Irene sat in the chair at her hairdressers. She was getting a perm so she'd look good for her upcoming 75th birthday celebration. She was deep into gossip with Marge, the salon's owner, when, in mid-sentence, Irene slumped in the chair and fell forward. Marge knew what to do. Call 911 has been so ingrained into our brains that Marge knew instantly to call 911. Luckily, the salon was only 5 blocks from the hospital so the EMTs arrived within 3 minutes. Irene had a cardiac arrest. The EMTs started CPR and brought her to the E.R. in full arrest mode. The E.R. team had been alerted so we were ready and waiting for her arrival. The EKG showed a flat line. She had already been intubated so we could maintain her airway and get that precious oxygen into her system.
Because Irene had no cardiac electrical activity, we shocked her. Nothing happened.
We shocked her again. We saw a blip on the monitor, then that flat line appeared again. We increased the joules (the intensity of the electric current) and shocked her again. She couldn't maintain any electrical rhythm although her heart sure was trying.
We eventually had to shock her eight times. The room smelled like bacon. Her chest was scorched, but she finally maintained a rhythm and we pronounced our code blue a success, temporarily at least.
Off she went to the ICU, still intubated, where attentive nurses watched her throughout the night and into the next morning. Her heart was maintaining a normal rhythm, quite - an accomplishment actually, since fewer than 3% of those who “code” survive the event. The doctors believed she could be safely extubated.
Several staff gathered around her bed for this moment of truth. Would she breathe on her own? The balloon on the tube cuff was deflated, the tube was slowly withdrawn from her trachea, and we hoped and prayed she wouldn't have a laryngospasm necessitating the re-entry of the tuhe. She did not. She opened her eyes, looked up at all of us, and said, “How does my hair look?”