Dr. Diane Gorgas
The Columbus Dispatch (Ohio)
Copyright 2006 The Columbus Dispatch
All Rights Reserved
Working as an emergency physician has great rewards and great frustrations. Some problems are easily treated or sewn together; other injuries and illnesses are more complex.
For example, after a call comes in that Columbus medics are bringing in a patient in cardiac arrest, I wait, considering the challenges that will arrive with the patient.
Can we save him? The numbers are not good. Only 6 percent to 8 percent of out-of-hospital cardiac-arrest patients in Columbus are discharged from the hospital with a good status.
Where did the patient go into cardiac arrest? Was it at home or in public? Are medical conditions complicating the patient’s recovery? What was his heart’s rhythm when he was found?
If it was in ventricular fibrillation, he would have a greater chance of responding to treatment. If it was asystole — flat-lined — his chances would be dismal.
Did he get CPR from a bystander before the medics arrived?
I curse the things I can’t change and think about what we can do to correct them.
I can’t control where the patient has his arrest, I can’t correct his history of poorly controlled diabetes and I can’t change the fact that his heart rhythm does not respond to defibrillation.
But CPR is another matter. We know that if he got CPR while he waited for the medics to arrive, his chances of survival double.
There are cities in the United States where nearly 50 percent of cardiac-arrest victims receive CPR from someone. In Columbus, only about 20 percent get it. Although CPR programs are becoming more accessible, few people are trained.
As I prepare for my patient, I hope that someone brave enough to try CPR was nearby when his heart stopped.
But when the medic squad arrives, their faces are grim, and one of them is performing chest compressions while straddling the patient on the gurney.
I know immediately that they could not get his heart to beat.
As the medics give their report, I count the negatives one by one. No witnesses to the arrest; no CPR; unable to get his pulse back.
I wish things were different. I wish someone had witnessed his collapse and started CPR. I wish that the medics had been able to get a pulse back.
And I wish he didn’t look so much like my grandfather.
Dr. Diane Gorgas is an emergency physician at Ohio State University Medical Center.