March 5, 2010

Cardiac Arrest Patient Saved by Ambulance, Medic, and Truck Crews   

A woman awoke in the early hours to find her husband collapsed and unresponsive at their Bethesda home.  She thought he was unconscious and called 911.  Bethesda-Chevy Chase Rescue Squad Ambulance 726 and Medic 741, as well as Cabin John Park Truck 710, were dispatched to render aid.

While the units were en route, the 911 dispatcher alerted the crews that the patient “was a possible code”—meaning he was suspected to be in cardiac arrest.   Ambulance 726 arrived on scene first and found the patient unresponsive without a pulse and not breathing.  Crew members immediately began performing life-saving efforts including cardiopulmonary resuscitation (CPR) and defibrillation (administering an electric shock) with an automated external defibrillator.

Medic 741 and Truck 710 (which also had a paramedic on board) arrived shortly thereafter, and paramedics from Medic 741 assumed control of the incident, assessed the patient and continued life saving interventions.  Medics performed cardiovascular rhythm analysis and pulse checks and determined that the patient’s heart was beating sufficiently to sustain life and continued rescue breathing for the patient.  However, the patient’s condition deteriorated again, and the medics defibrillated the patient for a third time.  The patient again regained a life-sustaining heart rhythm, and resuscitation efforts continued.  The paramedics started an IV and administered IV fluids while the EMTs and truck crew secured the patient on a long backboard.  While carrying the patient to the ambulance, the crews had to surmount an ivy-covered embankment and were reduced to pushing the backboard (with the patient on it) up a hill to the sidewalk above.  They quickly loaded the patient on Medic 741 and, with assistance from Truck 710’s crew, transported the patient to an area hospital.

En route to the hospital, the crew continued rescue breathing and cardiac monitoring and attempted to administer cardiac drugs.  The crew successfully intubated the patient, which involves inserting an airway tube into the patient’s trachea in order to help him breathe.  The patient’s cardiac function continued to improve and, once intubated, the patient’s respiratory function improved.

Both medics and the EMT continued supportive patient care on the way to the hospital.  Upon arrival, the crew transferred the patient to the emergency department, where the patient continued to improve and was given post-resuscitation medication and supportive care.

Most out-of-hospital cases of cardiac arrest are fatal.   However, rapid intervention (calling 911, early medical assessment and defibrillation, and proper follow-up care) can increase the chance of survival.

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