RESIA. Saved by the alertness of those present and the presence of a defibrillator nearby. A practical demonstration of the usefulness of a Dae device at hand took place on the afternoon of Wednesday 10 August when, at about 3.10 pm, a man in 1956 suffered sudden cardiac arrest while he was near Malga Coot, in Municipality of Resia (165 people suffer sudden cardiac arrest every day in Italy). In these cases the time factor is decisive for the survival of the victim, since if some maneuvers are not carried out – within everyone’s reach – after 10-12 minutes the probability of survival without devastating neurological damage is negligible.
In this case, however, the witnesses (trained in cardiopulmonary resuscitation maneuvers in
as Cnsas volunteers) promptly activated 112 by telephone, receiving the
pre-arrival instructions (IPA) by the Nurse on duty, with instructions to retrieve the nearest defibrillator (which was fortunately located about 20 meters away from the place where the man had accused the illness) and to start chest compressions external, guided and assisted by the expert nurse via telephone. After less than a minute the defibrillator had already been connected to the victim, indicating the need to deliver one
electric shock to stop the ventricular fibrillation that caused the arrest
sudden cardiac arrest (statistically 70% of out-of-hospital sudden cardiac arrests
begins with this malignant but still treatable arrhythmia) the operator on site then delivered the electric shock and immediately resumed chest compressions, obtaining a resumption of vital signs (movements and breathing) at the end of 2 minutes of chest compressions.
In fact, on subsequent analysis, the defibrillator did not indicate the need for further electrical therapies.
Meanwhile the Sores had activated the Udine helicopter rescue, together with the ambulance from the Chiusaforte post, in support of the operations.
The patient, reached by the helicopter rescue resuscitator, was then stabilized and transported
at the Udine hospital in sufficiently stable conditions, given the situation, where further investigations and treatments are underway.
This event represents the exemplary implementation of the “chain of survival”, which is a useful metaphor for understanding the decisive maneuvers and actions to obtain the best outcome in terms of survival from non-traumatic sudden cardiac arrest:
1) formation of the population through Blsd courses dedicated to the laity;
2) information on the location of the defibrillators in order to make them readily usable to the
need;
3) early activation of Nue 112 and Sores;
4) early start of chest compressions, guided by the operator Sores (instructions pre
I arrive);
5) early positioning of the defibrillator on the victim’s chest and eventual delivery
of the shock;
6) continuation of guided cardiopulmonary resuscitation maneuvers until the arrival of medical help;
7) Hospitalization dedicated to the victims of cardiac arrest with a multidisciplinary team expert in the management of the subsequent phases of the disease.
But how did the Resia event become feasible?
Financial assistance from some sponsors (Primacassa – Friulovest bank and Zkb bank)
together with the logistical support of Cnsas Fvg and training from the Federation
Italian Sports Doctor, with the coordination of Sores allowed to position
in 31 mountain sites in our region a kit consisting of defibrillators and haemorrhage kits to guarantee life-saving maneuvers by the present trained in this regard (First Responders)
in case of sudden cardiac arrest or life-threatening bleeding. The project –
first in Italy as far as we know – it also provided for the provision of Blsd and Stop the Bleed training courses to managing volunteers or in any case residing in the areas of
shelters (a total of 300 volunteers trained).
The list of structures equipped with kits with geolocation and the ability to activate rescue, pending the intervention of 118, is obviously managed and known to Sores through the
own computer system, but by the end of the year it will be made available to the public through an App specifically built for these purposes.