, the Advanced Life Support Unit (AVS) was activated in the next room, confirming the diagnosis and active
Loading treatment with clopidogrel 300 mg vo, ASA 250 mg according to protocol, and fluid therapy is adjusted prior to air transfer.
The patient is seated in helicopter and activated simultaneously with SVA.
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During flight, the patient has a ventricular cardiorespiratory arrest (CA) (VF), which, after a protocol of flight performance is treated with biphasic consolidation at maximum dose of fibrillation (200).
After three discharges and persistence of the rhythm, we proceeded to a brief face-to-face consultation in order to maintain depth above the point maneuvers of advanced life support, performing a quality cardiopulmonary resuscitation (CPR) achieving a minimum.
The patient enters and persists in rhythm refractory to electrical and medical treatment with transient episode of polymorphic ventricular tachycardia.
The following drugs were administered: amiodarone 300 mg-150 mg iv, NSAID 1/ 4 IV, magnesium sulphate 1.5 mg iv.
After 31 discharges and 58 minutes of CPR, the ROSC patient, although in a situation of hemodynamic instability (TA 81/57), requires sedation, analgesia infusion of noradrenaline and amiodarone.
The flight continues to the intended hospital.
1.
The patient is directly linked to the catheterization laboratory where complete occlusion of the right coronary artery is observed, resulting in aspiration of the component and placement of a conventional stent in the proximal-media area, with good results.
After primary angioplasty, the patient was admitted to the ICU with amines infusion, which were progressively withdrawn due to good response, sedoanalgesia, relaxation, muscle, mechanical ventilation, and therapeutic hypothermia for up to 34 hours.
1.
After 30 hours of admission, adequate level of consciousness was found in the sedation window, and successful extubation was performed.
Due to the favorable evolution, it was decided to refer the patient to Perfom at 48 hours, to the Cardiology Unit, without presenting any type of arrhythmia in the following days, although it required up to 5 antihypertensives at full doses for tensional level 1, No
The patient was discharged on the eighth day of admission with antihypertensive treatment, beta-blocker and baseline diuretic.
