When someone unexpectedly drops dead

 

On January 2023 a football player for the Buffalo Bills named Damar Hamlin was tackling an opponent and the opposing player’s shoulder struck his chest.  Both players fell.  When Hamlin stood he took a few steps, then collapsed.  His heart had stopped working.  One of the team’s health people came onto the field, began CPR, and, using an AED shocked the heart. A moment later the heart muscle started pumping blood to the man’s body.

The ventricles of the heart are finely woven assemblages of small muscle fibrils that contract in unison.  They propel oxygen containing blood to the brain and the rest of the body.  When the heart is traumatized by a blow or a myocardial infarction, the fibrils can stop working as a team.  Then start quivering or contracting independently, and the ventricle doesn’t compress.  Blood stops flowing.  We call the accompanying EKG electrical pattern ventricular fibrillation.  The cells of the body can survive without oxygen for 4 minutes. Then they start to die.  When a “fibrillating” heart is shocked, its muscular fibrils “freeze” for a few seconds.  Then they again start functioning, usually normally like their old selves.  With all the fibers again working as a team the ventricle of the heart pumps blood. 

For most of us there are defibrillators in airports and many shopping centers. They’re not pricey, and they are easy to operate, but many are afraid to use them. U.C. Berkeley put one near a volley ball court and locked the case so no one can easily steal it. That also means no one can use it if someone drops. Hard to figure what they were thinking.  In the absence of a defibrillator, rescuers commonly resort to plan B and give CPR. Their efforts push some blood through the system.  My hospital required me to retake a class in CPR every two years. The last time I took the course, the teacher said people who develop a lethal rhythm need to be shocked early. If the jolt is delivered within a minute, 90 percent of people survive (presumably without noticeable brain damage). After two minutes 75 percent survive, and at four minutes only 55 percent.

There are defibrillators up and down the halls of Chicago’s O’Hare Airport. A survey performed shortly after they were installed found the gadgets had already been used 14 times, and 9 of those shocked came back to life.  When someone witnesses a sudden death, confirms the heart isn’t beating, and has access to an AED—automated external defibrillator—they merely need to open the case and listen.  An automated recorded voice tells them what to do next:

“Attach the electrode pads.

“Don’t touch the patient.

“Analyzing. Shock advised.

“Charging. Stand clear.

“Push the flashing button to deliver shock. Stand clear.”[M1] 

Most people who check out one of the brief YouTube videos on AEDs realize how simple their operation has become. If they’ve seen episodes of TV shows like ER, they’ve witnessed the drill a few times. Which doesn’t mean it’s not frightening to perform the task on a live person.  Most people don’t notice the devices that hang on public walls. A survey in a Netherlands train station (per a project manager from Kings County, Washington) found that half the people questioned “couldn’t identify an AED,” and fewer than half of them would consider using one of the devices.  After 40 years, 300,000 people are still dropping and dying each year, and the survival rate to hospital discharge is 8.4 percent.

https://www.vox.com/science-and-health/2023/1/3/23537280/damar-hamlin-heart-cardiac-arrest-nfl

https://www.vox.com/science-and-health/2023/1/3/23537280/damar-hamlin-heart-cardiac-arrest-nfl

 

 

 [M1]This may work better formatted as an extract.

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