|Erik, (on the far left) and his family) (Photo: Kirk Barron- Appeal-Democrat)|
This week I read the remarkable story of Erik Shieve. Erik is a sixteen year old high school student who lives in California who was not known to have any medical problems. On May 24th, 2014, Erik had just played in a basketball game. He went to sit down and promptly collapsed. He was observed to be having a seizure. He was not breathing and did not have a heartbeat. CPR began at once, but there was no AED at the venue ! Two physicians initiated CPR and continued to provide it for ten minutes, until he could be transported to a hospital three miles away.
Most of the time, a sudden cardiac arrest in a teen that does not receive aid from an AED within several minutes, results in a sudden cardiac death. Erik endured a cardiac arrest with continuous CPR for ten minutes, and by the time he received a shock from a defibrillator, he would, most times, either not have survived, or would have experienced significant brain damage from having endured a sustained arrest for such a duration. This day however, the miracle we as parents hope for in such circumstances, came. Eric was not only resuscitated after ten minutes, but was talking coherently when his heart returned to a normal rhythm. He was then transferred to Intensive Care Unit. The fact that Erik had survived and was talking was relayed in a wonderful text message for those at the game from which he had departed. For each minute that defibrillation is delayed, the child, teen, or adult in sudden cardiac arrest, even with CPR, has a 7-10 % decrease in survival. I am thrilled for Erik and for his family. Erik was ultimately transferred from the ICU to another California hospital in order to receive an implantable internal defibrillator.
I cannot hear stories such as this without my heart skipping its own beat and traveling back to the day, now five and a half years ago, when our beloved Daniel who had played soccer with college aged students the day before, at a family gathering, collapsed in the bathroom and also experienced an apparent cardiac arrest. When my husband and I got through the locked door, there was evidence of a seizure. (When there is a sudden cardiac arrest and a complete and sudden cessation of oxygenated blood to the brain, there is often a brief seizure, often with vomiting, and the patient often falls forward while collapsing.) I started CPR at once and our daughter called 911 requesting the medical helicopter to the farm and telling them there was a cardiac arrest in a twelve and a half year old boy. Although I gave two doses of epinephrine in total, we didn't own an AED, why would we have ? The deputy sheriffs who were first to arrive, had one and tried it repeatedly,as per protocol, but by then we were likely at the fifteen minute mark. I had done CPR continuously until they arrived and his color was very good, but that day, there had been no spontaneous return of breathing or of heartbeat. We did everything we could possibly do. I really did expect that miracle for us ! Daniel got CPR almost immediately. He received two doses of injectable epinephrine (because we had it for those family members who are beesting allergic) All that was missing was the AED. That day, the 7-10% per minute decrease in survival piled up too quickly. Our miracle didn't come. My being an RN who worked critical care and who had successfully resuscitated more patients that I can quantify, counted for nothing that day. I did not have the one piece of equipment that may have made the difference that day. I still can't quite believe that our healthy, vibrant son Daniel, left us that day. It often feels as if he is simply away and busy on some pivotal project.
We do now own an AED.. It is an expensive proposition for a family to have. The patches and the specialized battery should be changed each year, at a cost of a bit more than a hundred dollars. The software to the device sometimes needs updating. Ours has modes which allow it to operate for babies, children and for adults, although not all AEDs are designed to operate in this fashion. Sadly, it may never be used here again, and was notably absent when the day when it may have been the only thing that would have allowed Daniel to remain with us and finish growing up, ultimately go out into the world. However, an AED should be at every practice, every sporting event, every school, and every governmental building. I am sure Erik Shieve's family would agree !