I just did CPR on Prince Charming's Carousel

A Fairy Tale of Good Luck

This last weekend I resuscitated a sudden cardiac arrest on the Prince Charming’s carousel at Disney World in Orlando Florida.

But things could have gone badly wrong.

I was waiting to get on the ride with my 4 year old daughter when two people started shouting for help. I jumped the barrier and ran in, dodging an employee trying to block my way by mumbling “I’m a doctor” and found a middle aged lady collapsed on the floor amongst the plastic steeds.

It had been a few years since I last reviewed my CPR basics or had even been involved in running a “code blue” as it’s called in the hospital, where the doctor usually shows up midway through, by which time the nurses and respiratory therapists have already gotten the basics out of the way and are well into administering chest compressions and delivering oxygen via an airway of some kind.

The respiratory therapist delivers “breaths” by compressing an inflatable bag connected to tubing going into the patients mouth. A head nurse keeps track of everything, while other staff members cycle in and out doing chest compressions every couple minutes.

The doctor usually settles in at the foot of the bed and directs the proceedings, examining the heart monitor, blood gas levels, labs, calling for epinephrine injections, etc.

In this case I was showing up right at the beginning and had to quickly establish what was actually happening. Was this a situation that called for rescuscitation? Was she just passed out, was she choking, having a seizure?

There was no breathing, no pulse and she was not responsive.

So I jumped straight into chest compressions and then after a few seconds remembered the “2 rescue breaths” that used to be taught in CPR classes (though nowadays it’s recommended to skip them since it’s thought chest compressions alone are better) so I interrupted the chest compressions and gave the 2 rescue breaths and then went straight back to chest compressions and within a few moments she started moving and then suddenly sat straight up in shock asking “where am I?”

Two of her family members where there and she recognized them, and within seconds she remembered who and where she was and started to get up only to feel lightheaded and we told her to stay seated and raise her legs.

An off duty ER doc showed up, the Disney staff called emergency services and that was it. Apparently she had a history of SVT (supra ventricular tachycardia) and was on medication for that. I never found out if she had had the shots or not.

Everything turned out fine in the end, but it might not have. And although the rescuscitation may have been what saved her life, in different circumstances what I did and didn’t do might have killed her.

What I should have done right at the start was tell one person to call 911, and another to go find and bring an AED, or automated external defibrillator. As soon as that showed up we should have hooked her up and checked her heart rhythm. Given her history of SVT it’s quite possible she was in a very rapid electrical rhythm that might have been amenable to an electrical shock.

If I had been given this exact same scenario on a test at that moment I would have answered it correctly, but in real life I didn’t do what I should have done: in the heat of the moment, being as rusty as I was, none of this occurred to me.

What I realized after this experience was that everyone needs to learn and relearn CPR. Medical providers who see patients in clinics or in hospitals are required to attend training every 2 years, but in many cases this really isn’t enough, especially in situations where the skills aren’t regularly utilized.

I would say those trained in CPR should review it at least monthly to keep it fresh. It takes just a few minutes to run through various scenarios and imagine what you should do in each one.

If someone collapsed in front of me right now I would know what to do and d it, but if it happened 5 years from now I would probably be fumbling again unless I had recently reviewed it.

In a cardiac arrest situation time is brain. The longer it takes to recover heart function the more likely permanent brain damage becomes.

What’s worse is that this is the third event in my personal life where CPR of some kind or another was required (I lost track of how many times I’ve been involved in CPR during 13 years working in hospitals).

5 or so years ago my first son choked and stopped breathing. I administered a version of the Heimlich maneuver that revived him, but my wife and mother in law were already there and could have done it much sooner had they known how to assess the situation and respond.

30+ years ago my youngest brother nearly drowned and my mother did CPR until the paramedics arrived.

Thankfully there was no brain damage in either case.

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It seems obvious to me now that everyone should know CPR. It’s not actually that complicated. Apparently it used to be taught in high school health class, but not routinely any more.

It only takes a few hours to learn it properly, and just minutes to review what you’ve learned.

If you practice and review what you know it becomes automatic. It could save someones life one day if medical services are not immediately available.

CPR administered immediately doubles or triples the chances of surviving an out of hospital cardiac arrest.

Now that at least 5 billion people have been spiked, and even competitive athletes in peak physical condition regularly collapse on and off the field, it’s high time everyone knows there way around an AED.

Take on the responsibility and live without regrets.

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