Tech with CPR training saves man’s
life
by Mary Helen
YarboroughPublic Relations
He may be an instrument tech in MUSC’s Digestive Disease Center, but Dan Clamp became the difference between life and death for a Greenville man on a night Dec. 1.
Clamp was at his home in Folly Beach when a knock at the door initiated events that would last all night, and for one man, almost a lifetime.
Dan Clamp“There was a lady moving next door, and she had a U-Haul van and an older gentleman helping her,” said Clamp, a nursing school aspirant. “I had seen them moving all day, and at about eight that night, she knocked on my door.”
Clamp didn’t know his neighbor that well, but she knew he worked at the hospital, he said.
“She said something wasn’t quite right with her friend and she wanted me to take a look at him,” Clamped recalled. “So, I went over and he was conscious, but he was exhausted.”
The woman’s home had been packed and emptied of all furniture. The only seat in the house was a toilet.
“He was sitting on the toilet, because there was no furniture anywhere,” Clamp said. “It appeared to be exhaustion, but he mentioned that his left arm was in pain.”
By this time, Clamp realized the man was headed for a full-blown heart attack.
“I immediately told (my neighbor) to call 9-1-1 and get him to the ER. He didn’t want to go to the ER,” Clamp said. “He said, ‘If I could just rest a minute,’ and then he started to code. He went into cardiac arrest.”
Clamp laid the man on the floor and proceeded to apply the cardio-pulmonary resuscitation (CPR) training he acquired one year earlier.
“I tilted his head back and did a mouth sweep,” Clamp said. “I took out his dentures, which were loose. (If they are not loose, it’s better to leave them in to help create a good seal. Loose dentures can become dislodged and block the throat.) I gave him two rescue breaths and started chest compressions.”
Meanwhile, Folly Beach police, trained in emergency medical response, responded to the 911 call. Folly Beach police cars also are equipped with automated external defibrillators (AEDs).
The man, in his early 60s, had no heart beat or respiration for five minutes until the police placed the AED on his chest and shocked his heart back into rhythm. The decompression kept the blood flowing to his heart and brain even though it had not been beating on its own. “It helped postpone the onset of brain death,” Clamp said.
The man took a breath and his heart continued to beat, but he required rescue breaths, Clamp explained.
“I administered two rescue breaths every 30 seconds. Then the paramedics arrived. They got there in 10 minutes, but it seemed like an hour,” he said.
The paramedics loaded the man in the ambulance and Clamp rode along. He was now committed to a man he had never known, but a man whose life had lain in Clamp’s hands.
Upon arrival at MUSC, the man was promptly placed in the heart catheterization lab where doctors discovered a completely blocked right coronary artery.
“The patient had what is called an ST segment elevation inferior wall myocardial infarction that was caused by occlusion of his right coronary artery, which was the dominant coronary artery in this particular patient,” said Bruce Usher, M.D., the attending cardiologist and director of MUSC’s Cardiology Fellowship Program. “The artery was occluded by a clot (thrombus) and the clot extended from the opening of the artery to the end of the artery.”
Usher explained that the patient had ventricular fibrillation in the emergency department approximately 10 to 20 times requiring cardio-pulmonary resuscitation (CPR) and electrical shocks.
“He was taken to the cardiac cath lab as a last ditch effort to restore blood flow to the area of his heart supplied by the right coronary artery,” Usher explained. “In the cath lab, he again had about 10 to 20 episodes of cardiac arrest requiring electrical shock and of course management of his respiratory system and metabolic derangements. We attempted to restore flow to the right coronary artery and were unsuccessful because of the large clot in the artery.”
MUSC medical staff applied everything they could to extend the life of this dying man. Their determination proved critical in the long run.
“We did use an intra-aortic balloon pump to help support his blood pressure and respirator or ventilator to manage his breathing,” Usher said. “He was (sent) to the CCU and managed medically at that time, although we did not know the status of his brain function.”
Surgery was never an option for this patient who was constantly having cardiac arrest, Usher said.
According to the American Hospital Association, about 1 million to 1.5 million myocardial infractions occur each year in the United States, and about 400,000 of these people never survive to reach the hospital due to the cardiac arrhythmia ventricular fibrillation, which this patient had, Usher explained.
“Only with early CPR and electrical shock, as occurred in this patient by Dan Clamp and the EMS, was this patient kept from being in the group that does not survive to reach the hospital. The superb treatment in the ER, cath lab and CCU allowed this patient to recover,” Usher said.
While the man lay in the CCU, life sustained by every available piece of equipment and personnel assistance that a hospital has, the man, who by all accounts should have died, rebounded.
“The doctors had told family members that if life support were removed, this man would die,” Clamp said. “There was some discussion of whether to remove life support, because the family did not believe it would have been right for him to continue if he was brain dead.”
That critical point, to remove life support, was to have come a week after this semi-retired, flea market merchant’s heart first stopped beating.
“But on Sunday, he woke up and was trying to extubate himself,” Clamp said with a gentle laugh. “He was trying to pull the ventilator out of his throat.”
“A miracle, for sure,” is how Clamp and others described it. But it was the amazing perseverance of the human body to overcome nature’s wrath assisted by an undying will by medical professionals not to readily lose a fight.
It turns out, said Clamp, this man’s healthy arteries compensated for the blocked artery and took over within a week.
Still, prognosis is tied to risk-factor modification and appropriate medical management, according to the American Heart Association/American College of Cardiology Guidelines, and follow-up with his primary care physician and a cardiologist, Usher explained, adding, “With very superb care by the CCU staff and this cardiology team, he was supported and had a remarkable recovery.”
You, too, can save a life
Clamp was honored by the Folly Beach City Council for his heroic act. But Clamp said that it’s not about him or being a hero, it’s about using his experience to inspire others to become trained in basic life support (BLS) through the American Heart Association.
In December 2005, exactly one year before he applied what he learned on the Greenville man, Clamp had become certified in BLS, which includes mastering CPR. He took the course at Miller-Mont Technical College in North Charleston where he previously had graduated with an associate’s degree in surgical technology.
“Everyone, at least one member from each family, should become certified in BLS,” Clamp said. “You may never know when you would have to use it, or whose life may rely on your response.”
CPR facts, statistics
- About 75 percent to 80 percent of all out-of-hospital cardiac arrests happen at home, so being trained to perform cardiopulmonary resuscitation (CPR) can mean the difference between life and death for a loved one.
- Effective bystander CPR, provided immediately after cardiac arrest, can double a victim’s chance of survival.
- CPR helps maintain vital blood flow to the heart and brain and increases the amount of time that an electric shock from a defibrillator can be effective.
- Approximately 95 percent of sudden cardiac arrest victims die before reaching the hospital.
- Death from sudden cardiac arrest is not inevitable. If more people knew CPR, more lives could be saved.
- Brain death starts to occur 4 to 6 minutes after someone experiences cardiac arrest if no CPR and defibrillation occurs during that time.
- If bystander CPR is not provided, a sudden cardiac arrest victim’s chances of survival fall 7 percent to 10 percent for every minute of delay until defibrillation. Few attempts at resuscitation are successful if CPR and defibrillation are not provided within minutes of collapse.
- Coronary heart disease accounts for about 550,000 of the 911,000 adults who die as a result of cardiovascular disease.
- Approximately 330,000 of all annual adult coronary heart disease deaths in the United States are due to sudden cardiac arrest, suffered outside the hospital setting and in hospital emergency departments. About 900 Americans die every day due to sudden cardiac arrest.
- Sudden cardiac arrest is most often caused by an abnormal heart rhythm called ventricular fibrillation (VF). Cardiac arrest can also occur after the onset of a heart attack or as a result of electrocution or near-drowning.
- When sudden cardiac arrest occurs, the victim collapses, becomes unresponsive to gentle shaking, stops normal breathing and after two rescue breaths, still isn’t breathing normally, coughing or moving.
Friday, Feb. 9, 2007
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