Clinically dead for 40 minutes and alive to tell the tale

What started as a normal working day in suburban Melbourne for Vanessa, a 41-year-old mother of two, suddenly became a lengthy battle for her life. While sitting on her couch at home Vanessa started feeling chest pains and collapsed.

Fortunately, her mother was with her and remembered seeing the Australian Heart Foundation’s “Warning Signs” advertisement and recognised the symptoms of a heart attack. A call to ‘Triple 0’ had Mobile Intensive Care Ambulance (MICA) paramedics at the house within minutes. She arrested soon after the paramedics arrived, but was successfully defibrillated with a single shock and was stabilised for the journey to Monash Medical Centre in Melbourne, Australia.

During transportation, the ECG data was transmitted from the ambulance to the hospital to alert Emergency Department staff of an incoming STEMI patient and the need to activate the cardiac catheterisation lab. Upon arrival Vanessa was conscious and talking to the medical staff, however she suffered a second cardiac arrest while speaking to the Interventional Cardiologist. Nurses started manual CPR and defibrillation, but after a few minutes it became obvious that ventricular fibrillation could not be reverted and that resuscitation was likely to be protracted.

Several staff members were co-opted to transfer Vanessa to the operating table and to provide manual CPR. This quickly became a trying task given that the staff were wearing heavy lead aprons and standing on stools so as to be in the correct position to deliver compressions on the elevated operating table.

The Clinical Nurse Educator working in the adjacent lab was called to assist and made the decision to use the LUCAS 2 mechanical chest compression device to provide automatic external chest compressions. The radiolucent carbon fibre backboard was placed under Vanessa’s shoulders and the piston/suction cup placed over her chest. Once started, the LUCAS 2 applied continuous chest compressions of at least five centimetres at a consistent rate of 100 or more compressions per minute.

The mechanical compressions maintained blood pressure within the vessels and allowed the doctors to gain access to Vanessa’s femoral arteries. The Interventional Cardiologist performed an angiogram and then threaded catheters through to the site of the blockage to conduct an angioplasty to unblock the coronary arteries. The LUCAS 2 worked continuously the entire time under the drapes of the sterile field, protecting the staff from unnecessary exposure to fluoroscopy.

Despite having a downtime of approximately 53 minutes, she was discharged from the hospital just seven days later. Post operative tests indicated that she had no noticeable neurological deficits and following a stress echo cardiogram at 6 weeks Vanessa was cleared to return to full-time work and a fully normal life.