Compression only CPR

In the time since the American Heart Association has begun advocating Compression Only Layperson CPR, I haven’t really heard and stories of confirmed success. While we all know that layperson CPR tends to be inadequate and layperson CPR breathing tends to end up in the stomach, there has been little to indicate that the outcome was any different than before.

Well, JEMS has a story that might just give us some hope that the AHA did the right thing. CNN has the full story. There are some interesting facts to consider in this story. First, the patient was a 33 year old female–not a likely case for sudden cardiac arrest, under most circumstances. Second, she was otherwise healthy, with no known cardiac history. Third of importance to me is that her husband is a Sheriff’s deputy–While he says that it was “different” that being at work, there is little doubt in my mind that his training and experience helped in some way. Fourth, but maybe the most important thing here–a skilled dispatcher walked him through CPR–Compression Only CPR. All of these factors are important.

Lets examine what we can–33 year old women rarely experience sudden cardiac arrest. When they do it is usually caused by other (known or unknown) serious medical conditions–cancer, immune disorders, cardiovascular disease, etc. Initially it was uknown what caused Kathie Harden to die for 18 minutes that night. Kathie being just 33, her husband actually waking up just prior to her losing pulses, outstanding Dispatch direction, quick EMS response, and skilled hospital care can all be thanked. After her initially recovery it is found that she contracted a flu-like virus that attached itself to the left side of her heart, deteriorating heart muscle and function until the Right side of her heart could no longer function. She now lives with an internal cardiac pacer/defirilator.

After arriving at the hospital, Post-Arrest Cardiac Hypothermia was used to cool Kathie’s body to abnormally low temperatures. This is useful in protecting heart and brain function. It allows the body time to repair and recover before trying to fully “restart”. Initially neuro exams did not look good, but after just a few hours Kathie had started to show signs of improvement. After 18 hours Kathie was back from the grips of death. Theraputic Hypothermia was discontinued. She was soon on her path to recovery and “life went on”.

So here’s the thing: what saved Kathie? Was it Compression only CPR? Was it her skilled husband? How about fast EMS response? Her age? All signs indicate that all of these factors were essential to her survival. Most Certianly the Flagstaff EMS Calltaker that helped Scott pound on his wife’s chest that night deserves more than just a little credit. Arizona has worked hard to increase Cardiac Arrest Survivability and this is proof they are winning the battle. Keeping callers calm while giving them the tools to prolong life until destination care can be provided is no easy task and the fine people in EMS call centers everywhere need to be given credit.

Does this mean Compression Only CPR is the end all of Cardiac Arrest Care? Obviously not. Kathie recieved several rounds of CPR and several shocks from the AED brought by EMS. In the end cardiac drugs(epi) and defibrilation saved Kathie. But without early Compression only CPR it is certain that the tools EMS brought with would have had little chance to obtain ROSC.

I’d like to congratulate Flagstaff EMS Dispatch, Scott Harden, and the men and women of Flagstaff Medical Center EMS for providing outstanding care to Kathie that night. Every one of them did their part in saving a life–something that sadly most of us rarely get the opportunity to do, despite our profession.