Abstract
European Resuscitation Council Guidelines for Resuscitation 2010 and Advanced Life Support Provider Course teaches that the open oxygen supply must be removed from the patient during defibrillation to the distance of minimum of 1 meter. Scientific articles describe few incidents of fire during defibrillation in oxygen – enriched atmospheres. It was performed a series of measurement of the oxygen concentration in the ambulance vehicle of 10 cubic meters. The measurements were made in parked vehicle. Patient was seated on the stretchers and oxygen was applied with oxygen mask on high flow (15 l per minute). The oxygen concentration was measured on different places in the ambulance car – the patient’s face, on the chest, on the wall in front of the car, on the wall in the rear and on the celling. We measured temperature, atmospheric pressure and humidity together with oxygen concentration. The result of our study showed that the oxygen concentration has risen from 20.9 % at all locations of the ambulance. In certain locations the concentration has increased at least to 30 %. It has prepared recommendations for defibrillation during oxygen administration according to the literature and our study.
Highlights
European Resuscitation Council Guidelines for Resuscitation 2015 (Nolan et al, 2010) and Advanced Life Support Provider Course (ERC, 2011) teaches that the open source of oxygen must be removed from the patient during defibrillation to the distance of minimum of 1 meter
The question is if the fire can occur in the situation of ambulance transportation, when the patient is on high flow oxygen (15 l/min) and suddenly collapse and the cardiac arrest occur and we will start with immediate defibrillation
The result of our study showed that the oxygen concentration has risen from 20.9 % at all locations of the ambulance
Summary
European Resuscitation Council Guidelines for Resuscitation 2015 (Nolan et al, 2010) and Advanced Life Support Provider Course (ERC, 2011) teaches that the open source of oxygen (e.g. face mask, bag valve) must be removed from the patient during defibrillation to the distance of minimum of 1 meter. Scientific articles describe few incidents of fire during defibrillation in oxygen – enriched atmospheres. In the second case the personnel leave the open source of oxygen from the respirator on the chest of the patient, where the ECG leads were connected. During the 5th defibrillation attempt the fire occurred on the chest and went to the source of oxygen and burn out the respirator. In the 1995 another case was published in Scotland, where the oxygen enriched bedding ignited. A. Theodorou et al published in the Paediatrics, where there was ignition of bedding. Theodorou et al published in the Paediatrics, where there was ignition of bedding The result of this incident is a recommendation to avoid contact of oxygen and bedding (Lefever, 1995). The same recommendation is in the guide manual of medical oxygen gas (Conoxia, 2007)
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