Surviving Cardiac Arrest...

 SHIFT 24...Rick's ReFlections of his 32 years career in the Fire Service...

Stand by for medical…Rescue 82, Engine 80 respond to a CH1, man down with CPR in progress at the ramp to Concourse ‘A’. There are many times that we reach a patient and have plenty of time to think, to observe, to plan and take action. Then there are other times…taking action is the only thing that matters, and fast is the only way. The ‘cardiac arrest’ patient is unquestionably one to expedite on. Arriving on this patient, CPR was in fact in progress. Also, one of our Lieutenants was in the area doing inspections, so he had run to his vehicle and grabbed his AED (automatic external defibrillator). We just so happen to both arrive at the same time so I took his ‘fun’ from him. A fact that he’s never let me forget. Anyway…I begin directing our crews to continue CPR, one begins using the Bag valve mask, another sets up the intubation equipment, another begins to search for an IV and I have the monitor.

 

This cardiac arrest or ‘code’ as we call them was running smoothly, but we just never seem to convert the patient into a normal or even different rhythm for that matter. In fact nearly 15 to 20 minutes had gone by and we continue administering our ACLS meds, CPR, shocking his V-Fib, when all of a sudden the patient’s rhythm does change. With any change back in those days we were to confirm if there was a pulse or not. With nearly 20 minutes of down time, I was sure that our 60+ year old patient was in a ‘psuedo’ or PEA rhythm. I was quite surprised when Ken, who was performing CPR, says: “he’s got a pulse”. I couldn’t believe it, so I checked for myself. The dude had not only had a pulse, but it was pounding. We package the patient and off to the ER he goes. My second great surprise came the next shift at briefing when they start talking about our ‘code’ from the previous shift. “Hey”, one of the guys says, “did you hear about our code”? “No, I said”. “They say he went home yesterday”.

 

The above scenario is rarely the case. Cardiac Arrest victims even today still have a dismal 5% survivability, especially when someone’s been down for greater than 5 minutes, and 15 minutes…almost unheard of. It is always great to hear about a good outcome for a patient. Of course it’s great for him or her, but also a definite morale booster for us. I sometimes wonder what an individual, such as this patient, did with his or her ‘new lease’ on life. It would be a fun conversation over coffee to listen to them tell their story of how things might have changed. Unfortunately (with HIPPA) we seldom even hear about a patient’s outcome let alone what difference a good outcome might have made.