Resuscitation of patients with ischaemic heart disease before admission to hospital

Abstract

This paper provides data about the efficacy of resuscitation before hospital admission of 139 patients with myocardial infarction. Successful resuscitation was effected in 43 (30.9 percent) patients, of whom 29 (20.9 percent) survived and were discharged from hospital. An organizational scheme is given for resuscitation measures before admission, in which the following teams participate: premedical, general first-aid ambulance team and specialized first-aid cardiological team (Mobile Coronary Care Unit, MCCU - definition of World Health Organization). The effectiveness of resuscitation depends upon the patient's age, and the presence and degree of circulatory insufficiency before clinical death. It proved possible to revive successfully patients of advanced age and with proceding mild or moderate acute circulatory insufficiency. Resuscitation was not successful in patients with preceding severe circulatory insufficiency. Blood electrolytes were studied in the post-resuscitation period. There was a statistically significant decline in plasma potassium ion concentration. Potassium salts should be introduced in the form of a polarizing mixture, especially to patients with an irregular cardiac rhythm in the post-resuscitation period. Problems of intracardiac injections of drugs, intubation, and pervenous electric pacing in patients with myocardial infarction during resuscitation are discussed. It has been concluded that the optimum form of resuscitation before admission of patients with myocardial infarction involves rendering maximal aid at the place of occurrence of the infarction.