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Wednesday, June 29, 2011

It had to happen sometime...

Heart lecture interrupted by heart attack
By Daniel Hartill, Sun Journal
Posted June 29, 2011, at 9:29 a.m.
Last modified June 29, 2011, at 6:21 p.m.

Russ Dillingham | Sun Journal

LEWISTON, Maine — Dr. William Phillips figured he was being kidded when a lecture on coronary heart disease was interrupted by a man complaining of chest pain.

A moment later, the cardiologist and nearby nurses saved the man’s life.

“I can’t tell you how I was hoping that guy was going to open his eyes, because, I thought, nothing could be worse if he dies right here,” Phillips said Tuesday.

As Phillips and the nurses began CPR, more than 100 people, many with histories of heart problems, watched.

“What I’m hoping is that they got the lesson about calling 911,” he said. “They got to see firsthand the importance of immediate response.”

The lecture had begun in the usual way.

Folks gathered Monday evening in a conference room at 12 High St. beside Central Maine Medical Center. The topic was a comparison of bypass surgery versus stenting for heart patients.

“We were talking about angina and this man raised his hand and said, ‘I’m having it right now,’” Phillips said. “I said, ‘Are you kidding?’

“And he said, ‘No.’”

That’s when Phillips got serious.

“I said to one of the nurses, ‘Could you get a wheelchair and take him over to the emergency room?’” Phillips said.

There wasn’t time, though. The man collapsed and Phillips ran to his side.

“In the meantime, he had completely arrested,” the doctor said. “He had no pulse. He wasn’t breathing. We started CPR and everybody’s standing around.”

Three cardiac rehab nurses — Brenda Robitaille, Nicola Adams and Heidi Langois — were there, too.

“It wasn’t just me,” Phillips said. “If I had been alone, it would have been terrible.”

One of the nurses brought in an automated external defibrillator, a portable electronic device that diagnoses a sudden, life-threatening heart problem and shocks the heart back into rhythm.

“The AED saved his life,” Phillips said.

“Then, (paramedics) came in the door,” he said. “They started an IV. They gave him an EKG and took the patient over to the emergency room.”

Later, Phillips checked in on the man.

“I went over to the emergency room, and he was sitting up in the bed, talking with his wife and waiting for test results,” the doctor said. Central Maine Medical Center declined to identify the patient, citing confidentiality laws.

But before Phillips checked on the man, he had a lecture to finish.

“After we had taken a breather, everybody wanted to continue on with the talk,” he said. “It was a pretty impressive event. I think the people there will remember the lecture for that.”

Phillips hopes the attendees will remember the importance of rapid response to heart problems.

“What if the man had been driving himself to the hospital?” Phillips said. The incident also highlighted the use of AEDs.

A West Paris man used one to save his father on June 12. The devices are becoming more common in local institutions such as schools.

“This is the second time in as many weeks that a local (AED) has saved a life,” Phillips said.

To see more of the Sun Journal, visit

Good News From Sweeden

Increase in survival and bystander CPR in out-of-hospital shockable arrhythmia: bystander CPR and female gender are predictors of improved outcome. Experiences from Sweden in an 18-year perspective

Anna Adielsson1, Jacob Hollenberg2, Thomas Karlsson3, Jonny Lindqvist3, Stefan Lundin1, Johan Silfverstolpe4, Leif Svensson4, Johan Herlitz3,5
+ Author Affiliations

1Department of Anaesthesia and Intensive Care Medicine, Sahlgrenska University Hospital, Göteborg, Sweden
2Stockholm Pre-hospital Centre, South Hospital, Stockholm, Sweden
3Institute of Medicine, Department of Molecular and Clinical Medicine, Sahlgrenska University Hospital, Göteborg, Sweden
4Emergency Medical Services, KAMBER, Regionhuset, Lund, Sweden
5The Centre for Pre-hospital Research in Western Sweden, University College of Borås, Borås, Sweden
Correspondence to
Johan Herlitz, Institution of Medicine, Department of Molecular and Clinical Medicine, Sahlgrenska University Hospital, Göteborg SE-413 45, Sweden;
Accepted 5 May 2011
Published Online First 29 June 2011

Objectives In a national perspective, to describe survival among patients found in ventricular fibrillation or pulseless ventricular tachycardia witnessed by a bystander and with a presumed cardiac aetiology and answer two principal questions: (1) what are the changes over time? and (2) which are the factors of importance?

Design Observational register study.

Setting Sweden.

Patients All patients included in the Swedish Out of Hospital Cardiac Arrest Register between 1 January 1990 and 31 December 2009 who were found in bystander-witnessed ventricular fibrillation with a presumed cardiac aetiology.

Interventions Bystander cardiopulmonary resuscitation (CPR) and defibrillation.

Main outcome measures Survival to 1 month.

Results In all, 7187 patients fulfilled the set criteria. Age, place of out-of-hospital cardiac arrest (OHCA) and gender did not change. Bystander CPR increased from 46% to 73%; 95% CI for OR 1.060 to 1.081 per year. The median delay from collapse to defibrillation increased from 12 min to 14 min (p for trend 0.0004). Early survival increased from 28% to 45% (95% CI 1.044 to 1.065) and survival to 1 month increased from 12% to 23% (95% CI 1.058 to 1.086). Strong predictors of early and late survival were a short interval from collapse to defibrillation, bystander CPR, female gender and OHCA outside the home.

Conclusion In a long-term perspective in Sweden, survival to 1 month after ventricular fibrillation almost doubled. This was associated with a marked increase in bystander CPR. Strong predictors of outcome were a short delay to defibrillation, bystander CPR, female gender and place of collapse.