Wednesday, July 24, 2013

Does Cardiac Arrest, By Itself, Hurt ?

A Sudden Cardiac Arrest.  This is the only picture of this I could find.  Most people who experience a sudden cardiac arrest due to arrhythmic means fall forward and are therefore found face down.  (Picture )

    Over the last four and a half years, when I have encountered parents who lost a child to a sudden heart rhythm disturbance, they have often asked, "Do you think it hurt when our son (or daughter) experienced a cardiac arrest" (due to a rhythm disturbance) ?    Physicians tell us no, and I am inclined to agree.   Some years ago, I was the charge nurse of an ICU step down unit. I was not only in charge of the unit between 3pm-11pm,  had my own patients also, but I was certified and responsible to treat arrhythmias using standing orders, on the adjacent unit, which was a cardiac telemetry unit.  One afternoon, after taking report, and checking that all the intravenous admixtures I needed for my own patients were present and accounted for, I made rounds on my own few patients.  Afterward, it was my job to make rounds on each of the telemetry patients on the adjacent unit which I could conceivably treat during the next eight hours. There were about fifteen of them. I went room to room with my clipboard making note of the current rhythm of each patient and talking to each for a short time.   Everyone was stable and it was shaping up to be a warm but pleasant night.  Then I went in to see a very pleasant older, lucid woman, and we spoke for a moment, and while I was there, she was speaking, and in mid-sentence, she fell into asystole.  She sat in cardiac arrest in mid sentence !   Almost instinctively I took my right hand and tapped her midsternally. (This is known as a pre-cordial thump)    Her heart rhythm returned instantly and she completed her sentence !    She had no recollection of her brief cardiac arrest, although our telemetry unit had automatically printed out a rhythm strip for documentation as it had been preset to do.  I calmly explained what had happened and told her that I would be notifying her doctor, and that likely she would be moved from that unit, onto mine.   She had no recollection of it. She had no pain, no discomfort, and was simply "absent from her body" for a very short time.   Later that night her cardiologist did a minimally invasive procedure which inserted a pacemaker.   The following day she was back in her original room on the telemetry unit and she was doing just fine. She was later discharged to home, and according to her cardiologist, did well afterward.
                   I don't expect that those who experience a simple cardiac arrest experience any pain.  What happens afterward, of course is the purview of theologians, and others in terms of the cognitive and spiritual experiences..   I have resuscitated enough people who have described a beautiful and very real world beyond here, so I am in fact, well satisfied of its existence.  After all, scripture tells us inasmuch "To be absent from the body is to be present with the Lord."
                I also recall as the mother of a child I lost before my eyes presumably due to a sudden arrhythmic death despite CPR and epinephrine injection, wondering the same thing.  Did my dear boy suffer ? Did he know I was trying to help him ?   Since he never regained consciousness during CPR by me, by the sheriff, or the use of  the AED and the helicopter emergency crew, he is likely never to have experienced what happened from the perspective of  his earthly body.

II Corinthians 5:6-8
"Therefore we are always confident, knowing that, whilst we are at home in the body (the earthly body), we are absent from the Lord (we need the heavenly body to be with him): For we walk by faith, not by sight: We are confident, I say, and willing rather to be absent from the body (the earthly body), and to be present with the Lord."

      So, although there may be discomfort before someone experiences a cardiac arrest, those who spontaneously fall into one, like Daniel, and like many children and teens with Long QT,  Short QT. and similar syndromes may not have any discomfort whatsoever.  They simply departed their bodies.

       I hope this is a comfort to those of you who not only have to deal with the stark reality of your child having departed Earth.  At least you know that the likelihood was that there was no discomfort for your child associated with the arrhythmic event itself.

       May God bless you and may you feel Him close to you during this difficult time.

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