So I helped save a life last night...

[TraumaRN]

The patient was about to be discharged last night on my shift, he had just gotten a sandwich and juice from us and was waiting on us to discharge him from the ER when he very suddenly collapsed back into his stretcher. I was about 15-20 feet away when it happens and immediately ran over to assist.

The attending ER physician did a quick primary survey checking ABCs as I checked for a pulse. There was none. I immediately started doing chest compressions as the attending physican tore past me and yelled for help and she grabbed the crash cart. In the mean while I continued to do chest compressions with one hand and managed to put him on the cardiac monitor with the other(thankfully he was directly under a monitor)

The monitor showed asystole, by this time the ER resident was there, as was our ER pharmacist, 2 other nurses, a respiratory therapist and an EMT student. I was doing continous chest compressions at this point, as the ER resident used a glidescope to intubate without having me stop chest compressions. The other nurse gave epinephrine and atropine. The patient is now on the ventilator. I hold compressions after 2 minutes for a rhythm check. He's in Pulseless electrical activity I continue my chest compressions for another 2 minutes and we check for a pulse...

And SUCCESS! He has a pulse, and a blood pressure. We hold CPR. He's back. We call the neurologist and cardiology. Neurology wants to induce hypothermia, so we put him on a machine called an Arctic Sun that cools his body temperature to 92-93F. An hour later I take him up to the ICU where he still remains. He's slowly becoming more responsive and they hope to stop the hypothermia today. Since he had immediate CPR and then hypothermia he should manage to have a similar level of brain function and normal function as well.

And just for those wondering, he crashed because of hypoxia/hypercapnia, which only become apparent after we drew an arterial blood gas. His pCO2 was 92(!!!)

Afterwards I felt pretty darn good. Its not often you can bring someone back from sudden cardiac arrest.

 

[JohnCU]

so he was dead? how'd he get exposed to the co2?

 

[Fritzo]

Nice work. Something you'll remember for the rest of your life


I remember the last time I saved someone's life..

:::FLASHBACK:::

 

[Ns1]

wow, props to you good sir

you interested in a job at a nearby hospital? lol

 

[KeithTalent]

Originally posted by: Fritzo
Nice work. Something you'll remember for the rest of your life


I remember the last time I saved someone's life..

:::FLASHBACK:::

Bwahaha, classic! :thumbsup:

Grats OP! :beer:

KT

 

[RiverDog]

First job was at a hospital, it's something you never forget. Good Job!!

 

[indamixx99]

Good stuff! :thumbsup:

 

[MmmSkyscraper]

:beer::thumbsup:

 

[Injury]

Originally posted by: JohnCU
so he was dead? how'd he get exposed to the co2?

Kinda curious about this, too.

What are the requirements to be considered "dead"? Beyond resuscitation? No breathing/pulse?

 

[Azraele]

What caused the hypoxia/hypercapnia? And why was he in the Er to begin with?

 

[ranmaniac]

:thumbsup:

 

[ATLien247]

Had you not already been at the hospital, would you say that performing CPR for the same man would mean a lower chance of resuscitation?

 

[jandrews]

I thought this was going to be some fantastic story about some ordinary guy giving cpr to someone on the street but it appears he was already at the hospital anyway lol. Props for saving him though of course.

 

[TraumaRN]

Originally posted by: Injury

Originally posted by: JohnCU
so he was dead? how'd he get exposed to the co2?

Kinda curious about this, too.

What are the requirements to be considered "dead"? Beyond resuscitation? No breathing/pulse?

Clinically dead as in no pulse/vital signs.

Originally posted by: Azraele
What caused the hypoxia/hypercapnia? And why was he in the Er to begin with?

He was originally in the ER for an asthma attack, what probably happened was that he had air trapping in his lungs. As in he wasnt effectively exhaling all the air out when he breathed out. Usually you see it in asthma patients who are children and people with COPD. He didn't have COPD so it is a bit of a mystery. But either way his own ineffective respirations eventually shut down his own respiratory drive.

Originally posted by: ATLien247
Had you not already been at the hospital, would you say that performing CPR for the same man would mean a lower chance of resuscitation?

Probably yes. The ability to instantly start CPR and give the appropriate drugs and securing an advanced airway(intubation then on a ventilator) saved his life.

 

[Cattlegod]

sweet, sounds like something off of a show.

 

[KK]

how old was the patient?

 

[sandmanwake]

Originally posted by: DeathBUA


And just for those wondering, he crashed because of hypoxia/hypercapnia, which only become apparent after we drew an arterial blood gas. His pCO2 was 92(!!!)

You lie. It was lupus.

 

[Eli]

Weird. You would think that someone would pass out and be rather incoherent if they were breathing but not actually respirating enough to sustain themselves.

 

[TraumaRN]

Originally posted by: Eli
Weird. You would think that someone would pass out and be rather incoherent if they were breathing but not actually respirating enough to sustain themselves.

except in the case of hypercapnia. His entire drive to breath basically shut down, respiratory failure/arrest, hence why he didn't just pass out.

 

[jagec]

Originally posted by: ATLien247
Had you not already been at the hospital, would you say that performing CPR for the same man would mean a lower chance of resuscitation?

Do you mean versus not performing CPR at all?

 

[Minjin]

What do you think about the "new style" of CPR? That is, doing it sans mouth-to-mouth. I remember reading a while back how statistically they were shown to be no different. And I just saw something in the news recently about it so it must be picking up steam.

 

[rise]

:thumbsup:

having spent more than my fair share of time in hospitals, i admire what you guys do. not just in the life saving situations, but what you guys do everyday. personally, i could never do it.

 

[ATLien247]

Originally posted by: jagec

Originally posted by: ATLien247
Had you not already been at the hospital, would you say that performing CPR for the same man would mean a lower chance of resuscitation?

Do you mean versus not performing CPR at all?

No, I meant if he were not at the hospital. Like, say he was at home, without a defibrillator, and EMTs were 10 minutes away.

 

[TraumaRN]

Originally posted by: Minjin
What do you think about the "new style" of CPR? That is, doing it sans mouth-to-mouth. I remember reading a while back how statistically they were shown to be no different. And I just saw something in the news recently about it so it must be picking up steam.

Well CPR for us is usually continual chest compressions. There is no 30-2 or any of that. Because we have 4-8 people around in a situation like that. And one of the first thing we did is secure an advanced airway. And if you read ACLS(advanced cardiovascular life support) protocols it calls for continous compressions once and advanced airway is placed. The breathing to some extent is less important than the chest compressions.

 

[TraumaRN]

Originally posted by: ATLien247

Originally posted by: jagec

Originally posted by: ATLien247
Had you not already been at the hospital, would you say that performing CPR for the same man would mean a lower chance of resuscitation?

Do you mean versus not performing CPR at all?

No, I meant if he were not at the hospital. Like, say he was at home, without a defibrillator, and EMTs were 10 minutes away.

Odds are very very very against his survival.

I'll put it this way, odds of survival when you have out of hospital cardiac arrest are about 6% on a national basis whether there was immediate CPR or not. And not matter where the person suffers a cardiac arrest every minute that passes WITHOUT CPR decreases survival rate by roughly 10%. So after 10 minutes your odds of survival are essentially zero.

Also more food for thought, immediate CPR whether in hospital or out of hospital increases odds of survivial approximately 2-4 times, then when immediate CPR isnt performed.