by Matt Englund
graphic by Rachel Morris
Bob Zandt was jogging on the treadmill at O2 Fitness on a Wednesday morning in late April, when he began feeling fuzzy. He stepped off the treadmill and sat down on a weight bench to rest – that’s all he remembers from that morning at the gym.
Bob was in sudden cardiac arrest, a malfunction in the heart’s electrical system that causes an abnormal or irregular heart rhythm. With the heart no longer able to circulate blood effectively, the brain and other organs soon begin to fail. Without intervention, cardiac arrest can be fatal in minutes.
Fortunately, the staff of O2 Fitness and three UNC Hospitals nurses who happened to be at the gym acted quickly. Amanda Greer, a CRNA, Britney Karschner, a pediatric nurse who works part-time at O2 Fitness, and Vanessa Zito, a nurse with the UNC Center for Heart and Vascular Care, had never met before that morning, but their quick response and teamwork saved Bob’s life.
“Those three nurses made all the difference in the world,” said Bob. “It would have been a totally different outcome if they hadn’t taken immediate action. They knew what to do. I’m a living testimony to their skill.”
Springing into action
Amanda was on a stationary bike on the floor above Bob when he collapsed. She noticed a commotion and looked to see what was wrong.
“Someone was on the ground and the trainers were running toward him,” Amanda said. “You sometimes see people fall down at the gym but I noticed right away this was something more serious.”
Amanda jumped off the bike and ran downstairs. The people around Bob told her that 911 was being called and that Wes Richardson, a trainer at O2 Fitness, had gone to get the automatic external defibrillator (AED).
“Since I’m a CRNA and airway management is what I’m trained in I ran up to his head and noticed right away that he was not breathing in a normal pattern.” Amanda said.
At this point, Bob still had a pulse so Amanda began performing rescue breaths to help with his agonal breathing.
Meanwhile, Britney, who was working at the front desk that morning, was calling 911. “My front desk manager came up, I think knowing I was a nurse, and said ‘you need to be back there,’ so she took over talking to the 911 operator and I ran back to help.” Britney said.
Seconds later, Britney found Bob. “He was not breathing well and he was turning blue. I sat down next to him and checked his pulse. It was gone, so I started CPR.”
Vanessa had just come out of the locker room and noticed a commotion. “Someone was on the ground and it looked like they were getting the defibrillator, so I rushed over to see if I could help.”
Vanessa sat alongside Bob to check his femoral pulse, while Amanda tried to assist him with his breathing and Britney performed chest compressions.
“Britney told me later she had never done CPR on a patient before,” said Amanda. “But she didn’t hesitate, and those compressions were what kept his heart in the state it needed to be in for the shock to work so well.”
By the time Britney had given him a full cycle of compressions, Wes had returned with the AED and the pads were placed on Bob. The AED analyzed Bob’s heartbeat and found it in a shockable rhythm. The AED then informed the nurses that shock was advised. They broke physical contact with Bob and the AED fired.
“After it shocked him, we started CPR right away again,” said Amanda, “but then his breathing and his pulse improved, so we stopped and waited for EMS.”
“I don’t think he’d be with us if it weren’t for the AED,” said Vanessa “He was stuck in a shaky rhythm, and the AED is exactly what stopped that.”
Ready and able to help
Diana Monroe, Bob’s wife, was also at the gym that morning and found him on the floor with Amanda, Britney and Vanessa just as they were taking off the AED pads. She was grateful for their expertise. “I’ve taken CPR/AED classes and I know the device talks you through the process, but it was still scary. If I were doing CPR on somebody I would think, ‘maybe the pulse is there and I just missed it.’ I’m happy those nurses were able to help.”
According to the American Heart Association, more than 300,000 sudden cardiac arrests occur outside the hospital every year and the survival rate is less than 10 percent. Survival rates can more than double with timely application of CPR and correct use of an AED. Because sudden cardiac arrest can occur without warning, it is important to stay up-to-date on how to perform CPR and use an AED.
Having the skills necessary to respond helped the nurses act quickly, said Vanessa. “I remember a couple of women saying ‘I used to know CPR but I haven’t gone to class in so many years – I don’t even know if they do it the same way.’ There were a lot people there that might have been able to help him, but CPR changes almost every year so staying current in CPR is important.
“One of the things we’re doing as a service at UNC Heart & Vascular is educating patient families and friends that come to visit in hands-only CPR,” said Vanessa. “After you call 911, if you can do hard, fast and effective compressions, you can probably buy them some time until EMS gets there.”
“We caught him at the perfect time”
Bob had regained consciousness by the time EMS arrived to take him to UNC Hospitals. “When he left the gym, he was talking and looking around,” said Vanessa. “He said goodbye to the woman at the front desk as he rolled by. He doesn’t remember that but he was oriented enough to do that.”
Bob is recovering and has been fitted with a defibrillator. “I’m the titanium man now,” he joked. “It’s a little square spot under my skin. I recently had it checked and it hasn’t fired. It’s my insurance policy.”
Amanda said Bob was lucky that morning. “He was in a place where there was an AED, people who knew how to use it, and we caught him at the perfect time. If it had taken a couple more minutes for the AED to get there it might not have gone the same way. That’s the amazing thing to me about this story.”
Bob agrees. “I’m so happy it turned out to be a good story. It could have been completely different.”
UNC Advanced Life Support offers Heartsaver/AED classes so you can stay up-to-date on the CPR techniques and learn how to use an AED. Visit their website here to find out about course offering.