October 16, 2009 Volume 110 Number 20

Union members use cardiac device to save a life

By Michael Gutwig, Editor

ESTACADA — Terry Anglin lay motionless on the floor. His skin colorless. Eyes open and fixed. No pulse.

“I thought for sure he was dead,” said neighbor John Kirkpatrick, who responded after hearing Anglin’s girlfriend screaming in the front yard across the street from his rural home.

Kirkpatrick, a volunteer firefighter and retired Painters and Allied Trades District Council 5 representative, started CPR as his wife ran to call 9-1-1.

Less than six minutes later, the Estacada Fire Department rolled onto the scene.

The team of firefighters immediately went to work, first strapping Anglin to a device called an AutoPulse, a relatively new piece of equipment that performs the action of chest compressions. Over the next 45 minutes Anglin was shocked with a defibrillator three times and injected with vasopressin, epinephrine and atropine — all while receiving perfectly-administered CPR.

“We followed protocol by the book and he took everything we had,” said Estacada Fire Lt. Bruce Courtain.

Paramedics from American Medical Response Northwest arrived and transported Anglin to Mt. Hood Medical Center, then to Providence Hospital, and finally to Kaiser Sunnyside, where he remained in an induced coma for 18 days.

When he awoke, the 62-year-old recently retired pipefitter and longtime member of Plumbers and Fitters Local 290 thought his union brothers had pranked him. After all, he hadn’t even cashed his first retirement check.

“A heart attack? Yeah, right. Where are they? This is the best joke ever,” Anglin recalled telling nurses as he looked for his buddies to come in laughing.

In fact, Anglin had not had a heart attack. It was worse than that. He had experienced sudden cardiac arrest (no heart beat). Cardiac arrest claims more than 325,000 lives each year in the U.S. and is the leading cause of unexpected death worldwide.

Fortunately for Anglin, he had a neighbor trained in CPR and willing to help, and a fire department with state-of-the-art equipment.

Statistics show that the chance of surviving cardiac arrest outside a hospital setting are poor — only 2 percent of victims make it without long-term damage. According to the American Heart Association, for every minute that goes by without CPR, the survival rate decreases seven to 10 percent.

“Quick thinking and proper training made the difference in Mr. Anglin’s case,” said Estacada Fire Department public information officer Tim Trickey. “Had John (Kirkpatrick) not been there to start CPR, having all of the equipment in the world wouldn’t have mattered.”

But the AutoPulse definitely helped.

“I would like to see one of those in every fire station, ambulance, and hospital in the country,” said Anglin, who on Oct. 1 met for the first time the firefighters who saved his life Aug. 29.

For victims of cardiac arrest, circulation of blood has to be returned to the brain and vital organs as soon as possible (known as perfusion). Standard manual compressions, even when they are done perfectly, can only provide up to 20 percent of normal blood flow to the heart and up to 40 percent to the brain.

“And one person can’t do CPR for very long,” Kirkpatrick said. “Just the few minutes that I did it, I was exhausted.”

The AutoPulse, with its delivery of uninterrupted, high-quality chest compressions, substituted for Anglin’s heart and kept the blood and oxygen circulating to his vital organs.

Estacada Fire Department Engineer Tim Corner told the Labor Press that the treatment applied to Anglin that afternoon took all five emergency responders (three from the Fire Department, and two from AMR). “The AutoPulse freed us to perform those other life-saving tasks,” he said.

Corner noted that the fire department had just acquired AutoPulse in mid-July and Anglin was its first patient.

Back at his home in Estacada, Anglin expressed gratitude to Kirkpatrick, the fire department, AMR paramedics, and the nurses and doctors who treated him. All of the workers have union affiliations. Firefighters are members of Clackamas Fire Fighters Local 1159; emergency medical technicians at AMR are Teamsters, and nurses are members of Oregon Federation of Nurses and Health Care Professionals Local 5017 at Kaiser Sunnyside and the Oregon Nurses Association at Providence.

Anglin reiterated that all emergency rescuers should have access to the AutoPulse, and that everyone should learn how to administer CPR.

Most union training centers require apprentices to complete CPR training, and classes are always available to journeymen and women.

In addition to CPR training, Plumbers and Fitters Local 290 (Anglin’s union) promotes the use of Automated External Defibrillators (AEDs). “AEDs tell you exactly what to do. Anyone can use one,” said John Endicott, business manager of Local 290.

The lunch-box-size devices are at the union’s training centers in Tualatin and Springfield.

Endicott said over the past 10 years AEDs, which cost about $1,500, have become more commonplace at schools, office buildings, airports and other public places.

In a recent article published in the Columbian newspaper in Vancouver, Oregon Health & Science University Dr. Mohamud Daya said someday AEDs “will probably become like fire extinguishers.”

The AutoPulse sells for about $15,000 a unit and is to be used only by trained medical personnel.

“The Auto- Pulse is picking up speed, but it’s not common yet,” Trickey said.

John Phelps, a sales rep for AutoPulse manufacturer Zoll Medical Corporation, said 28 devices are in use by emergency medical service responders and hospitals in Oregon, 16 in Washington, and only 3,100 nationwide.

The AutoPulse can be found in Hermiston, Pendleton, Springfield, Eugene, and along the Central Oregon Coast.

“Sandy and Estacada fire departments were the first to get them in the Portland area,” Phelps told the Labor Press.

Sandy firefighters also saved a person’s life using the AutoPulse.

Kirkpatrick and other firefighters agree that it’s important to know CPR and to have access to AEDs and the AutoPulse, but he says it’s “also important that you get involved if you see someone collapse and stop breathing.”

Kirkpatrick pointed to studies that show only 20 to 30 percent of bystanders perform CPR when someone needs it. Researchers have found that in many cases the reason people didn’t help was because they were reluctant to put their mouth on someone else’s.

More recent studies, however, show that compression-only CPR is just as effective as traditional CPR, which involves both compressions and mouth-to-mouth resuscitation.

“We are dealing with an aging workforce and a lot of unhealthy lifestyles, — smoking, high fat and salt diets,” Corner said. “Add to that strenuous work like construction and that’s a bad recipe.”

Anglin admits that he did all the wrong things by smoking, eating high calorie foods, and not exercising, other than the physical demands of his job.

“I thought I was immune. I was in total denial,” he said.

More than a month after the episode, Anglin has a defibrillator implanted in his chest. He’s quit smoking, eliminated all salt from his diet, and he takes statins for high cholesterol.

“I know it’s hard advice to hear, but cut back on salt and give up cigarettes,” Anglin tells his union brothers and sisters. “You’ll be better off when you retire. Look at me. I can’t hunt or fish by myself anymore. I thought I was indestructible. I’m not. You’re not. It will beat you.”

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