Nurse finds herself in right place, right time

By Mary Landers (SavannahNow.com)

Julie Anderson Paul knew something was desperately wrong from the tone of the other mother’s voice. The 34-year-old nurse had just settled back into her beach chair after a walk on Tybee’s north end when she heard the unmistakable sound of panic.

“Help my son. Oh please, please, please.”

The possibilities raced through Paul’s mind as she pounded to the surf: seizure, shark bite or drowning.

She saw the toddler’s face, blue beneath his summer buzz cut. A swim diaper had been pulled down revealing he’d soiled himself, a dire sign to Paul, who knew that it can be the body’s last act before death.

Kneeling by the 3-year-old boy, former Southside firefighter Roy Neely had already started CPR. Paul announced she was a pediatric nurse and took over the breathing portion of the child’s CPR.

She could see that Neely had been getting air in the boy’s belly rather than the lungs so she tilted his head back and instructing a woman, who identified herself as a dialysis nurse, to continue the chest compressions with one hand, standard practice for a child.

She could taste vomit in the boy’s mouth, another bad sign.

Time slowed.

“When you’re doing CPR, a minute is like an hour,” she said.

Paul remembers thinking about being a nurse and about being a mother. Then, with her face pressed against his, she heard him moan.

“I gave him more breaths and he opened his eyes. They rolled in the back of his head. The (dialysis nurse) said, ‘He’s got a pulse.’”

She turned the boy’s head to his side in case he vomited, but he didn’t. Then the lifeguards arrived. They had been checking on another individual north of the north beach jetties, according to the Tybee Ocean Rescue incident report filed that day.

The guards put an oxygen mask on the child and drove him on their mule to the EMTs waiting at the parking lot and an ambulance whisked him away.

Like that, the incident was over. She didn’t know the boy’s name or the mother’s name or even the names of the other rescuers.

“I went and washed my face off,” Paul said. “Then I got all choked up. People were coming up saying, ‘You’re my hero.’”

She shrugs that label off. She was doing what she was trained to do as a nurse, though in her 10 years of working on the children’s floor at Candler, she had only had to perform CPR about three times.

When kids get that sick they’re transferred to Memorial’s intensive care unit, she said.

The next day she awoke feeling like she’d run a marathon, a result of the adrenaline that coursed through her body, she thinks. She still didn’t know if the boy was OK.

“The nurse in me was thinking everything could go wrong after a near drowning,” she said. She called Memorial and explained that she was a nurse involved in resuscitating a 3-year-old boy at Tybee the day before. Was the boy there and was he going to recover?

Because of privacy laws, the nurse who answered couldn’t give out any specific information, but she did something even better. She handed over the phone to the boy’s mother.

“She was already choked up,” Paul said. She said ‘Thank you so much you saved my little boy’s life.’”

The boy’s mom turned the phone over to the little boy, whose name is Richard.

“Thank you,” he said. “I love you.”

Paul plans to help organize a CPR training, including pediatric CPR, soon.

Why are the survival numbers different?

I've had several people ask me why they keep seeing different numbers for survival percentages. Here's the heart of the problem:

1. It all depends upon what you mean by survival. In days gone by - and for very good reasons in the modern age - 'survival' meant the "return of spontaneous circulation" (Come on, folks, couldn't we just say the victim got his or her pulse back?)
2. Unfortunately, getting your pulse back doesn't always leave you at the same station. The difference is your CPC score:
   • CPC = 1 means you have no significant neurological deficit.
   • CPC = 2 means you are able to perform the activities of daily living, perhaps with some minimal accomodation.
   • CPC = 3 means you have some severe neurological deficit that interferes to varying degrees with your ability to perform the activities of daily living.
   • CPC = 4 means you are in a coma.
3. If you are measuring survival in terms of getting a pulse back, you include all CPC levels.
   
   • If you are measureing survival in terms of surviving - i.e., being able to perform the activities of daily living, you include on victims who are at CPR levels 1 & 2.
   
   • If you measure 'getting your pulse back' you will find that 9/6% of cardiac arrest victims in the CARES database do so. If you measure 'being able to perform the activities of daily living' you will get a survival number closer to 6.5%.
   
   

Be Annoying: It could save a life

The CDC's publication of five years of CARES data underscores the importance of time.

On a sample of 31,583 cardiac arrest victims, a Bystander applied the AED only 3.7% of the time, and the 911 Responder applied the AED the other 96.7% of the time. Twenty-three percent of the people to whom a Bystander applied an AED survived, and nine percent of the people to whom the 911 Responder applied the AED survived.

This doesn't mean that Bystanders are two and a half times better at applying AEDs. It means that the Bystander was able to get an AED on the victim sooner, if there were one there. (These numbers won't tie exactly to the CARES ROSC data because they have been adjusted to eliminate the victims who didn't die but who weren't independently able to perform the activities of daily living after the incident.)

Why did the Bystander only apply the AED in 3.7% of the cases? The most likely reason is that there wasn't an AED near the scene of the cardiac arrest. Other possible reasons are the AED was too far away, and the Bystander was alone, performing CPR, or the bystander didn't know how to use an AED. I'll bet there was at least one case in the database where there was a clearly-marked AED in a case within 20 feet of the arrest, and the Bystander was too freaked out by what was going on to recognize it.

So what does this have to do with being annoying? Don't worry about how uncomfortable you might feel doing this - it won't be as uncomfortable as a colonoscopy - every time you walk into a store, ask the store personnel where their AED is. Ask the editor in chief of your local newspaper to publish a list of the public places where there isn't a public-access AED. Call the local TV and radio stations and get them on the case. And get your friends and family to do the same. and please don't assume someone else will do this: it's the cumulative effect of a lot of us asking that will get the job done.

Yes, there is a lot more we all could do, but let's just all focus on being annoying from now through the end of October: October is Sudden Cardiac Arrest Awareness month...and that would be a really good month to get an AED for your home, if you can. That's where two out of three arrests happen.

Check back in a day or so - the next posting will take some of the mystery out of AED details.

Marin moms use CPR at party to revive man who was clinically dead

By Jessica Bernstein-Wax Marin Independent Journal Posted: 09/23/2011 11:09:37 AM PDT Updated: 09/23/2011 11:09:38 AM PDT

Two Marin moms are still reeling after they saved a San Francisco man's life last weekend using CPR techniques they learned as children. On Sunday afternoon, San Rafael resident Jennifer Ani and San Anselmo resident Michal "Miki" Goralsky were at a party in Ross for first-grade students at the Brandeis Hillel Day School when parent Mike Ryan collapsed and turned purple.

"We were all outside, and it was time for the piñata and all the kids were in line," Ani said. "I was about 10 feet from him and his eyes rolled back in his head and his knees buckled and he fell to the ground."

After a few moments of chaos, Goralsky began administering compressions to Ryan's chest and Ani performed mouth-to-mouth resuscitation. The older brother of one of the first-graders whisked all of the small children to another part of the property.

Paramedics arrived several minutes later and took Ryan to Marin General Hospital, where doctors told him he had suffered a heart attack and had been clinically dead for a short time.

Ryan, a 51-year-old diabetic who had no previous problems with his heart, underwent quadruple bypass surgery Thursday morning and is doing well, said his wife, Hagit Glickman.

"CPR not only saved his life but brought him back to life ... with no damage from the heart attack due to how quickly the women acted and how well they did what they did," Glickman said.

Dr. Brian Strunk, chief of cardiology at Marin General, said Ryan had blockages in all three of his arteries and would have died or ended up in a vegetative state without CPR.

Strunk emphasized the need for lay people to take CPR classes, saying every minute after a heart attack is critical and emergency personnel rarely get to the patient immediately.

"Without those two ladies doing the CPR, he would have been brain dead," Strunk said. "As it is, his head is completely intact, and they saved his heart enough."

With surgery, Ryan will be able to lead a normal life, he added.

Ryan told the Independent Journal on Wednesday that he remembered falling and then returning to consciousness from a strange, dream-like state.

"They're wonder women that saved my life," said Ryan, chairman of the Executive Impact Group, which advises companies on business strategy and development.

The experience made such a profound impression on Ani, Goralsky and other Brandeis parents that a group of first-grade families are planning to take a CPR class together.

"The lesson here for me is that you cannot wait and think that somebody else will do it -- you need to act," Goralsky said.

A recent American Red Cross survey found that one in four people have been in a situation in which someone required CPR, said Cynthia Shaw, a spokeswoman for the Red Cross' Bay Area chapter.

"You never know when you'll need to respond to an emergency," Shaw said. "You never know when you're going to see somebody in front of you collapse with a heart attack."

With proper training, everyday people have the power to stabilize a patient while waiting for emergency personnel to arrive, potentially saving a life, she said.

Ani and Goralsky didn't know Ryan and Glickman before the birthday party, but now all four parents say they're eager to spend time together. "I expect to live until at least 80 or 100, and we'll keep Jennifer and Miki in our lives,"

Ryan said. "My birthday's now Sept. 18 instead of Jan. 19. It's a whole new life."

Accuracy makes a difference.

The story below ran under the headline "Azle Student Athlete Hurt on the Field"

I would argue that the headline "Azie Student Athlete died on field, saved by CPR & AED" not only would be more accurate, but would be more likely to cause a reader to consider making sure that all the schools in their area had trained personnel and READY ACCESS TO AN AED AT EVERY ATHLETIC CONTEST AND PRACTICE.

Bob

Azle Student Athlete Hurt on the Field
Published : Tuesday, 20 Sep 2011, 9:16 PM CDT FOX 4 News myfoxdfw.com Web Team

AZLE, Texas - A seventh grade football player from Azle Junior High School stopped breathing after a violent collision during a game Tuesday night.

It happened at the school. He was hit on the field and stopped breathing.

The school district said trainers and a school nurse performed CPR and used a portable defibrillator on the boy until paramedics arrived. He started breathing again.

The boy was conscious and talking when he was flown by air ambulance to a Fort Worth hospital, the district said. Stay tuned to myFOXdfw.com and FOX 4 News for updates on this story.

Read more on myFOXdfw.com: http://www.myfoxdfw.com/dpp/news/education/092011-azle-student-athlete-hurt-on-the-field#ixzz1YZe5IEW2

Football player watches his team win after dying of a sudden cardiac arrest.

[ NB: There's more than a ten percent chance that you'll witness a family member or friend have a sudden cardiac arrest someday As you read the story below, think about how you will feel if that person stays dead because you didn't know what to do. Bob] (from katc.com) It's been four months since Breaux Bridge High School Sophomore Teddrick Lewis was on the football field. He went into cardiac arrest during a practice in May. Teddrick is not playing ball anymore but Friday nights, he's back on the field with his team and he has his coaches to thank for it. "Last thing I remember, I was on a helicopter," Teddrick recalled. "I was just hearing noise and breathing funny." The Breaux Bridge sophomore collapsed on the field and became unresponsive. After that, his memory went hazy. Coach Paul Broussard had just seconds to act. "When we got to him, he was on his stomach so we rolled him over and our first thought was he was having a seizure," Coach Broussard said. But it wasn't a seizure. Teddrick was going into cardiac arrest. Coach Broussard's training immediately kicked-in as he started giving Teddrick CPR. Another coach grabbed a portable defibrillator. "It was hard to realize what had happened," Coach Broussard said of the situation. Today, Teddrick can no longer play any contact sports, but that's not keeping him from being with the team and the coach who helped save his life. "I'm always telling my coaches 'thank you for saving my life.'" Teddrick says, "without them, I wouldn't be here right now." And Tedderick is not only thankful for his coaches but Breaux Bridge also walked away with a win Friday night at Comeaux High.

And Another Save

By JON ERICSON, jonathan.ericson@wcfcourier.com | Posted: Friday, September 16, 2011 11:05 am | CEDAR FALLS, Iowa ---- A race for one high school athlete turned into a fight for life. A 17-year-old Decorah cross country runner collapsed Thursday evening while running in the Rich Engel Cross Country Classic at Birdsall Park in Cedar Falls. A spectator at the event, Dr. Greg Hoekstra, began doing CPR on him until a Cedar Falls police officer Sam Shafer and reserve officer Bob Wright arrived on the scene. The officers had an automated external defibrillator and administered the shock to jump start the young man's heart. The athlete was taken to Sartori Hospital. Sartori personnel called the on-scene response a "textbook save" and noted that CPR alone would most likely not have saved the student's life. Cedar Falls Police have been carrying the defibrillators in each squad car for about eight years. Each officer is re-certified to use the devices each year. "Frequently we're on the scene before ambulances and paramedics, so you have to do what you can," said Police Chief Jeff Olson. "We're just thrilled when we can do something like this to help." The athlete's name has not been released. Read More: runner collapses