Just curious about the point of no return and such. My understanding is if the individual has been without a pulse for too long that the brain cells start dying, and apparently are the first ones in the body to do so. Yet that would also include the cerebellum which controls autonomic functions, right? Is that why they have to hook him up to a respirator? Is the prognosis as bleak as the various headlines yesterday seemed to indicate? Has anyone actually come back from such a diagnosis (in which case it might have been mistaken)?
It wasn’t reported that he had a coronary (coronary thrombosis). The reports I saw said that he had a cardiac arrest. So blood was still being pumped to his brain, although inefficiently. Patients get hooked up to ventilators when they’re breathing inefficiently or not at all.
There are only a precious, few minutes after someone goes into cardiac arrest for someone to initiate action to save the brain from oxygen starvation. That is why CPR, although it doesn’t often work, is so widely taught. AEDs or automatic defibrillators are becoming more widely stocked in areas like schools but even then someone needs to take action to keep the blood moving until the AED arrives. The AED is very simple. You just hook it up and it will read the vitals and tell you when to push the button. But even if it takes only 5 minutes to get the AED that is too long to wait without other action to keep the blood moving.
If someone is with the person who has an attack, and they take action while waiting for help, the patient has a chance of recovery.
As I understand from the mostly crappy news coverage, Tom was found unresponsive in the early morning hours. There probably was no one who witnessed the event and an unknown amount of time had passed, the precious minutes went by before he was found.
No, cardiac arrest means ‘pulseless non-breather’. No perfusion of any significance, unless CPR is being done.
As noted by DJ, the first few minutes are critical. Early defibrillation is what’s needed. But not all cardiac arrest victims are revivable, even if defib happens early. Chances are never good, unlike what is seen on TV.
Thanks. I thought there was till some blood being pumped in various types of fibrillation.
In atrial fibrillation, yes. But atrial fibrillation doesn’t generally result in cardiac arrest, and indeed can be lived with for many years successfully.
Ventricular fibrillation doesn’t perfuse. Ventricular tachycardia can perfuse, depending on a variety of factors. But it tends to deteriorate into non-perfusing pretty quickly. That’s why those rhythms are shocked quickly when detected.
Indeed. I had a friend who died a few years ago. He went into cardiac arrest while in the ER, and even then, with just about the best help you could possibly have in such an event, it wasn’t enough. He spent a month in a coma before finally passing away.
A ventilator can not only move air for you if you are not doing so yourself, it can give you a higher concentration of oxygen, so that if you are moving air inefficiently, the air you do get has more oxygen, or more to the point, if your blood flow is not good, each pump “counts for more” by being more highly oxygenated.-
When my son was born, he had meconium in his airway, and they wanted to keep him from aspirating it into his lungs. He was born not breathing, which is normally a very, very bad thing, but in his case, it might have been lucky. He didn’t take a deep breath at birth, and suck way down a lot of meconium, which bacteria consider nutrient-rich. Babies that aspirate meconium are in danger of lung infections.
Anyway, he got good and suctioned, before they began to respirate him, and then he started crying, and turned all shades of red, after being born blue.
He was in an isolette on 10% oxygen for 12 hours, so he wouldn’t take deep breaths, and any leftover meconium could work it’s way out. He was on his stomach, tilted slightly downward-- only about a 5% grade. He also had a shot of a powerful antibiotic, and another one after 12 hours, just before they let him out of the isolette.
It was kind of the same idea-- oxygenated air goes further.
I kind of jumped, though, when I heard he was on oxygen, and though of all the preemies from the 1960s with retrolental fibroplasia blindness from very high concentrations of oxygen in incubators. The doctors were surprised I knew about that, and explained that 10% was not very much.
Indeed. During my time as both a CPR-certified ambulance driver and then a New York State E.M.T. I had occasion to perform both manual C.P.R. and use an A.E.D on a patient.
You are almost always fighting a useless battle. This isn’t “E.R.”. Let’s assume the very best case scenario- that the emergency was directly across the street from the ambulance building. ( I did that call once. My daughter’s violin teacher’s front sidewalk was across from our ambulance bay. Response time was called out and in at the same time. Orange County 911 Dispatch asked us to confirm. 
). So, the tones go out at 9:00 pm. Crew assembles by 9:04. Rolls at 9:05. Enters home at 9:06. Starts C.P.R. at 9:07 ( after ascertaining there is zero pulse. )
Assuming that Mrs. Violin Teacher dropped out of her easy chair and that drop was witnessed and 911 was called IMMEDIATELY, she has been without oxygen to her brain for 7-8 minutes in the very best scenario. Here’s a minute by minute log of what happens to the brain and body in total oxygen deprivation.
I did, what, maybe 2 dozen C.P.R. calls in the years I rode? Maybe 3 dozen? Of those, we brought someone back to a normal sinus rhythm no more than once or twice- and in both of those cases it didn’t last long after arrival at the hospital. Keep in mind that a cardiac call launches Paramedic response, not just E.M.T.'s. Paramedics can push drugs and on a cardiac call, boy howdy do they push the drugs. A series of chemicals designed to help the heart restart.
It’s usually just too long a period of time. ONCE- once- I did manual C.P.R. with my partner, and by the time the Paramedics arrived we had taken the patient from completely dead to a normal rhythm. The Paramedics checked her, we loaded her and took her to the hospital. Where she remained alive and alert. For roughly 30 hours. Then she died, for good.
You just cannot trick the body that way, not usually.
Here’s a useful site from the [url-“http://braininjuryfoundation.org/”]Brain Injury Foundation on oxygen deprivation to the brain. A very interesting idea being floated here.
Bottom line? Learn C.P.R. and if you work in a company or institution of ANY size- 9 employees or 900- get an A.E.D. on the wall and give some training in its use. Its use is done with pictograms, you really don’t have to be trained. It’s more to make people familiar enough with the gear that in the ( for civilians ) frightening heat of the moment, precious minutes aren’t lost figuring the stuff out.
American Red Cross C.P.R. programs nationwide.
( Oh- the violin teacher call? It wasn’t a C.P.R. call. It was a broken leg from a bad fall. Just used the proximity to mak the point. )
Hmm? Normal air is 21% oxygen.
Did they mean 10% extra on top of that? Or was he deliberately being oxygen-deprived?