Search This Blog

Monday, February 14, 2011

Dead for 16-20 minutes, he lived to tell about it


  • NICOLE BROCHU

Charles Morgan was taking a smoke break from his evening shift at a West Palm Beach car dealership when he dropped dead of a massive heart attack. He was 52.

More than two months later, Morgan has no recollection of any of it. Not his boss' CPR efforts, or the crowd that milled around in horror, or the paramedics who brought him back to life with advanced emergency equipment most fire departments have yet to acquire.

The real stunner, even to the men who saved him: He suffered no brain damage or other ill effects, even though his heart had stopped beating for 16 to 20 minutes.

"I'm a lucky man," said the grandfather of two.

Anyone who hears his story would agree. But luck played only one role in the resurrection of Charles Morgan. The car salesman's renewed lease on life is also a credit to quick-thinking co-workers, well-trained paramedics and, especially, an effective combination of cutting-edge lifesaving equipment that made all the difference that December day.

The American Heart Association estimates that fewer than 8 percent of those who suffer cardiac arrest outside the hospital survive, and the vast majority of them are left with some level of debilitating brain damage.

Morgan is not the first to beat those ugly odds, though he joins a rare fraternity of symptom-free survivors.

But experts say his miraculous revival grows less shocking every year, as more fire-rescue agencies around the country share West Palm Beach's foresight and invest in progressive equipment that not only got Morgan's heart beating again, but protected his brain from cell damage. It's the kind of equipment that until recently you'd find only in hospitals. Think AED-level technology, but for EMTs in the field, and with much broader application.

"You gotta love it when a plan comes together," said city Fire-Rescue First Platoon Battalion Chief Malcolm Bomford.

Like any plan with a miraculous outcome, this one, as Morgan noted, "had so many things" that had to go right to give the story a happy ending, and Morgan a new beginning.

And it all started with Rich Harward. Morgan's general manager at Schumacher Volkswagen, and his regular smoke break buddy, Harward was about to join Morgan outside when another co-worker noticed the salesman on the ground, his face in the dirt and his legs twitching. Harward ran to the dying man's side and, as someone else dialed 911, years of training as a former police officer and Marine kicked in.

Harward saw that Morgan's tongue had sunk into the back of his throat, so he reached in and pulled it out to clear his airway. Moments later, the deteriorating patient began gurgling, then took his last breath. Harward immediately began chest compressions — updated AHA guidelines say this is theessential component of CPR — and kept them going until paramedics arrived.

Call Harward's intervention Difference Maker No. 1. The AHA credits bystander CPR with doubling, even tripling, heart attack victims' chance of survival, because it keeps blood flowing to the brain.

"It's all about saving the brain, really," said Dr. Richard Howard, an interventional cardiologist forBroward Health in Fort Lauderdale. "That's what saved this guy's life, having someone there to do CPR."

Harward was the first key player in Morgan's survival. The others came in a fire truck outfitted with state-of-the-art lifesaving gear and an emergency team that knew how to use it.

When the crew from Fire Station 5 reached the scene, Morgan was "purple, not breathing, without a pulse, and we found a crowd around him that was very distressed," said Capt. Danny Collazo, recounting the scene with crew members around a table inside Station 5. Next to him sat his former patient, his eyes rimmed with tears, listening to a story of death and revival retold, Morgan said, "like it was happening to somebody else."

Collazo and his team consider three high-tech devices instrumental in the Dec. 11 rescue. Meet Difference Makers Nos. 2, 3 and 4:

• A $12,000 to $15,000 automated CPR machine that delivered computer-timed chest compressions through a strap fit snugly around Morgan's torso — with 80 percent greater effectiveness than manual compressions.

• A $10,000 glide scope, with a camera at the end, that allowed paramedics a clear view, via a computer screen, of Morgan's airway so they could intubate him more quickly and without injury to his throat.

• A $600 dorm-sized refrigerator that kept IV bags cold enough to lower the patient's body temperature, inducing hypothermia and staving off the swelling in the brain that causes tissue death and destroys function.

The first two gadgets were key to getting Morgan's heart beating on its own again — six to 10 minutes after paramedics began working on him, and 16 to 20 minutes after they estimated he hit the ground. The hypothermia therapy was what saved his brain from long-term damage.

All of it combined into one stunning rescue, one Collazo says he's seen only a few times in his 15-year career. West Palm Beach fire-rescue officials wonder why the technology, as available as it is, is not more commonplace on fire trucks, even in a down economy. "For us, it's become a standard of care," Bomford said, crediting the city for its foresight. "Nationally, it's not a standard of care."

"These guys are more excited to see [Morgan] than probably he is to see them," said Battalion Chief Brent Braunworth. "I implore other fire departments to research this [technology] … because sitting right here is an example that it works."

The magnitude of serving as such a remarkable example is not lost on the man who remembers none of it. Unaware even that his coronary arteries were 90 percent blocked until his collapse, Morgan has stopped smoking, he sees his cardiologist once a month, and he's taken up a new habit — thrice-weekly workouts.

He can think of no better way to honor the second chance he's been given, and the men who worked so hard to see him get it.

nbrochu@Tribune.com, 561-243-6603, Twitter: @nicolebrochu