Everyday EMS Tips reader Marty from Connecticut sent me this article about a Brooklyn NY man who arrested at the hospital and was successfully resuscitated and discharged neurologically intact. The patient and his doctor’s call this a miracle. Certainly it is a noteworthy event because of the time length and interventions involve but I wonder if we should expect a positive outcome. As you read the article keep in mind these important factors:
- the patient arrested in the emergency department surrounded by action oriented professionals
- it was a witnessed arrest
- shocks were delivered quickly
- the rhythm is not explicitly stated but since eight shocks were delivered I am assuming persistent V-Fib
- “staffers” gave him chest compressions. Likely following AHA guidelines to rotate in a new staffer every two minutes or less
- the patient was given a clot busting drug, type not listed. Compressions must have been effective enough to circulate the drug
- as soon as ROSC was achieved induced hypothermia began immediately
- the patient was transferred to a cath lab in the same hospital. Door to balloon time of zero
Should we expect patient’s that have cardiac arrest witnessed by BLS and ALS professionals should survive? I think we should especially when the presenting rhythm is v-fib. The theoretical survival threshold of witnessed v-fib could be as high as 60-70% (EMSEduCast episode 27).
