American Morning
Buying time to save patients
CNN Medical Senior Producer
North of the Arctic Circle, the weather is unforgiving, the population is scattered and the distances are immense. At the University Hospital of North Norway in Tromsø, the northernmost teaching hospital in the world, doctors routinely use a helicopter ambulance and fixed-wing plane to transport the most serious cases for care – or to bring emergency care to the patient. It’s all about buying time.
During a visit Tromsø, we shadowed Dr. Mads Gilbert, who heads the Department of Emergency Medical Services at the hospital, a small city surrounded by water and mountains. He describes trauma care in this part of the world as “cold, dark, distance and dangerous.” The cold poses its own challenges, and Dr. Gilbert and the team see a lot of hypothermia from ski accidents and people who’ve fallen out of fishing boats falling into the water.
Dr. Gilbert was on call 24 hours a day all week when we were there. He is 62, a rangy man with the energy and enthusiasm of someone half his age.
“What we do with emergency medicine — be it airway breathing, chest compressions, bleeding control, treating hypothermia — is to slow or even stop the death process. So it’s really the struggle between life and death and I always feel like we’re standing on the shore with the tide coming up. We’re trying to pull people from the tide of death and onto the dry land of life,” Gilbert said with a flourish.
Hours after we arrived, his team scrambled in the middle of the night, putting on jumpsuits and helmets and climbing aboard the helicopter ambulance. The temperature was just a degree or two above freezing as the helicopter lifted off and a chilling rain soon began to fall. A young man was suffering from an uncontrollable seizure, and the local doctor wasn’t sure whether it was an allergic reaction or something more serious. The helicopter ambulance team brought the patient back to the hospital.
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They say health insurance reform is three years out after you pass it, that won't help me I'm already 62, I will be 65 by then, I will be eligible for medicare. But hurry up anyway, I want it for those would need it now.
Cheating death should really be about the 36% of Americans who can't afford to see a physician. 15% uninsured and 21% insured but with insufficient insurance to cover their minimum medical needs. Every day they live they cheat death. That's why 122 Americans a day die from having no or insuffient health care or who are victims of insurance denial or recission. These are the people who are REALLY cheating death.
Dr. Sanjay:
I was running on the treadmill this morning when I saw the “Cheating Death” story and heard you talk about Sudden Cardiac Arrest I thought making you aware of my survival story may help save someone.
I was 66 when hit with SCA more than a year ago. I was at work and saved by co-workers. The lead rescuer, Lou, was the same age.
I do not remember any of it, but I think the important ingredients to my survival are:
• My company had trained volunteers and defibrillators on site. They estimate Lou was on me within a few minutes. A co-worker heard the thump of my fall, found me, screamed for help and called 911. Lou was standing near-by. Other team member s did mouth –to-mouth and set up the defibrillator which was used several times.
• The persistence of the work team, fire department and nearby hospital cardiac team was critical. The fire department arrived within 10 minutes. No one gave up even though there was no pulse. They tell me some of them were soaked with sweat; it is hard work! The pulse did not return until I was in the elevator headed for the ambulance. I think that was around 45 minutes later.
• The ER doctor at Morristown Memorial in Morristown, NJ decided to use the cold suit. I was the eleventh person it was used on.
• Before it happened I was on no medications and in good physical condition from regular exercise.
I was on a ventilator and unconscious for five days and when I came around was just fine. I went back to work and my exercise routine. Some think my full recovery is due to the cold suit and some the physical condition I was in, including the doctor who made the decision to use it. We cannot rule out Divine Intervention, but it almost feels sacrilegious to suggest that I was singled out. There were lots of people praying.
More people may survive if there is more public awareness of what you said this morning about the importance of by-standers just doing something. The odds would increase even more dramatically if more companies and public places had the training and equipment that I was so fortunate to benefit from.
New York Channel 7 did and reenactment and aired it about a year ago to get that message out. They did a terrific job of illustrating the critical steps and the value of people trained to act quickly.
By the way, I did not see a light. I think everything stopped so suddenly and completely that that there was not even seconds of semi-consciousness.
Jim Stoltz