While conducting a product demonstration for an electric utility co-op in Northern Virginia six months ago, Richmond sales engineer Lee Younts reached out to stop a transformer from falling to the ground — and 7,200 volts of electricity pulsed through his body.Younts' heart stopped, and he fell down, clutching his chest. The nearly 50 staff members present had only about six minutes to help Younts beat the odds against survival. (More than 95 percent of cardiac arrest victims die before they reach the hospital, according to the American Heart Association.)
Senior lineman Dustin Dell had been trained in cardiopulmonary resuscitation and he was aware of new CPR guidelines that instruct bystanders to immediately focus on chest compressions rather than breathing into a patient's mouth. Dell started chest compressions on Younts — keeping blood flowing through his body and oxygen moving to his brain — while someone else called 911. Using an automated external defibrillator (AED), fellow staffer Justin Bastien then delivered two shocks to Younts' chest.
Younts opened his eyes. "I started off with a heart not beating, being a different color, then the blood started coming back," he says. Within 20 minutes, an emergency crew arrived and took him by helicopter to the Burn Center at Washington Hospital Center. Using a process called therapeutic hypothermia — it "cools the body down to 88 or 89 degrees to prevent the rush of blood to the brain, which in turn can cause a lot of brain damage," says Dell — Younts was revived.
"The doctor says he does not recognize any brain damage," says Younts, 35. "My friends tell me I am as smart as I ever was. So we think it worked."
Dr. Joseph Ornato, chairman of VCU's Department of Emergency Medicine, has been involved in writing national CPR guidelines since the 1970s. As Younts' case demonstrates, he says, the lives of many people nationwide could be saved because of the simplified guidelines released in November. The biggest change, he explains, is that the order of recommended actions were reversed. Rather than the previous A-B-C order (airway, breathing, then compressions), "the C now comes before the A and the B — the chest compressions before the airway and breathing."
Ornato adds that the changes were made in response to medical studies. "There is a ton of scientific evidence that came out in the past 10 years saying that for an adult whose hearts stops for at least five to six minutes, it is much more important to pump blood to the vital organs than to take the time to try to get a couple of artificial breaths in a person," he says. "You have enough oxygen to last at least five or six minutes."
The revision, which Time magazine in December labeled one of the Top 10 medical breakthroughs of 2010, came 50 years after the development of CPR. The guidelines are reviewed every five years, says Dr. Tom Aufderheide, president of Citizen CPR Foundation, a national advocacy group.
Time magazine reported that only a third of the people who need CPR actually get it, largely because of bystanders' apprehensions. But simply following the new guidelines to press "hard and fast" on the center of the victim's chest — about 100 compressions per minute — can double or triple the odds of the patient's survival, Ornato says.
"The real message to laypeople is to act," Aufderheide says. "You can act; your actions can save a life."
But CPR is often not enough, Ornato adds, so an AED must be applied, and it works by causing the heart to start beating and beginning to regulate the patient's pulse. "Every minute delay until a defibrillator can be applied and used on an adult cardiac arrest victim, the chances of survival drop by about 10 percent," Ornato says.
Younts says that his Sept. 21 accident occurred because the 100-pound device he was demonstrating was mistakenly plugged in. The device prevents outages on utility lines. Noting that he was fortunate to have been surrounded by staffers trained in using CPR and AEDs, Younts says he received training soon after he recovered.
For those who find themselves witnessing a cardiac arrest, Younts has this advice: "You cannot hurt anybody any more than they are already hurt. They are dead ... Just respond."