St. Paul’s Hospital tests new life-saving heart attack protocol
Vancouver facility is the first in Canada to combine hands-on CPR, a chest-compression machine, and hospital heart pump to save lives.
|Report an Error|
Share via Email
Valentine’s can be a day of heartache for some. But for Genya Kaplun, it’s the day his heart stopped entirely.
Were it not for quick-thinking emergency responders with a trusty chest-compression machine named Lucas, the 38-year-old Vancouver IT manager would have stayed dead on Feb. 14, 2014 after his girlfriend found him unresponsive on their balcony.
Kaplun was in “full-blown” cardiac arrest when paramedics arrived and started Cardiopulmonary Resuscitation (CPR) by hand.
“In all honesty, I unfortunately don’t remember much of what happened,” he said. “The last thing I remember I was with my girlfriend for Valentine’s Day. The next thing I know, I woke up in the hospital two weeks later feeling relatively okay.
“What I didn’t know was that I was pretty close to actually being dead, really.”
What saved Kaplun was responders’ decision to call ahead to St. Paul’s Hospital emergency room to prepare a life-saving heart-pumping device known as “ECMO-CPR” (Extracorporeal Membrane Oxygenation CPR) for their arrival.
Paramedics then “bridged” his trip in the ambulance — where it’s difficult to keep doing CPR by hand — with the Lucas mechanical chest-compression machine.
“That provided him CPR until he was able to be hooked up to the ECMO machine,” explained Dr. Brian Grunau, at St. Paul’s emergency medicine department, “which was able to provide support and which allowed him to survive.”
Not only did that course of action save Kaplun’s life. It’s now formed a pilot trial of combining those elements — CPR by hand, Lucas machine, and ECMO — for patients deemed to have a good chance of surviving without significant brain or organ damage after a heart attack.
“When you have a cardiac arrest, the blood flow stops to the organs of the body,” Grunau told reporters attending a demonstration of the Lucas machine Wednesday. “Then, if there’s enough time that goes on from the cardiac arrest with no blood flow, then the organs will die. Particularly the brain is the most vulnerable to this … you can have irreversible damage that occurs.”
As the lead investigator of the pilot trial, Grunau emphasized that neither Lucas nor ECMO are a replacement for “human-performed CPR” at the scene, and is only for patients deemed to not already be at risk of irreversible organ damage.
The ECMO machine operated at St. Paul’s basically pumps a patient’s heart for them “while doctors work to fix what caused the arrest” in the first place,” according to a statement from the hospital and B.C. Emergency Health Services, the two partners in the trial initiative.
“This change we’ve got today, that we’ve started in the last few weeks, is really a paradigm shift,” Dr. William Dick, B.C. Emergency Health Services’ medical programs vice-president, told reporters. Now, he added, “when that phone call comes in, they’re ready right now … Once there’s blood flow, now people can take a step back (and ask), ‘What caused this cardiac arrest?’ Because cardiac arrest is really just a symptom of something underlying.
“You’ve got to fix the underlying problem.”
One of the leading causes of death in Canada, Vancouver and North Vancouver alone saw 627 suspected heart attacks last year. But only 14 per cent of patients survive if they’re not in a hospital.
The research project hopes they can triple that survival rate with the new protocols.
“They did their best to try to revive me,” Kaplun said with a grateful chuckle. “They weren’t able to. Under normal circumstances, that would have been it.”
He told Metro he's still got a small spiral-shaped scar on his chest from the mechanical CPR machine, and is considering getting it tattooed more visibly as a lifelong reminder his life was saved.