Howard Snitzer doesn’t remember going to the grocery store. He suffered a massive heart attack when he was on his way and collapsed in the street. With a population of only 800 in Goodhue, Minnesota, USA, Snitzer’s chances of survival were slim, especially when you consider the odds – some estimates indicate that only five percent of people suffering from cardiac arrest on US streets are resuscitated.
But Snitzer’s story isn’t just one of survival; it’s also one of remarkable rescue efforts. He was kept alive by dozens by passers-by, volunteer emergency responders and medical personnel. Altogether, 25 people took turns performing CPR, keeping him alive for an incredible hour and a half until his heartbeat could be restored to normal. Today, he is alive and well with no residual effects.
One of the most difficult decisions for any Emergency First Responder is when to discontinue CPR. Course participants learn to stop CPR when the rescuer: is too exhausted to continue; when the rescuer’s own life is endangered; or when the rescuer is relieved by a higher medical authority. If there are multiple rescuers, no other lives are threatened and professional medical assistance is far away, CPR may continue for an hour or more. So how do rescuers know when to quit?
The New York Times reported on a study that found hospital patients have a better chance of surviving when CPR is continued just nine minutes longer than average. The study, conducted in hundreds of hospitals, showed that some doctors were giving up too soon. Conventional medical thinking has held that prolonged CPR is usually futile since survivors typically suffer permanent brain damage. The study, however, found that hospital patients who received prolonged CPR and survived had no more adverse effects than those who were quickly resuscitated.
Prolonged CPR can be exhausting, but the payoff can be extraordinary. Consider Brandon Hopper of Kent, Washington, USA, a 19-year-old with a congenital heart defect who collapsed in the middle of the woods.
“We found some elk and took off running after them to see if we can get some pictures and that’s when it happened,” Hopper told local media.
He wasn’t breathing and there was no mobile phone reception. While one buddy ran to call 911, the other started CPR. Local first responders arrived and stepped in, keeping up compressions while waiting for the medical airlift.
Working as a team to stabilize him for transport Hopper’s buddies, the local first responders, the airlift nurse and the pilot took turns administering CPR in the back of the ambulance in the middle of the woods for 86 minutes.
“We almost stopped the resuscitation three or four times,” the airlift nurse said. “But no one was willing to give up.”
After spending three weeks in the hospital and getting a new defibrillator, Hooper works two jobs and lives a normal life.
How long is long enough? There isn’t a general rule and not every patient would benefit from prolonged CPR. But, for Emergency First Responders, as long as the rescuers are able and not in danger, it’s better to continue than to stop. Just ask Howard Snitzer and Brandon Hopper.
