February 2, 2023
Opinion: My near-death experience teaches a lesson
Eighteen months ago, I woke up in the cardiac intensive care unit of the University of Cincinnati Medical Center. “What happened?” I repeatedly asked the clinicians taking care of me as my brain struggled to process how I had gone from a dinner with friends to being on a ventilator in a hospital.
I had experienced cardiac arrest in which a major artery supplying blood to my heart had suddenly become blocked and caused ventricular fibrillation, an arrhythmia that is typically fatal.
Like the NFL player Damar Hamlin who recently experienced cardiac arrest during a Monday Night Football game, my odds of survival were enhanced by several factors. When I collapsed without warning, I was with people who recognized I didn’t have a pulse and started CPR immediately.
The restaurant where I was eating did not have a defibrillator, but Cincinnati emergency medical services arrived in less than five minutes and used a defibrillator and medications to jump-start my heart. I was fortunate to be near a major university hospital with highly skilled personnel (the same hospital that initially treated Hamlin).
Within 23 minutes of my cardiac arrest, I was in the University of Cincinnati emergency room and soon transported to the cardiac catheterization lab, where the medical team opened my blocked artery. Four days later, I walked out of the hospital.
Since then, I have thought often about what happened and how lucky I was. Some people have a cardiac arrest that is unwitnessed. Others are not with people who know how to perform CPR or have access to a defibrillator. Without CPR, the brain is damaged within three to four minutes. Sometimes EMS isn’t able to arrive quickly enough to prevent irreversible brain damage or death.
About 1,000 Americans a day have cardiac arrest outside of hospital settings, according to the Sudden Cardiac Arrest Foundation, and survival rates are about 10%, the American Heart Association says. In contrast, in Europe, the percentage of people who have an out-of-hospital cardiac arrest and survive to be discharged from a hospital after treatment is 11.7%; in Oceania, it’s 16.2%, though in Asia it is alarmingly just 4.5%, according to data published in 2020 in the journal Critical Care.
Why are survival rates so low? Why can’t the US, a country with arguably the most advanced medical system in the world, do better?