OCEANSIDE — An extraordinary chain of survival involving family, first responders and Tri-City Medical Center saved David Mills’ life after he suffered a sudden cardiac arrest at home.
Mills’ cardiac arrest was caused by ventricular fibrillation, or VFib, which is a malfunction of the heart’s normal rhythm that can be fatal if not treated within minutes as the heart stops pumping blood to the body, including the brain and lungs.
“David, who is 67 and retired, underwent a total of 70 minutes of in- and out-of-hospital CPR, whereas the average CPR duration is about 25 to 30 minutes,” said Dr. Andrew Fischer, an emergency medicine specialist and base hospital medical director at Tri-City. “Medical data indicates that after about 45 minutes and definitely beyond 60 minutes, the chances of survival and having a favorable neurological outcome are less than 1%. This is why David’s survival and full recovery is so amazing.”
The chain of survival began when his wife, Georgia, heard him make some strange noises and found him unconscious with no pulse. She immediately called 911 while her 25-year-old grandson, Jacob, began doing CPR with guidance from the 911 operator.
“Starting CPR immediately is critical as the brain can only go about four to six minutes without oxygen before permanent damage occurs,” said Fischer, who treated Mills upon his arrival to the emergency room. “Too often, bystanders wait for the paramedics to arrive, which can be too late. People who go into cardiac arrest still have residual oxygen in their blood, and hands-only CPR can keep that blood circulating until help gets there.”
In Mills’ case, first responders from the San Diego County Sheriff’s Department arrived on scene within five minutes and continued CPR until the Vista Fire Department arrived shortly thereafter.
Since VFib is a “shockable rhythm,” the EMTs and paramedics used an automated external defibrillator to shock his heart and attached him to a mechanical CPR device that provides automated chest compressions.
“Tri-City is one of seven base station hospitals in San Diego County, meaning we provide EMTs responding to a 911 call with medical direction while they are en route to the nearest hospital,” Fischer said. “The call came into our radio room that the patient was on his way and that there had been a ‘witnessed arrest’ – the wife was there when it happened – and ‘bystander CPR’ from his grandson, which were positive signs. Knowing these parameters and that his heart was still in VFib with a shockable rhythm, we continued CPR with minimal interruptions during our assessment.”
The Tri-City team continued to treat Mills with antiarrhythmic drugs and other medications, as well as targeted temperature management, which lowered his core body temperature to between 32 and 36 degrees Celsius (89.6 to 96.8 degrees Fahrenheit). This mild, induced hypothermia improves survivability and neurologic outcomes.
Tri-City cardiologists inserted a stent into Mills’ heart as an EKG and ultrasound had revealed that his cardiac arrest was caused by an inferior myocardial infarction, or heart attack, due to a blocked artery.
Mills continues to recover, stating that he feels “physically stronger every day and is emotionally very optimistic about his future.”
“Tri-City has long been recognized as a center of excellence for the most critical of patients, including those who suffer cardiac arrest,” said Dr. Gene Ma, Tri-City president, CEO and emergency room physician. “This is yet another demonstration of the exemplary collaboration of our teams working together to deliver exceptional care for the betterment of our community.”
