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Who will help during a cardiac arrest?

Posted Dec 23 2008 9:14pm

I would like to share an event that I witnessed and was a part of this evening while out to dinner with friends and my wife. Earlier in the evening we went out to dinner to a restaurant that we have been to several times and have enjoyed, mostly due to the establishment's eclectic décor and menu. The food is quite good. We were sitting at our table looking over the wine list when I heard a siren off in the distance coming closer. Our table was near the front door of the restaurant and I notice a fire department EMS supervisor truck pull up and stop just outside the window. I didn’t give it much thought until the paramedic who was operating the vehicle came into the restaurant - one whom I recognized from work. She went a table two tables down from where we were sitting.

I was momentarily left incredulous to notice an elderly women on the floor and someone was performing CPR on her. We had been in the restaurant all of five minutes. The paramedic was alone and I knew the ambulances were tied up but would be coming. Our town has four rescues which are very busy in the summer. I looked across the table and told my friends I would be right back. I went over to assist the paramedic as she was by herself.

The woman was unresponsive, only a weak attempt at breathing was evident every so often – a pattern we call agonal breathing. I quickly asked the paramedic for an ambu-bag to breathe for her and an airway. She gave me the bag and airway. I placed an airway in the lady’s throat to help keep her airway open and began to breathe for her – manually. The medic began to put on the defib-pacing pads. I confirmed that the lady had no pulse. I did a short period of CPR while the medic was attaching the defibrillator pads. The medic and I noticed that the woman was in ventricular fibrillation as we looked at the monitor. Her heart was quivering like a bowl of jelly not producing any effective pumping and the clock was ticking. If we didn’t intervene quickly she was going to be dead.

I stopped breathing for the lady as the medic charged up the defibrillator to shock her heart. Seconds seemed like minutes as they always do in tense situations. I looked around the restaurant while I was waiting for the woman to be shocked and I noticed everyone sitting in their chairs still talking and eating as if nothing was going on around them. The shock was delivered; I resumed CPR for brief period and continued to breathe for the woman. I felt for a pulse and there was one, a nice strong carotid pulse. I looked at the medic and told her she had a pulse. We both looked at the monitor and she was back in a normal rhythm albeit a bit slow but it was OK. She still wasn’t breathing though, no problem.

The ambulance had arrived by this time along with police and another paramedic fire department supervisor. Loads of help had made it. We got the woman onto a back board and brought her out to the ambulance which of course was tying up traffic, all the while I was working to keep breathing for the lady with the ambu-bag. We loaded the woman in the ambulance and I asked the medics if they were all set and they said yes.

I went back inside the restaurant, made my way to the bathroom to wash my hands and returned to my table joining my friends and wife. I had a sip of my wine. For me it was just like being at work, not a big deal by any means. After working in emergency and critical care medicine for twenty some years you get used to stuff.

What I did find amazing was the reaction of the crowd in the restaurant, all the while just sitting there watching us, eating and drinking, as if they were watching television. Were these people so horrified at the spectacle that they just didn’t want to take part in this woman’s life and death experience? Was it some self centered apathy similar to the events that took place in New York last month with the man who was hit by a car and laid in the street while people walked by him and didn’t help him? Is it just a fear of getting involved, or is it something else?

What would anyone have done anyway? Perhaps move some tables, give us more room, do CPR, or at least offer to help. There was only one other person who came to this woman’s aid. Her husband, an elderly man was just sitting in his chair completely motionless and clearly helpless to offer any assistance.

An elderly couple out for dinner on a holiday weekend that turned out to be a disaster. I don’t know if the woman survived this evening. I will go back to work on Saturday and will find out. Hopefully she will do alright and she will be back home with her husband soon. People often say that healthcare providers don’t care about patients, that they are apathetic, and insensitive to the trials and tribulations of others that are ill or injured. If that is true, then it is because society as a whole has become that way over time. This evening I saw a woman fighting for her life in a room full of people and only one person tried to help her. I think that speaks poorly for all of us humans.

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