Cardiac Arrest

I experienced my first cardiac arrest here in Atlanta the other day.  It was not really the best experience and I am not too eager to tell the story, but some have expressed an interest, so here it is.


The call was initially sent out as diabetic emergency, but as we arrived on scene we were informed that CPR was in progress.  Upon entering the residence, we found our patient a 52 year old male lying supine (on his back) with vomit all over.  Apparently, he had just finished eating dinner (chicken noodle soup) when his eyes rolled back in his head and he fell off of his chair unconscious.  Everyone was screaming and people kept running back and forth through the room as we tried to suction the vomit, get an airway in place (tube down his throat to breath for him), and get him on the monitor (put the pads on and see what his heart was doing).  As we were doing this, we had a panic stricken neighbor doing CPR till the fire department arrived.  After not being able to place a good airway because of continued vomiting and finding that our patient was in asystole (no electrical activity in the heart.  A rhythm that we can not shock) we used the fire department to get him out to the ambulance.  I had taken over on CPR after unsuccessfully being able to improving ineffective CPR being done by others (Important note: CPR has to be fast, hard (brake ribs), deep and you need to allow proper recoil of the chest.   Good CPR is the most important factor in lives being saved according to the American Heart Association).  A line for fluids and medications was then started via a IO (bone needle) into the tibia (I am not sure why that was done before any attempts were made on an IV, but we needed a line).  After giving the first round of drugs we were off and I switched back off CPR to see if I could improve the airway.  After just one second at the head, I could see that our tube (a king airway) was not getting any oxygen to the lungs.  I pulled it and found that the whole thing had become filled with partially digested chicken noodle soup.  After suctioning another 500 ml of junk out of our patient I just threw in a OPA (plastic tool used to keep the mouth open and to keep the tongue out of the way) and bagged him since we were arriving at the hospital.   For a little we had a rhythm on our monitor, indicating electrical activity in the heart, but we never felt a pulse so his heart never started beating again.


At the hospital they were able to get an NG tube in (tube to the stomach) and sucked out all the rest the chicken noodle soup and the air that had filled his stomach.  This made it possible for them the get an airway in place, but they never had anything but asystole on their monitor and the doctor ended up calling it (declaring the patient dead).  


I think I should mention that we also pushed several more rounds of drugs and checked his blood sugar on top of other things that I didn't mention above, however this was unfortunately not one we were able to save.  In every call like this you find yourself wondering if there is more you could have done or if you should have done something differently, especially when they are younger, like this guy who was only 52.  But what saves me from worrying too much, is my knowledge that there is a master physician watching over every patient that I take care of.  Our loving Heavenly Father is the master of all and he decides who will stay and who will go.  Sometimes he allows me to be an instrument in his hands to save lives, but other times he calls them back to him.  As I have worked in this field I have seen and heard about miracles were people get away from certain death without a scratch, but then other times it is just the persons time and I am coming to accept that reality.  His will be done.