Dropping Dead - What happens ?

[Landsurfer]

My heart stops .... and then restarts a few seconds later ....
I have an implanted "Reveal Insertable Cardiac Monitor" in my left breast ... ...
I have Long QT Syndrome .. every now and again my heart stops ... i get 20 - 30 minutes warning ... start getting sleepy .. then heart stops, reboots and we are up and running again .
Woke up once surrounded by paramedics with "the machine that goes bing" attached to me but wandered out to the ambulance under my own power ... which got some funny looks from the medics.
I can cycle as far as i want, climb every mountain, pedal as fast i want .... when my heart rate is raised all is well .... it's when i'm relaxed, 48 bpm ... 38 bpm ... 28 bpm .... 0 bpm ...... 58 bpm ... and then we're back in the room ...lol
It won't kill me but it frightens the living day lights out of folks ...
I carry a card in my wallet and ID tags on my bike frame .....
When my heart stops i get no great insight into life (Or death .. obviously )... no tunnel with light at the end of it .. no spectral voices or re-living of past life ... i just go to sleep ..... and snore ... alledgley .......... ....... .... . !

The last thing i need is a defibrillator ....

 

[Racing roadkill]

SCA isn't that uncommon, it happened to my lad when he was nineteen.

24/11/18 one minute he was sat next to me talking, and then all of a sudden he passed out like he'd fainted. After about thirty seconds of trying to wake him I rang for an ambulance, at 20:30 on a Saturday night, the operator kept on the phone and my wife started CPR until the ambulance arrived, and then they gave him two goes with the defibrillator to get him going again.

When you look into it it's surprising how many people it happens to each year.

It’s surprisingly prevalent in outwardly fit young people too.

 

[kingrollo]

What is a non shockable rhythm ? - does that mean game over ? - wouldn't you just try a shock in any case.

In the incident on Monday - In the incident on Monday - I heard the defrib saying 'shock advised' - obviously it didn't work

They then put a machine on her to continue to CPR - whilst she went to A+E Resus

What would they have done in Resus ?

 

[mrandmrspoves]

What is a non shockable rhythm ? - does that mean game over ? - wouldn't you just try a shock in any case.

In the incident on Monday - In the incident on Monday - I heard the defrib saying 'shock advised' - obviously it didn't work

They then put a machine on her to continue to CPR - whilst she went to A+E Resus

What would they have done in Resus ?

When a cardiac arrest occurs there can be a number of different presentations and underlying causes. A defibrillator can only correct 2 causes - they are ventricular fibrillation (where instead of contracting and pumping blood the ventricles are just twitching) and fast ventricular tachycardia (where the ventricles are trying to pump so quickly that it is not geting a chance to fill with blood in between contractions)
In both these situations the defibrillator delivers a shock to stun the heart into stopping and the hope is that the heart will then start to generate the correct electrical rhythm. (It's a bit like in the olden days when a television started flickering and you gave it a good whack on the top or rebooting a computer)
The defibrillator is not a jump starter so it cannot jump the heart into beating if the electrical activity has stopped. There are also conditions where the electrical activity of the heart is still present but there is no cardiac output - so on a heart monitor you see a normal ECG but the person has no pulse. (This is called Pulseless Electrical Activity or PEA) Shocking the heart when it is in PEA won't work because it is not the electrics causing the problem. The easiest cause of PEA to understand is hypovolaemia, where the person has had a major bleed and there is no longer enough blood in the system to pump...... in that case you would need to identify and stop the source of bleeding and give intravenous (or into the bone) fluids.
If PEA is present you always need to identify the cause and treat it directly. Other causes of PEA include opiate drug overdose (reverse with Naloxone) Cardiac Tamponade (blood gathers in the protective membrane that surround the heart and compresses the heart - draw the blood of and stop cause of bleeding). Electrolyte imbalance - essential elements such as Potassium are disordered (correct electrolyte imbalance) Hypothermia (continue CPR while rewarming the patient)
Tension pneumothorax (a lung is leaking air into the chest cavity - insert a chest drain to allow chest to deflate). There are a few more causes but that gives you an idea of what may happen in resus.
On top of the above the resus team will intubate to get a secure airway, continue to monitor the electrical output because it can change so someone who presents with a non-shockable rhythm may as a result of CPR or treatment develop a shockable rhyrhm. Drugs like Adrenaline and Atropine are normally used to stimulate or regulate cardiac electrical activity so they will be administered at intervals as indicated. Bloods will be collected if possible to identify abnormalities with electrolytes and check blood sugar to ensure it isn't too low or high.
In an unexpected cardiac arrest resuscitation attempts will normally continue for at least half an hour.

 

[ColinJ]

A remarkably detailed reply!

you would need to identify and stop the source of bleeding and give intravenous (or into the bone) fluids.

That sounds really odd! How does that work, and why is it done?

 

[midlife]

Bone has a good blood supply, sticking fluids into the bone cavity is almost the same as putting it into a vein. Usually done in major trauma / battlefield / can’t find a vein.

 

[ColinJ]

I learn something new every day!

 

[mrandmrspoves]

A remarkably detailed reply!


That sounds really odd! How does that work, and why is it done?

That was the abbreviated version! (I couldn't sleep anyway)

Yes where a person has collapsed their veins usually deflate as well, making it very hard to get a cannula in. (Really good CPR sometimes helps prevent this but it is often still a problem)
The intraossoeus route uses a small hollow drill piece that is driven through the skin into the bone by a small device like an electric screwdriver. The site chosen will be a place where the bone is just under the skin for example the very top of the arm or on the front of the leg just below the knee. From start to finish it takes less than a minute to inserts an IO cannula (much of that time is spent disinfecting the skin surface) once the cannula is inserted fluids can be administered pretty much in the same way as if the cannula was in a vein.

 

[kingrollo]

Still can't get my head around that you can be having a conversation with an apparently healthy person - 5 second s later they are dead.

 

[mrandmrspoves]

Still can't get my head around that you can be having a conversation with an apparently healthy person - 5 second s later they are dead.

It is hard to come to terms with - especially when witnessed up close and even more so when the person is relatively young.
None of us know how long our clock will keep ticking and that includes seemingly fit people.

 

[stephec]

Still can't get my head around that you can be having a conversation with an apparently healthy person - 5 second s later they are dead.

It happens, SCA has no warning signs, one minute I was sat next to my son talking to him and without any warning he closed his eyes and fell to the floor in front of me. I

 

[Slick]

Deleted as I didn't read the entire thread.

 

[alicat]

^^^^ Stephec says in post 45 that he and his wife managed to revive their son. Still very scary, though!

 

[Slick]

^^^^ Stephec says in post 45 that he and his wife managed to revive their son. Still very scary, though!

Thanks.

 

[confusedcyclist]

I spotted a few misconceptions in the thread, Defibrillators don't and can't restart an arrested (stopped) heart, they actually stop the heart, interrupting an abnormal rhythm, so it starts again hopefully in proper rhythm. The intention of CPR is to fill the lungs with air, and attempt to get the heart pumping again by supplying the body with oxygen once more. Automatic defibrillators won't actually work in cases of Cardiac Arrest, they only work for atrial fibrillation, you don't need to worry about that because AEDs are smart enough to know this for you. If someone collapses to the ground, and they are non-responsive, perform CPR. If they don't need CPR, they will be protesting your painful attempts. If they don't respond, just keep going. Pump 30 times, blow air, repeat until an ambulance arrives.