"When a Heart Stops, Every Moment Counts"
For Patricia Totaro, those precious seconds took place in an unexpectedly
ideal place: church. Dropping off her 11-year-old son at his school in
Hamilton, Patricia suddenly collapsed in cardiac arrest.
Sudden Cardiac Arrest
A sudden cardiac arrest (SCA) occurs when the heart suddenly and completely
stops beating. In Patricia’s case, it is believed mitral valve prolapse,
an abnormality of the heart valves, was to blame.
Clinically, an individual who suffers an SCA has died at the moment the hear stops. Without immediate intervention of CPR and defibrillation, most do not survive.
After her collapse, Patricia was surrounded by fellow parishioners willing to help. “I was at my son’s school in the church when I normally would have been at work. I was fortunate in that there happened to be a doctor and a nurse at the church, and they had an AED (automated external defibrillator) on site,” explains Patricia.
They started the CPR, began administering shocks via the AED (three in total) and called 911. Patricia was rushed to RWJ Hamilton’s emergency department.
Saving the Brain
Years ago, patients like Patricia who lived through cardiac arrest had a tremendously difficult road to recovery. During cardiac arrest, the brain is starved of oxygen. The longer this occurs, the less likely the patient will return to normal brain function.
With therapeutic hypothermia, the body is cooled down to 90ºF to 93ºF
within six to eight hours after return of the pulse, and remains cool
for 12 to 24 hours.
Patricia was an active 47-year-old architect and mother when she collapsed.
Thanks to therapeutic hypothermia, she recovered all cognitive function
following her SCA.
“I’ve had no residual effects,” says Patricia. “I
was fitted with a pacemaker and defibrillator, which are there in case
I need them and I had surgery on my heart valve, but my life is much the
same as it was before.”
Abdallah El-Habr, MD, medical Director, intensivist program, has seen
amazing results following therapeutic hypothermia. “Since we started
doing this treatment, we have had successful outcomes with patients like
Patricia who come into our emergency department as well as in-hospital
patients in cardiac arrest,” says Dr. El-Habr.
“The reason it works well is it protects the brain from the damages
occurring after cardiac arrest. The sooner it is started, the better the
outcome.”
Cynthia Bascara, APN, MSN, CCRN, advanced practice nurse, critical care,
adds that hospitals across the country have begun offering therapeutic
hypothermia, and RWJ Hamilton’s multidisciplinary approach is quite
comprehensive and research-based.
“The intervention is an intense process that involves a team of
medical professionals working together to treat the patient in the most
holistic manner,” she says. “Our nurses receive ongoing education
and training to ensure competency and caring practices for patients and
their loved ones.”
Today, Patricia is working, traveling, kick boxing and of course, enjoying
time with her son. Always interested in community projects, like the Shenck
Farmstead of the West Windsor Historical Society where she was photographed,
a thankful Patricia likes to take opportunities to pay it forward on her
second chance at life.
How to Save a Life
Sudden cardiac arrest (SCA) is a condition in which the heart stops beating.
Someone in SCA will have lost consciousness, stopped breathing and be
lifeless. CPR combined with defibrillation can restore life. Here are
important steps to follow if you witness someone in SCA:
HELP: Time is of utmost importance for someone in SCA. The chances of survival
decrease 10% with each passing minute after collapse. You may be the person’s
only chance of survival.
CALL: Call 9-1-1 to get professional help on the way. Be sure to communicate
with a specific person, otherwise bystanders may hesitate and wait for
someone else to call.
AED: Use an automated external defibrillator (AED), if available. This therapy
can restore a normal heart rhythm. Follow the voice and visual prompts
that come with the AED.
CPR: IF an AED is not available, use cardiopulmonary resuscitation (CPR). If
you are not trained in CPR, push down hard and fast in the center of the
chest. Think “Stayin’Alive” by The Bee Gees as a beat
to follow.