Sunday morning 5.00 am, I was in deep sleep when the door bell rang, multiple times....
I got up startled, wondering who it is at this hour.
I saw my neighbour, a young man, desperate...his father was not being able to breath properly.
I ran to his home and to the patient's side, checked his pulse. It was feeble but present. But he was gasping, unconscious. I quickly asked whether he was diabetic, he was, it could be hypoglycemia I thought. He was cold, definitely in shock. He needed to be in a hospital ASAP. I was just gathering my thoughts when he took a loud gasp and stopped breathing. It was panic and mayhem with all his dear ones around. They all were fearing the worst. The daughter in law called the ambulance. It would take 20 minutes, they said...too late, We had to carry him to the hospital.
I initiated CPR, but couldnt do it all along while we were carrying him. I checked his pupils just before we transported him. They were fixed. It was almost over. We somehow gathered the watchmen and carried him downstairs, got him into a car and drove him to a hospital. Within 20 minutes of me seeing him, we were in the ICU. Once there, the monitors were put on, Oxygen started, Shots of Atropine and Adrenaline were given. Yet no response. Defibrillator was brought in. Still no response. We continued CPR for 20 mins. But no.. he was gone. The reasons could not be deciphered. But the only possibility could have been a massive cardiac arrest.
I got up startled, wondering who it is at this hour.
I saw my neighbour, a young man, desperate...his father was not being able to breath properly.
I initiated CPR, but couldnt do it all along while we were carrying him. I checked his pupils just before we transported him. They were fixed. It was almost over. We somehow gathered the watchmen and carried him downstairs, got him into a car and drove him to a hospital. Within 20 minutes of me seeing him, we were in the ICU. Once there, the monitors were put on, Oxygen started, Shots of Atropine and Adrenaline were given. Yet no response. Defibrillator was brought in. Still no response. We continued CPR for 20 mins. But no.. he was gone. The reasons could not be deciphered. But the only possibility could have been a massive cardiac arrest.
The next 2 hours went in absorbing what had happened and getting the body to the mortuary. The entire episode played in my mind again and again. What more could I have done? I kept wondering. Can I really save lives? NO. We, humans are absolutely helpless in certain situations. At times things work out, at times they don't. But there could definitely have been some way. Some way a life could have been saved.
Only if.. the golden hour had not passed....
The patient, a 71 year old diabetic, hypertensive male was having a minor cough and cold since a few days. That fateful night, he got up at 4.00 am in the middle of the night complaining of breathlessness. All home remedies were then tried, but only when he became unresponsive, they realized this was something more than cold. It was a silent heart attack. From 4.00 am to 5.00 am was his golden hour. If he had reached the hospital in this period he had a chance to live. In a heart attack, the pumping ability of the heart gets affected. This causes less blood supply reaching the brain, and only when it is at a critically low level, the respiratory centre is affected and difficulty in breathing starts. Once a patient stops breathing, it is only a matter of 5-6 minutes. If adequate CPR is not given in this stage, death is inevitable. CPR or Cardiopulmonary resuscitation is Chest compression with intermittent mouth- to mouth breathing to supply Oxygen.
CPR needs to be continued continuously till the hospital is reached or ambulance services arrive.
Three things need to be done in the golden hour-
1. Identify the signs.
2. Call for help.
3. Get to the hospital promptly.
All heart attacks DO NOT cause Chest pain.
These signs need to be looked out for-
1. Heaviness over the chest
2. Pain radiating to arm/neck
3. Heartburn/nausea/ abdominal pain.
4. Perspiration.
5. Breathlessness.
6. Generally feeling unwell or a feeling of 'impending doom'.
Get the patient to lie down. Give an Aspirin(300 mg)to chew and NitroGlycerin only if the patient is already on it. If no relief in 3 MINUTES. Call an ambulance, let it be a false alarm. Keep the ambulance number handy, preferably a Cardiac Ambulance and go to a hospital where emergency Cardiac Services are available preferably one with a CATH lab where immediate Angioplasty could be possible.
If the patient stops breathing, start CPR, there are videos online which show how its done. One doesn't need to be a doctor to do it. DO Not leave the patient alone, continue CPR incessantly till you reach the hospital.
I couldn't save a life that day, but possibly spreading the word could save another one. Seize the golden hour.....
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