CPR in the real world

Last Monday evening, at the last minute, Art and I took a refresher CPR course at our resort. It's gotten simpler through the years. Now, if there's a witnessed cardiac arrest, CPR is chest compressions only. If a person's heart stops beating suddenly, there's oxygen already in the blood. The chest compression squeezes the heart to pump the oxygen to the vital organs of the body. The thinking these days is that the "two quick breaths" doesn't increase the chances of survival. I did my practice on a dummy under the watchful eye of a second-year University of Arizona medical student. Then we were shown how to operate an AED, a defibrillator that talks the user through the procedure, from placing the pads correctly, to running the analysis, to generating the shock if necessary. We were given the locations for the five defibrillators on the resort. Then we walked home.

Yesterday after lunch, Art and I rode our bicycles over to the pickleball courts to try our hand at this new sport. He was winning 10-8. He walked to retrieve the ball and suddenly clutched his left knee and approached the bench on the side to sit down. He had that knee replaced two summers ago and I was concerned he might have wrenched the appliance. I sat down beside him. "Does your knee hurt?" Art shook his head. "Does anything hurt?" He didn't answer. I looked at his face and it didn't look right. Out of my 65-year-old brain floated the questions you ask a person you suspect may be having a stroke. Can they repeat a complete sentence you give them? Can they smile? Can they raise both their arms? Art repeated the sentence faintly. Then he slumped into me.

I looked up. At the end of the pickleball court, half a dozen men were chatting. "Call 9-1-1",  I shouted. First step, remembered from my CPR training five days earlier.

I could see most of the men running toward me. "Let's get him on the ground," one said. Art resisted a little, but he was transferred from the bench to the ground by three of the men. He was breathing, gasping a little. One of the men said, "I'm a retired fire chief. The AED is on  the way." Someone had run 100 feet to retrieve one of the five defibrillators.

"Start CPR," said the chief. "He's still breathing," I responded. "You're not supposed to do it when they're breathing."

Then he wasn't breathing. No chest rising and falling, no pulse. Art was in cardiac arrest; his heart had stopped. I placed my hands over my husband's chest and started CPR. I thought his chest felt exactly like the dummy I'd practiced on. I paced myself for 100 compressions a minute, remembering the song "Staying Alive" which has the beat I needed to match.

The chief tore Art's t-shirt off, opened the AED box and extracted the shock pads. He placed one pad at the top left of Art's chest, the other at the bottom right. He pushed a button and the machine said, "Analyzing."

I was still doing CPR. A man standing over me said, "Want me to spell you?" I said, "I'm okay for now, but if you help, you need to kneel on the other side of his body to be ready to take over for me."

The AED said, "prepare to execute shock". The machine will only shock if there is no heartbeat or an arrhythmia that can be fixed. We pulled away and Art was shocked. His body jerked, drool oozed down the side of his mouth, and he opened his eyes.

He was alert as to place and time. The men remained with him until the paramedics arrived. The chief told the EMTs what had happened and passed the responsibility on to them. Then he said, "I'm going back over to the pool." I called to him and asked his name. Scott. A resident of the resort. I didn't get his last name. I need to thank him.

Art was transported to the University of Arizona Medical Center South Campus and I arrived by car about 45 minutes later. A cardiologist would be doing a cardiac catheterization. The procedure would take about an hour, he said. If they found anything they would probably fix it while they were in there. If a stent or a bypass was needed they would do it then. An hour later, the doc came out. "The best possible news. His arteries are clear. He did not have a heart attack."

In ICU for 15 hours, all the tests were run. Echocardiogram showed no damage to the heart. Blood work showed very low potassium levels, which is probably the cause of the cardiac arrest. Within six hours of admission Art's heart rhythm returned to normal; it has remained that way for 20 hours now. Potassium levels are now normal. Art is eating like a horse, texting friends, talking to visitors. He may be released tomorrow.

My husband's heart stopped. CPR performed by me kept the blood flowing to his vital organs until the AED shocked his heart back to life. Amazing.

I have no idea how I remembered CPR. It seemed natural to be kneeling there on the ground ministering to my husband. I felt no fear.

Then this morning I woke up at 4:00 a.m., full of fear and unable to go back to sleep. The adrenaline that kept me going had worn off.  It has been a busy day - six more hours at the hospital, talking to doctors, talking to five of our eight children by text and by phone, answering emails from concerned friends, remembering to eat from time to time.

I am very tired tonight. I hope I will sleep.

I saved a life. That's CPR in the real world.