I met my 55 year old patient as she was coding... again. My partner had seen her in consult for vent management prior to my shift. She had no medical problems aside from tobacco abuse and had been lifting a snowblower up into a truck when she had the sudden onset of chest pain and then she lost consciousness. Her family did CPR for 5 minutes; an outide hospital gave TPA for her STEMI(ST elevation myocardial infarction). Upon arrival at my hospital she had gone for cardiac cath where her LAD was stented. Her post-cath EKG was beautiful and now she was coding again.
And code she did for 75 minutes. She was between v fib (ventricular fibrillation) and PEA (pulsless electrical activity), I think. I say "I think" because I could not feel her pulse and we had to doppler her carotid. Her EKG showed new infarction. She went to the cath lab again. She continued to code in the cath lab for another 80 minutes. Despite a balloon pump and maximum pressors, her systolic BP did not go over 50 for HOURS. I thought for sure she was going to die.
The Cardiologist transferred her to the CVICU for her family to be with her. The thing is that she did NOT die. Slowly over the next 48 hours she was weaned off the balloon and pressors and extubated. She woke up and she appears without neurologic deficit.
I am totally humbled by her survival. The only way I am able to wrap my mind around it is to think that CPR saved her life. This reenforces that AHA recommendation for CPR only CPR. It works. It worked for this patient. She was truly given an early Christmas present!