How Long Can Someone Be Dead Before Being Revived

Howard Snitzer's heart stopped beating for 96 minutes last January. Get-go responders didn't give up on him, thanks in function to capnography, a technology that let them know Snitzer however had a adventure of coming back. May Clinic hide caption

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May Clinic

Howard Snitzer'southward middle stopped beating for 96 minutes last January. Outset responders didn't give up on him, thanks in part to capnography, a technology that let them know Snitzer yet had a take a chance of coming back.

May Dispensary

Final January, a Minnesota human being'south heart stopped beating for an amazing 96 minutes. Emergency room doctors thought he was dead. Only outset responders who gave CPR on the scene decided non to give up, in part because of technology that allowed them to see their efforts were working.

It'south chosen capnography, and it measures how much carbon dioxide is beingness expelled with each breath. This information helps doctors and emergency medical personnel determine whether a patient is hyperventilating or having a heart assail. It also helps them determine how to care for an asthma attack, or determine whether CPR is working.

How It Works

At a fire station in Brook Park, Ohio, medical officers put a tube in my nose and hook me up to the machine to show me how it works.

"OK, that last data stream there is the capnography. At present just breathe normal," Lt. Mark Lynch says, pointing at a graph on the screen that moves up and down when I breathe.

I watch the monitor as I inhale and breathe. "Every time I exhale out, it goes up," I remark.

"Yes. That'southward the exhalation. Correct," Lynch confirms.

There is also a number on the screen that corresponds to the carbon dioxide I exhale — an judge of carbon dioxide levels in my blood. Every bit I alter my animate, the number changes, likewise. By breathing rapidly, I blow out carbon dioxide, and the number on the screen goes down. If I hold my breath, it goes upward. Lynch explains that if I were unconscious and receiving CPR, the carbon dioxide levels would tell them how efficiently their chest compressions were pumping blood through my lungs and to my organs. Breathing normally, my number is 35.

"At present, during practiced CPR, this is probably going to be around 25 — if you keep this up in that 25 range, then there'south circulation still going on. ... That'southward where you're going to go a positive issue," Lynch says.

Capnography is non a new technology. In fact, it's been around for years, used by anesthesiologists to monitor a patient's breathing during surgery.

Only these days, the technology is making its way out of infirmary operating rooms and into portable devices that are helping first responders make disquisitional — sometimes life-saving — decisions.

Knowing When Not To Quit

That was certainly the case for Howard Snitzer when he collapsed in front of a Minnesota grocery store i cold night last Jan. Afterward he woke up days later on, some of the emergency medical personnel who helped that night told him what had happened.

"They said, 'We were wondering what you remember virtually your centre attack.' And I said, 'Cipher.' And they said, 'Well, here'south what we remember.' And they started telling this story, and I was just diddled away," Snitzer recalls.

For more than an hour and a half, Snitzer had no pulse. Emergency room doctors said there was aught more they could do. But one of the flight nurses who had come up with the emergency helicopter had been trained in capnography. Snitzer'south carbon dioxide levels suggested that blood was flowing to vital organs like the heart and brain, and the nurse thought Snitzer still had a adventure.

The nurse "called the emergency room doctor, who told him that I was dead and that they should walk away," says Snitzer. "And he hung up and he said to the rest of the people in the room, 'Is anyone else here uncomfortable with walking away from this?' And they all said yes. And it was at that bespeak that he called Dr. White."

That'due south Dr. Roger White, an anesthesiologist at Mayo Clinic. He'due south the one who finally came upwardly with the solution to get Snitzer'southward eye beating normally over again.

"Nosotros just continued believing that the measurement of carbon dioxide pressure said that if we can terminate that fatal rhythm, Howard will be OK," White explains.

After shocking Snitzer's centre 12 times and administering intravenous drugs, they finally did manage to stop that fatal heart rhythm. When a pulse and a regular heartbeat had been restored, Snitzer was airlifted to the Mayo Clinic.

White says that before the apply of capnography, the only way of assessing blood flow to vital organs was by feeling for a pulse or past looking for dilated pupils. He says those methods are very crude and tin fail. Snitzer never had a pulse despite good carbon dioxide readings. Without the information from capnography, he says, information technology would have been reasonable to stop CPR — and Snitzer likely would take died.

"The lesson that I certainly learn from this is you don't quit — you keep trying to stop that rhythm as long as you accept objective, measurable testify that the patient's encephalon is existence protected by acceptable blood menstruation as determined by the capnographic data," says White.

Capnography is slowly becoming standard equipment for emergency responders. Next year, the burn down section in Brook Park volition take v new capnography machines — as opposed to the i they have now.

The American Heart Association added capnography to its 2010 guidelines for treating cardiac arrest patients — a sign, says White, that it'due south a engineering science that emergency medical teams tin can no longer exercise without.

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Source: https://www.npr.org/2011/08/22/139670971/when-not-to-quit-man-revived-after-96-minutes

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