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Train Passengers Perform CPR After Man Collapses at West Newton Station
After a man collapsed on the platform in West Newton, Commuter Rail passengers stepped in to help out.
By Melanie Graham

It was an exciting commute for a few passengers on the Framingham/Worcester Commuter Rail line this morning.

David Perry, an Ashland resident, as well as Framingham resident Dean Bonis, helped perform CPR on a man at the West Newton station after the man collapsed and went into cardiac arrest.

"I knew I had the training and I knew what to do," Perry told Newton Patch.

Newton Fire Chief Paul Chagnon told Newton Patch this morning that the man was reported to be "awake and alert" in the hospital.

As the train pulled into the West Newton stop around 8 a.m., Perry and Bonis explained that someone ran onto their cars asking if there was a doctor available, as a man had just collapsed on the platform.

Perry, who is a trained CPR instructor, went out to the platform and met another man who had already started chest compressions.

Soon after, Bonis, who is originally from Auburdale, took over the chest compressions on the platform until EMS arrived. Bonis said he is an EMT in New York and works in Boston at Children's Hospital.

"It was a classic example of everyone coming together for bystander CPR," Perry said.

Perry said he received his CPR training and teacher certification a few years ago through his job in downtown Boston, where he works as an environmental engineer. With his certification, he says he mostly trains other people in his workplace and helps coordinate office safety.

According to Chagnon, the 58-year old male collapsed on the platform and was shocked with a defibrillator one time by EMS crews and resuscitated in the ambulance.

Scanner reports indicated the man was transported to Newton-Wellesley Hospital. Chagnon said this morning the man was transferred to a hospital in Boston, but could not indicate which hospital.

This morning's incident was not the first bystander CPR situation for Perry, though. A few years ago, Perry said he was stuck in traffic in the Lincoln Tunnel on his way to New York City when he saw a man kneeling by the side of the road. After getting out of the car to see what was wrong, Perry found out the man was having a heart attack and stepped in to help out.

During the Lincoln Tunnel incident, Perry recalls the ambulance "taking forever." But today, he said EMS crews were on the scene in no time.

Andrea Wheeler, a spokesperson for the Massachusetts Bay Commuter Rail, said the train conductors did not need to provide much assistance as Newton EMS was on scene shortly after the train arrived.

Perry noted that the train conductors did not need to use the Automated External Defibrillator (AED) on the train, as the bystander CPR and fast EMS response jumped to the task quickly and eventually restored a pulse to the patient.

"It speaks well to the mentality of people out there willing to step up and help out," Perry said.
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[Blogger's note: I'll bet the conductors could have gotten the on-train AED to the victim faster than the EMT's got to the victim.]

Agnes Cinat died and later thanked paramedics

WINDSOR, Ont. -- Agnes Cinat died the night the Canadian and American women’s hockey teams faced off for the Olympic gold medal game.

On Friday, the 81-year-old grandmother was on hand to talk about it during a reunion of emergency workers and the patients they helped revive.

Cinat said that she was watching the game on television Feb. 25, 2010, when she collapsed.

Her daughter Mary-Lou Cinat-Tino had been popping popcorn in the kitchen when Cinat called to her in a strange voice.

Cinat-Tino, a nurse, performed CPR before paramedics arrived. Paramedics shocked Cinat many times with a defibrillator and gave her several injections of drugs to get her heart pumping, said paramedic Mona Hansen, who had attended Assumption high school with one of Cinat’s daughters.

“My heart just dropped,” Hansen said of recognizing her patient. “It was so hard working on her.”

It took more than 15 minutes to revive Cinat.

“We weren’t sure how it would turn out,” paramedic Dawn Newman said. “When we heard she made it, we were shocked.”

“Usually when we have to work that hard on a patient, there aren’t good results,” Hansen said Friday at the Essex-Windsor EMS’s first survivors’ day, an event to connect patients who survived cardiac arrest with paramedics, dispatchers and firefighters who helped save them.

Newman, who had worked more than six years as a paramedic, said Cinat was the first of her cardiac arrest patients to be revived. It was the second for Hansen.

Barely five per cent of patients who exhibit no vital signs are brought back to life, said Randy Mellow, chief of the Essex-Windsor EMS. If a patient receives CPR, which is comprised of chest compressions and breaths for the distressed patient, the chance of survival jumps 10-fold, said Dr. Paul Bradford, who works in the emergency room at Hotel-Dieu Grace Hospital. Only 20 people in Essex County recovered from not having any vital signs in 2010. Ten attended Friday’s celebration.

Thom Racovitis, owner of Tunnel Bar-B-Q, collapsed in the parking lot of the restaurant on Oct. 26. An employee performed CPR until paramedics arrived. Paramedic Prentice Scott recognized Racovitis right away. It had been 13 years since Racovitis gave the paramedic his first job in Windsor, delivering baked goods. On his first day of work he gave Racovitis his two-weeks’ notice because he got his EMS job.

“I haven’t saved anyone else in 13 years. Isn’t that karma?” Scott said.

Every day since his recovery and every time he saw an ambulance or a paramedic, Racovitis wondered if that was the person who had saved his life.

Getting a chance to meet Scott and the other colleagues who saved Racovitis gave the family a chance for some closure, said Marilyn Racovitis, his wife.

On July 17 2010, Sasha Suvajdzin, 37, jumped into his cousin’s above-ground pool and struck his head on the bottom.

“I heard a crunch and I couldn’t move,” said Suvajdzin, a former tool and die maker. With a broken neck, Suvajdzin was paralyzed, unable to move his arms or legs. His cousin was in the pool with him and he thought Suvajdzin was fooling around. His cousin even brushed against him, but Suvajdzin was unable to touch him to alert him to his distress.

“I was holding my breath and I couldn’t anymore,” he said. His mouth popped open and his lungs filled with water.

“I drowned,” he said. His cousin pulled Suvajdzin out of the water and performed CPR — water gushed from Suvajdzin’s mouth like a fountain.

Suvajdzin was revived by paramedics before he was loaded into an ambulance.

After months of rehabilitation he has full use of his body, although he said his hands don’t work properly.

“It’s a chance at a second life,” said Suvajdzin, who has a son. “I have a chance to do it right.”

Even if a patient is revived, the vast majority die after arriving at hospital because resuscitation is done too late.

“The body might survive, but not the brain,” Bradford said. The window to revive a patient with no vital signs is very small and it takes a minimum of four to six minutes for paramedics or firefighters to respond to an emergency call, Mellow said.

Newman said people are often too embarrassed to do CPR.

“Even if you are doing bad CPR, it’s better than no CPR,” Hansen said.


mwolfson@windsorstar.com or 519-255-5709 or Twitter.com/WinStarMonica

© Copyright (c) The Windsor Star


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One more time...

7:32 p.m. CDT, August 18, 2011

ST. Charles, MO (KTVI-FOX2Now.com)— An Old Monroe woman is lucky to be alive. Sherry Howard suffered a heart attack but then a series of very fortunate events, including some cool technology, kept her alive. Sherry Howard said, "I feel very lucky to be alive I really do. I wouldn't know what to do without my kids my husband."

Her husband, Doug used C.P.R. when she collapsed more than 2 weeks ago in their Lincoln County Home. He hadn't used C.P.R. in decades. Doug Howard said, "I learned it at St. Charles High in health class, a health class deal I learned it in there and thought I would never use it."Dr. Mark Taber, with SSM Heart Institute, said, "The husband was a crucial component of her successful outcome."

Paramedics airlifted the woman to St. Joseph Health Center in St. Charles. Her doctor quickly opened the blocked artery and inserted a stent. But it she was not responding well and doctors feared her brain would be badly damaged. Dr. Taber added, "It was definitely life or death."Nurses began cooling Sherry's body with hypothermia technology. Her body was wrapped in a device for 24 hours. Her temperature dropped to 90 degrees. It's something medical experts learned from near drownings in cold water. A victim can be submerged for an hour and the frigid water protects the brain. Dr. Taber said, "Almost certainly had it not been for her receiving hypothermia cooling down her body after we put the stent in, her brain would have not survived."

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Now Sherry's prognosis is excellent. She's grateful to the doctors, paramedics and her husband. She said, "I love him very much I'm very glad he did what he did." Her husband said, "Afterwards everyone says I contributed to saving a life I just did what needed to be done." The couple recommends C.P.R. training for everyone.

It Works...

RHINEBECK — An advocacy organization is searching for the people who saved a woman's life Monday at the Beekman Arms.

Linda Cotter-Forbes, co-founder and director of the Heart Safe Club of Rhinebeck, said her organization wants to thank the three customers who used an automated external defibrillator to aid a woman having sudden cardiac arrest.

"It was around 1 p.m.," said Denise Cvijanovich, the tavern's assistant manager. "It was busy. Our greenhouse area was full."

Cvijanovich said the unidentified woman, who she described as "older," was seated for lunch in the greenhouse room with a couple of her friends.

"Suddenly, one of the customers came over to the desk saying another customer had passed out and to call 911," Cvijanovich said.

The woman appeared to be having cardiac arrest.

"At that point, a man asked if we had a defibrillator, which we do," Cvijanovich said.

The automated external defibrillator, or AED, a portable electronic device used to restore normal heart rhythm, had been donated to the restaurant by the Heart Safe Club, with funding from the Rhinebeck Rotary Club a few years ago.

Cvijanovich said the man and two other customers, one who said she was a nurse, first conducted compressions and mouth-to-mouth resuscitation on the woman. They then used the AED.

"They definitely knew what they were doing," Cvijanovich said.

The woman began regular breathing again about 10 minutes later, Cvijanovich said, shortly before an ambulance arrived from Northern Dutchess Hospital.

Friends, who later returned to thank restaurant staff, reported that the woman was stable at Vassar Brothers Medical Center in Poughkeepsie, she said.

"They said her prognosis was good," Cvijanovich said.

The longtime Beekman Arms employee said it was the first time the AED had been used at the restaurant.

"I was thrilled to hear that not only did someone use the skills of cardiopulmonary resuscitation to save someone's life but they used an AED donated by the heart club, which was instrumental in saving the woman's life," Cotter-Forbes told the Journal Monday evening.

The Heart Safe Club of Rhinebeck was founded shortly after Cotter-Forbes' daughter, Kaitlin, had a sudden cardiac arrest while playing softball at Rhinebeck High School in 2006. She was 15 years old at the time.

"Our main objective is to provide low-cost CPR and AED training," she said, adding that the moments following a sudden cardiac arrest are crucial.

"This highlights the importance of people not only learning the skills of CPR, (but) it also emphasizes the importance of public access to AEDs," she said.

To the unidentified heroes who used the AED to save the woman, Cotter-Forbes said, "We want to find out who they are and thank them."

To contact the Heart Safe Club of Rhinebeck, visit them on Facebook, or send an email to heartsafeclub@gmail.com.

Statistics from Survivors

The Sudden Cardiac Arrest Foundation's efforts in support of The Joint Commission on SCA initiatives have been significant. The Joint Commission today released a monograph, "Sudden Cardiac Arrest: Meeting the Challenge," related to this work. You can download the study from:
http://www.sca-aware.org/sca-news/the-joint-commission-issues-landmark-monograph-on-challenge-of-sudden-cardiac-arrest

Here are some highlights from this examination of the survivor database:
• About one-third of survivors (35%) are less than 40-years-old
• Most (71%) had no prior knowledge of heart disease
• Most received CPR from a bystander (73%)--predominantly from family members or friends (30%) or from strangers (29%)
• Less than one-third (28%) were treated with mild therapeutic hypothermia
• Most (72%) received implantable cardioverter defibrillators
• Most (71%) returned to their previous level of functioning.

You can learn more about the Sudden Cardiac Arrest Foundation at www.sca-aware.org

Isn't it amazing what you learn when you have data to analyze?

What we'll see in the years ahead.

For those of us who got comfortably used to seeing changes in resuscitation science every five years, the past few years have seemed fast-paced. But the rate of change is accelerating. It's time to fasten your seat belt.

Thanks to the pioneering work of the past few years, we are now beginning to accumulate solid data on what works and what doesn't.

Here's what I suspect lies ahead:

First, the age of five-year updates is behind us. I think we'll see changes in resuscitation science guidelines far more frequently than every five years.

Second, a dirty little secret has surfaced: most people don't do CPR well enough. I think we will see an increasing focus on the quality of the resuscitation effort: fewer and shorter interruptions in chest compressions, compressions more compliant with the two inches or more guideline, and shorter pauses between the cessation of chest compressions and the delivery of the shock.

Additionally, the evidence is growing compellingly in favor of more broadly pursuing therapeutic hypothermia, not only for cardiac arrest victims, but others. The trick here is to get the hospitals who receive cardiac arrest patients from ambulances to get the equipment and establish the protocols that will permit them to continue therapeutic hypothermia, once a chilled patient arrives in their ED. (You really shouldn't be initiating TH in the ambulance unless the hospital to which you are transporting the resuscitated victim can continue it.)

I, for one, will be spending considerable energy pushing for these changes over the next few years. i hope that my pre-hospital companions across the land will press for the same changes in their geographic areas. There is no reasonable excuse to lose the number of people to cardiac arrest as we do, particularly in light of the fact that there is a 10:1 difference in success rates in different geographies.

We have never been so close to being able to make a difference. Please help make it happen.

Bob

Therapeutic Hypothermia. AKA "Ice 'em down"

Tim Larsen was sprawled out on the men's restroom floor, purple and lifeless, but his job supervisor had been trained for such an emergency.

Tim Evans, another employee at Crane/Pacific Valves, 3201 Walnut Ave. in Signal Hill, immediately applied cardiopulmonary resuscitation, compressing Larsen's chest cavity until the paramedics arrived.

Every moment was critical April 18, and Evans continued to perform CPR while the paramedics set up defibrillator paddles.

"He's a heck of a good guy," Larsen said of Evans. "I just can't thank him enough."

Once a heartbeat was detected, Larsen was rushed to Long Beach Memorial Medical Center, where doctors worked to stabilize him, intensifying their efforts to prevent brain damage by using a high- tech process known as Arctic Sun.

The technique requires putting a patient's body into a hypothermic state with cooling pads that are connected to a machine that regulates their temperature.

The hypothermia process is relatively new at Memorial, where it's been used on about 20 patients during the past 18 months, according to Dr. Nima Ramezan, director of Neuro-Science and Stroke.

Evans' work on Larsen had given the doctors hope that the hypothermia treatment would succeed.

Dr. Omid Vahdat, who treated Larsen, said that when using the Arctic Sun equipment, a heart patient's body remains in a hypothermic state for at least 48 hours while doctors check on the well-being of the brain.

"The brain is the most sensitive organ," Vahdat said.

Vahdat said that using hypothermia is similar to the effort to keep an injured ankle from swelling.

Without slightly cooling the body, the brain could be damaged. But the cooling reduces the potential inflammation.

"This is the same concept," Vahdat said. "And it helps the healing process."

The Arctic Sun cooling pads are attached to the patient's legs, chest and arms.

A team of doctors - the cardiologist, neurologist, intensive care unit and primary physicians - work with the nurses in monitoring the patient's temperature, which drops only a few degrees.

"The temperature is not that cold," Vahdat said.

The cardiologist said he's pleased by the results of the cases he's handled.

"We've had exceptional success using this methodology," he said.

Larsen - nicknamed "Lucky 19" Arctic Sun patient - benefited from the hypothermia process, displaying his wellness afterward by answering his doctor's questions and demonstrating memory skills, Vahdat recalled.

Two studies show that using induced hypothermia has contributed to improved neurological outcomes, Ramezan said.

Patients benefiting from induced hypothermia include those who are comatose within six hours after a cardiac arrest; those able to maintain a blood pressure after CPR; or those in coma at the time of cooling, according to a report by the Perelman School of Medicine, University of Pennsylvania.

Patients who might be at risk from the hypothermia treatment may include those with major head trauma; those who have had major surgery within 14 days, since hypothermia may increase the risk of infection and bleeding; and those with a systemic infection because hypothermia inhibits immune function, the report says.

Larsen, however, met the criteria for the hypothermia process, doctors said.

In general, patients are cooled using the induced hypothermia protocol for 24 hours to a goal temperature of 89 to 93degrees, just slightly lower than 97.8 degrees, which is the lowof the regular human body temperature range. The target time to reach the temperature goal is six to eight hours.

The doctors worked to keep Larsen's body from shivering by giving him a sedative, Vahdat said. Shivering is considered very uncomfortable, and it generates heat, impairing the patient's ability to achieve the target cool temperature.

The doctors also monitor Arctic Sun-treated patients for arrhythmia associated with hypothermia. They also provide skin care, checking for burns every six hours.

To warm back up to a normal body temperature takes patients about eight hours.

Ramezan, the director of Neuro-Science and Stroke, declined to give the exact percentage of success rate at Memorial, saying that the numbers are too small to give a clear indication.

One patient, Dave San Jose, has high praise for the medical method, and he marked the one-year anniversary of his victory over death Thursday. San Jose is a well-known North Long Beach resident whose heart attack and return from the brink of death were well- publicized.

"I can't prove it, but I know the Arctic Sun is responsible for me being alive," said San Jose, 70.

San Jose said there's a need for more Arctic Sun machines, adding that two were in use at Memorial when he arrived there last year, and one had to be borrowed from another hospital.

"That machine is the only reason I'm talking now," he emphasized.

Vahdat said he is impressed by the success of the process.

"These are people who truly cheated death," he said.



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