Today miracle happen to me.
After more than 30 resuscitations, today I am able to revive a patient, after he went into asystole.
He is a 70 year-old Malay, came in with congestive heart failure, very poor ejection fraction, and came in with fluid overload. He had pitting oedema up to knee, shortness of breath and congested lungs.
Initially, he was well. After going to toilet, his son rushed to me, when I was taking blood for another patient. He had fainted in the toilet. He fell squarely behind the toilet door, obstructing the only way out. Fifteen minutes passed of struggling to moved him away from the door. When I able to get to him, he was already unresponsive. No pulse. My adrenaline gets into action.
Immediately he was pushed into the acute bed. Cardiac monitoring put on. Flat line, no pulse. Barely any effective breathing activity. CPR started. After about 3 minutes, he regain pulse, with an extremely bradycardic pulse that is. Medication to increase blood pressure started. Blood pressure maintained. He was intubated and ventilated.
It is not all lost hope when the patient went into asystole (or not heart beat). But the chances that we are dealing is pretty slim. For an average Joe with no medical complication, the chances or revival is about 15%. However, the percentage dropped to almost 0 if the patient is having multiple medical illness. On top of that, the patient after being revived, requires intubation, ventilation, Intensive Care Unit admission and nontheless complications to multiple organs. That is why we always take into consideration patient's wishes for resuscitation and family views with regards of this matter. Sometimes, it is not prolonging the life, but prolonging death.
Think about it.
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