Dropping Dead - What happens ?

[stephec]

My wife kept up CPR until the ambulance arrived, half eight on a Saturday night and we still got an ambulance and two paramedic cars within ten minutes, they were top class, two of them even came up onto the ward a week later to see how he was.

They got him going again before taking him to hospital where he spent a week in an induced coma. We were told on the second day that as he'd been without oxygen for up to twenty minutes severe brain damage was quite likely, and when he first woke up he was slow to react.

There's obviously no way the doctors could predict what recovery he'd make, it seems some people make a full recovery whilst others are not so lucky, just pot luck.

At first he looked similar to someone who's had a stroke, he spent from 24/11/18 to 12/07/19 in hospital, over half the time in a neuro rehab ward, and he's still having therapy now that he's home.

 

[mrandmrspoves]

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.

Much of what you have written is described in my previous post . You are incorrect on a couple of points. A defibrillator WILL work in a cardiac arrest - but only if the cause is Ventricular Fibrillation OR Fast Ventricular Tachycardia.
Cardiac arrest refers to a number of different situations all of which result in cessation of circulation but not all are caused by loss of cardiac electrical activity (asystole)or even cardiac contraction.
CPR will not normally restart the heart and it is not its function to do so. Restarting the heart normally depends on defibrillation or administration of adrenaline or reversing the reversible causes, some of which I describe under Pulseless Electrical Activity.
CPR hopefully achieves maintenance of oxygenated blood flow to the vital organs and in doing so it helps prevent the blood clotting in the organs - which when it occurs often leads to multi organ failure and death even if the heart is initially restarted. Another important and little known effect of CPR is to decompress the heart. (When the heart stops beating, it becomes swollen and engorged with blood that makes it more difficult for it to respond to the electrical stimulation that may still be present. Hence on commencement of CPR a defibrillator may not indicate that there is a shockable rhythm but after effective CPR a shockable rhythm may then be identified.
You're absolutely correct that a public access defibrillator (AED) will detect whether a shockable rhythm is present and cannot harm the patient as it will only deliver a shock if one is needed.

 

[Slick]

My wife kept up CPR until the ambulance arrived, half eight on a Saturday night and we still got an ambulance and two paramedic cars within ten minutes, they were top class, two of them even came up onto the ward a week later to see how he was.

They got him going again before taking him to hospital where he spent a week in an induced coma. We were told on the second day that as he'd been without oxygen for up to twenty minutes severe brain damage was quite likely, and when he first woke up he was slow to react.

There's obviously no way the doctors could predict what recovery he'd make, it seems some people make a full recovery whilst others are not so lucky, just pot luck.

At first he looked similar to someone who's had a stroke, he spent from 24/11/18 to 12/07/19 in hospital, over half the time in a neuro rehab ward, and he's still having therapy now that he's home.

I didn't realise any of that. I'm delighted to hear it worked out.

 

[stephec]

I didn't realise any of that. I'm delighted to hear it worked out.

Thanks Slick, we know he'll probably never get back to where he was before, but as we were told that 9/10 out of hospital SCAs don't survive we're more than just a bit lucky.

In all honesty the only reason he's alive is because I couldn't find anything to watch on Netflix. My wife had already told me that he was wanting a chat with me about work, so when he came in that night and asked me I was going to suggest going to the pub the next day to talk about it, but when he came in I still hadn't started watching something so I went into his room and twenty minutes later it happened.

If he'd have been on his own it would've been an hour before anyone found him, to say he's a bit lucky is quite an understatement.

 

[steve292]

You did your best in a very stresful situation when many would have panicked or walked away. If the heart is in fibrilation as other people here have said , CPR will keeep them alive, but only the defib will shock the heart allowing it to restart.

spolier.. he does not die. its a good ending

This is a youtube video that I was shown on a first aid course. It shows both the agonal breathing reflex and how effective the defibrillator can be. The guy in the video goes from being literally at his last breath to talking to the lifeguards and knowing who and where he is.
If there is a defib available to you it should be one of the first things to get after the initial assesment, along with raising the alarm/calling for help

 

[byegad]

It's always going to be a shock to those left bereaved. My dad had two heart attacks. First one at 47, felt ill, came me from work, called doctor, who called ambulance. After 5 days in ITU, as it was called in those days, he made a reasonable recovery.
Second one, 16 yrs later, while waiting for a traffic light to change to allow him, Mam, my sister and brother in law to cross the road, the lights changed, 3 people started to cross, he said to Mam, hang o......

He was, according to the coroner, effectively dead before he hit the floor. A massive infarction. He hit his head as he hit the floor and his cap had virtually no blood on it at the point of contact. His heart had stopped beating during the fall/topple. We knew from the first attack that he was on borrowed time, a very heavy smoker from 14, he stopped the day of the first attack, but too late to allow him to reach a true old age.

Mam took a month to die, suffering progressive organ failure. I know how I want to go!

 

[Slick]

Thanks Slick, we know he'll probably never get back to where he was before, but as we were told that 9/10 out of hospital SCAs don't survive we're more than just a bit lucky.

In all honesty the only reason he's alive is because I couldn't find anything to watch on Netflix. My wife had already told me that he was wanting a chat with me about work, so when he came in that night and asked me I was going to suggest going to the pub the next day to talk about it, but when he came in I still hadn't started watching something so I went into his room and twenty minutes later it happened.

If he'd have been on his own it would've been an hour before anyone found him, to say he's a bit lucky is quite an understatement.

Unbelievable, the very thin margins between being here and not.

 

[Slick]

It's always going to be a shock to those left bereaved. My dad had two heart attacks. First one at 47, felt ill, came me from work, called doctor, who called ambulance. After 5 days in ITU, as it was called in those days, he made a reasonable recovery.
Second one, 16 yrs later, while waiting for a traffic light to change to allow him, Mam, my sister and brother in law to cross the road, the lights changed, 3 people started to cross, he said to Mam, hang o......

He was, according to the coroner, effectively dead before he hit the floor. A massive infarction. He hit his head as he hit the floor and his cap had virtually no blood on it at the point of contact. His heart had stopped beating during the fall/topple. We knew from the first attack that he was on borrowed time, a very heavy smoker from 14, he stopped the day of the first attack, but too late to allow him to reach a true old age.

Mam took a month to die, suffering progressive organ failure. I know how I want to go!

Hardly seems the right thing to like such a description that probably resonated with more than me, but that was more for your final sentence as there was a time when I thought dropping would be a nightmare, only to learn like you, the hard way that it would be a blessing to some.

 

[presta]

Automatic defibrillators won't actually work in cases of Cardiac Arrest, they only work for atrial fibrillation

You don't need emergency defibrillation for AF, because AF doesn't stop the heart pumping. If you have AF they just take you to A&E where DCCV is just one of a number of options, and even then, there's time to shave your chest and give you a sedative first.

 

[mrandmrspoves]

You don't need emergency defibrillation for AF, because AF doesn't stop the heart pumping. If you have AF they just take you to A&E where DCCV is just one of a number of options, and even then, there's time to shave your chest and give you a sedative first.

Quite correct. Atrial fibrillation (AF) manifests as an irregular pulse and is quite common in the over 70's. In itself, AF seldom causes any symptoms but because it leads to an increased risk of blood clotting it is normally treated.
If the AF becomes fast AF the sufferer can become quite unwell, so if there is a prolonged episode of fast af that does not respond to medication it is sometimes treated by defibrillation. In this instance the defibrillation is called cardioversion.

 

[presta]

Quite correct. Atrial fibrillation (AF) manifests as an irregular pulse and is quite common in the over 70's. In itself, AF seldom causes any symptoms but because it leads to an increased risk of blood clotting it is normally treated.
If the AF becomes fast AF the sufferer can become quite unwell, so if there is a prolonged episode of fast af that does not respond to medication it is sometimes treated by defibrillation. In this instance the defibrillation is called cardioversion.

I have Fast AF. My record heart rate is 260, and at that rate you get a ticket to resus on the red telephone.
Out of the 10 times I've been taken in, I've only been given a DCCV once, and that wasn't until the following day. For anyone who hasn't seen a DCCV, this is quite amusing (not me, but I have a recording of me hollering a bit like that, too).

View: https://www.youtube.com/watch?v=KIEFXJ8QHxw&t=5s

 

[confusedcyclist]

You don't need emergency defibrillation for AF, because AF doesn't stop the heart pumping. If you have AF they just take you to A&E where DCCV is just one of a number of options, and even then, there's time to shave your chest and give you a sedative first.

Quite right, I guess I was coming in from the angle that any lay person might experience in a place of work or in a public where an AED might be provided, rather than by the professionals in a hospital setting.

 

[mrandmrspoves]

Quite right, I guess I was coming in from the angle that any lay person might experience in a place of work or in a public where an AED might be provided, rather than by the professionals in a hospital setting.

You had mistaken Atrial Fibrillation (not immediately life threatening and not treated with an AED, for Ventricular Fibrillation (immediately life threatening and treatable with an AED)

 

[confusedcyclist]

Oh yes, school boy error!

 

[kingrollo]

OP Here - the autopsy came back as Ischemic heart disease - is the SCA we were talking about earlier in the thread ?