Magazine article Parks & Recreation

The Heart of the Matter: In the Event of Sudden Cardiac Arrest, Having Access to an AED Can Mean the Difference between Life and Death

Magazine article Parks & Recreation

The Heart of the Matter: In the Event of Sudden Cardiac Arrest, Having Access to an AED Can Mean the Difference between Life and Death

Article excerpt


Amy Fortenberry was sitting in the front row in a classroom at the Oglebay Resort and Conference Center near Wheeling, West Virginia, listening to Jim Niskanen, parks and recreation director for Modesto, California, offer guidance on fund-raising alternatives at the National Recreation and Park Association Directors' School.

"He was doing a great job," says Fortenberry, director of parks and recreation for Piano, Texas. "But in the middle of it, he suddenly fell and did a face plant into the base of the podium."

Niskanen had collapsed, suffering from sudden cardiac arrest. "At first, I thought this was some sort of test, to see how we'd react," Fortenberry says. But almost immediately she realized "this was for real." A firefighter's wife with seven years of cardiopulmonary resuscitation instruction under her belt, she leaped out of her seat and went to work on Niskanen. She was joined by Lisa Cline, director of services at Odessa College in Texas, also a veteran of CPR training.

"We rolled him over, but I couldn't find a pulse, so we started CPR," Fortenberry remembers. "Someone ran to call 911, and I yelled for someone to get an AED"--an automated external defibrillator--"and it showed up about a minute later. I applied the AED's pad, someone else pushed the button, and it did what it was supposed to do: It told me to give him a shock. The first one, nothing. So I did a second, and he reached up and grabbed me. I saw his eyes correcting their focus, and pretty soon he was talking with a colleague who came over from the next room. Having the AED nearby was critical; it took 10 or 15 minutes for the ambulance to arrive. He wouldn't be alive today if an AED wasn't available. There was some heavy praying going on."

"We lost him at least twice," says Cline, who had been sitting in the rear of the class. The two Texas women didn't know each other before they began working as a team, but, Cline says, "we just reacted automatically, as if we'd known each other all our lives."

"I didn't know what happened," Niskanen recalls today. "I was probably out for less than five minutes, because after five minutes, you begin to lose brain function. I can remember everything, even which slide I was on in my lecture. I'm happy to be alive. It's an interesting set of circumstances: I could have been at my desk in Modesto and not survived. But the response was so quick, so good."

The ambulance ferried Niskanen to Wheeling Hospital, where nurse Mandy Bell, whose mother had died of sudden cardiac arrest, took over in the initial stages of his care. Cardiologist Robert Fanning, Jr., who had lost a brother to sudden cardiac arrest at the age of 29, soon determined that a major blockage in the left ventricle of Niskanen's heart had caused him to collapse, and that surgery was needed the next day. A few weeks after the surgery, well on the road to recovery, he returned home. But there is a further irony to his story:

Niskanen's brother Robert is director of research at Physio-Control, a division of the Medtronics Corporation, which made the very AED that saved Jim Niskanen's life, and has spent years working on life-saving instruments for the heart. Niskanen called his brother from the hospital.

"I said I had good news and bad news," he remembers. "I said the good news is that they had an AED and used it, and it worked. The bad news is that they used it on me!"

Estimates of the annual number of sudden cardiac arrest (SCA) cases in the United States range from 250,000 to 350,000. The survival rate is about 5 percent, which means that 19 of every 20 victims die. In large part, this is because they don't receive initial treatment--CPR and AED shocks--in time. The American Red Cross says that every minute a victim is unconscious results in a 10 percent decrease in the likelihood of resuscitation. After 10 minutes, very few victims recover. …

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