A combination of Dr. Dahle’s medical emergency training, a new approach to CPR called Cardiocerebral Resuscitation (CCR) and the use of an Automated External Defibrillator saved the life of a 54-year-old man who fell to the floor gasping for air and clenching his chest.
“I was walking through the baggage claim area when a man collapsed 30 feet away from me,” Dr. Dahle recalls. “Instantly, four bystanders had their cell phones out and began discussing whether they should call 911 or not. I told two of them to call, and sent someone else to get an AED.”
Next, Dr. Dahle felt for a pulse and found nothing.
“I started chest compressions and after I had pumped on the chest 50 times or so, someone showed up with the AED,” Dr. Dahle said.
An off-duty Scottsdale firefighter, returning from her vacation came to assist Dr. Dahle in attaching the AED pads on the victim’s chest. The machine analyzed the heart’s electrical activity, confirming it was no longer beating but quivering uncontrollably.
Dr. Dahle and the firefighter asked bystanders to stand back and pushed the button. Shock.
“Still no pulse,” remembers Dr. Dahle. “So I resumed chest compressions.”
After compressions and another shock from the AED, the man took a deep breath and struggled to get up from the floor. Paramedics arrived on scene shortly after and took him to a Valley hospital.
Shortly before the second shock, a Phoenix police officer assisted the life-saving team with rescue breaths. During the first five minutes of Dr. Dahle’s response, a bystander commented about needing to give mouth-to-mouth breaths.
“I informed him that wasn't necessary in the first five minutes of arrest,” Dr. Dahle says, referring to research from The University of Arizona Sarver Heart Center.
Cardiocerebral Resuscitation emphasizes continuous chest compressions and eliminates mouth-to-mouth ventilation for cases of sudden unexpected collapse in adults.
“We found that the most important factor of survival is to keep the blood moving through the body by continuous chest compressions,” says Gordon A. Ewy, MD, director of the Sarver Heart Center, who pioneered the CPR Research Group here. “Stopping chest compressions for ventilations was far more harmful than helpful. Excessive ventilations during chest compression turned out to be harmful, too.”
“We’re proud of Dr. Dahle’s quick thinking and use of his emergency training outside of the hospital,” said Harvey Meislin, MD, Professor and Head of Emergency Medicine at The University of Arizona’s College of Medicine. “Dr. Dahle is a well-trained Emergency Physician who is trained to assume command of resuscitations and apply the latest knowledge and techniques.”
The Department of Emergency Medicine’s residency program, under the direction of Sam Keim, MD, is one of the top-rated programs in the nation.
The Scottsdale Fire Department is one of several fire departments in the state to have recently adopted the new approach to CPR, working in close cooperation with the Sarver Heart Center and the SHARE (Save Hearts in Arizona Registry and Education) program of Arizona.
“What happened at Sky Harbor shows how powerful the new approach is,” Sarver Heart Center Director Dr. Ewy said. “In that case the first responders happened to be professionals, but really anybody with the basic training could save a life this way.”
As a cause of death, out-of-hospital cardiac arrest is second only to all cancer deaths combined, taking the lives of 490,000 Americans every year. Surveys have shown that four out of five individuals will not initiate bystander CPR, most often because of the aversion to mouth-to-mouth contact or fear of doing something wrong.
“Chances of surviving cardiac arrest are better with bystander-initiated CPR,” Dr. Ewy said. “If you call 911 and do nothing until the paramedics arrive, the patient has almost no chance of leaving the hospital alive. We expect Cardiocerebral Resuscitation to increase the willingness to perform CPR, as it eliminates the need for mouth-to-mouth ventilation.”
Referring to the more than 2,500 automated external defibrillators registered in Arizona, Dr. Ewy encourages bystanders to use them: “In addition to performing CPR, you can dramatically increase the chance of survival by attaching it to the victim and following the simple voice prompts.”
For more information:
University of Arizona College of Medicine: www.medicine.arizona.edu/
Department of Emergency Medicine: http://www.emergencymed.arizona.edu/
Cardiocerebral Resuscitation: Sarver Heart Center: www.heart.arizona.edu; or the SHARE web site at www.azshare.gov.
