The odds of surviving a sudden cardiac arrest are dismally low, especially if the crisis occurs in a remote location. A visitor to Crater Lake National Park last month beat those odds, thanks to a combination of good staff training and modern medical care. It was a situation where every link in the "chain of response and treatment" worked to perfection.
On the afternoon of July 16th, park dispatch received a radio call from the park’s remote north entrance station reporting a female bicyclist who was experiencing chest pain. Visitor Use Assistant Chris Reinhardt went to the 52-year-old woman’s aid and relayed patient information to responding rangers and other park emergency services personnel.
While other emergency responders were still en route, Reinhardt advised that the woman had become unresponsive and that he was beginning CPR. EMS personnel, including park medic Jason Ramsdell, arrived to find the woman in cardiac arrest. They immediately employed an automated external defibrillator (AED) to administer three shocks to the victim's heart. The shocks, combined with Advanced Life Support medications, restored her pulse. She was then flown by Mercy Air to a hospital in Medford.
We occasionally read news reports of similar incidents, but rarely know much about the outcome. In this case, the cardiologist who treated the woman called the park several weeks after the emergency to report that the incident had had a positive outcome; he pointed out that "every link in the chain of response and treatment resulted in saving her life." Those steps included:
• Prompt recognition of the problem.
• Effective CPR with fast, deep chest compressions.
• Prompt use of an AED.
• Early ordering of the life flight, as the woman likely would not have survived a ground transport.
• Getting the patient on a cardiac and breathing machine as soon as she arrived at the hospital in Medford.
• Implanting a new stent and placing the patient on a hypothermia machine.
According to a park spokesperson, "the cardiologist said that survival rates for CPR/AED events are less than 10%. The woman’s previously implanted stent had become completely clogged. She arrested 12 times after arriving at the hospital and was shocked back each time. But she was off the cardiac machine within three days, was off breathing tubes and other interventions within seven days, and was discharged from the hospital 12 days following the incident."
"While the full extent of damage to her heart may not be known for a few more weeks, her survival is the result of every person in the chain of care working together, providing excellent treatment and making wise decisions."
The doctor plans to submit the story of the incident to the American Heart Association due to the remote nature of the incident and the positive outcome.
Kudos to the park staff and others in the EMS system for a "save." The incident also offers a reminder to all of us about the benefits of learning CPR and how to use an AED, as well as the value of funding for AED equipment in locations such as NPS areas.