He's only 25 years old. No medical history, no recent illnesses.Witnesses state he simply slumped forward out of his chair onto the ground, seized briefly, did a few snoring respirations and then lay still.
A bystander rolled him on his side, shook him and shouted for help. A passing Police Officer ran up the stairs to grab the little AED.
By the time EMS was activated, all we were told was "CPR in progress."
We imagined a man in his 40s-70s, complicated medical history and maybe skipped a few meds on vacation. It happens.
When the first medic arrives on scene the patient is awake, alert and upset that so many people are trying to tell him to stay still. PD says they gave a shock. These units only shock one thing, this isn't adding up. This sin't uncommon for us, having a patient awake after cardiac arrest, just not this young.
More help arrives and the story doesn't match the patient presentation. As he is loaded onto the cot, clean 12 lead, no complaint other than a sore chest, I grabbed the little AED and raced back to my office to download the data. As the unit uploaded the summary of rhythms and interventions I was doubting the interventions on scene. "They were probably doing CPR during analysis mode" or "It was probably a rapid V-tach and they kept moving him" or "Why did they start compressions if-*UPLOAD COMPLETE*"
V-fib.
The most textbook v-fib I've ever seen. Then a shock advised and delivered and another 2 minutes of CPR over a very tired sinus bradycardia which slowly drifted back to v-fib. Second shock delivered and more CPR over a cleaner, faster sinus rhythm. 20 seconds later the compressions stop. This is where the patient regained consciousness. 1:30 after that the unit loses connection with the pads. That would be my medics switching to their monitor.
Man I love being wrong.
And Happy EMS Week to AED Cabinet #021 with its first confirmed save.
Comments