MEDICAL THERAPEUTIC HYPOTHERMIA - CODY'S STORY
12/17/2009
Cody Fisher led the life of a normal 17-year-old until his life changed in a matter of seconds. The New York teen was at his job as a camp counselor at Camp Nock-a-Mixon in Kintnersville this summer when he went into sudden cardiac arrest. Cody's heart had stopped beating effectively and his life was in imminent danger. The camp nurse, doctor and Emergency rescue workers used CPR (cardiopulmonary resuscitation) and an external automatic defibrillator (AED) to shock the teen's heart to start it beating again before he was taken to Doylestown Hospital.
It was there that the medical team determined Cody was a candidate for medical Therapeutic Hypothermia treatment. He had been resuscitated successfully and had a faint blood pressure and a heart rate. He had arrived at the hospital within the 6- to 8-hour window for the hypothermia treatment from the time he went into arrest. But Cody was still at risk for serious neurological injury. In fact, he had obvious signs of serious neurological injury when the medical team started to induce a medical coma and the hypothermia protocol. Using a specially designed cooling suit, Cody's core body temperature was quickly lowered to 91.4 degrees F or 33( C where it was maintained for 24 hours.
When the heart stops abruptly or beats ineffectively as in cardiac arrest, blood flow is interrupted and organs are deprived of oxygen. If the brain is denied oxygen for more than three minutes, it begins to die. Eugene Vallely RN, a critical care nurse educator and Jen Harrar RN, an Emergency Department nurse, oversee the treatment at Doylestown Hospital. According to Jen, if the body is cooled within four to eight hours after the heart stops, and has been restarted, the brain's metabolic rate slows and it can survive with less oxygen. Medical hypothermia also controls swelling and aids in the process of restoring brain activity once oxygen flow has returned, cooling also prevents the release of brain damaging chemicals called free radicals from being released.
It took more than 10 hours to slowly bring Cody's body temperature back up to normal. Cody's mother, Alisa Herschaft, didn't know at that point if her son would survive the serious ordeal. With his family by his side, Cody emerged from the coma, not knowing what had happened to him or remembering anything from the past few days.
"I am so lucky that Doylestown Hospital had a hypothermic suit," Cody said. "Unfortunately, very few hospitals have this important, additional step of life-saving equipment. "I was in the right place at the right time."
The team of physicians and nurses from the Heart Institute of Doylestown Hospital set about to determine what had sent Cody into cardiac arrest. An interventional cardiologist performed a catheterization on the teen to try to find the source of his heart problem. The doctor found that structurally, Cody's heart was fine. But the medical team soon discovered the teen had Wolff-Parkinson-White Syndrome (WPW). This is a heart condition in which there is an extra electrical pathway (circuit) in the heart that causes an irregular rapid heartbeat (arrhythmia). In rare cases, WPW can result in cardiac arrest, and thus sudden death.
A team of highly skilled Doylestown Hospital electrophysiologists (cardiologists who specialize in the electrical function of the heart) performed an EP ablation on Cody to fix the electrical problem with his heart. Doctors inserted a catheter into Cody's heart and used radiofrequency to eliminate the extra electrical current that caused the arrhythmia. It was a success. Cody was ready to resume the normal activities of a soon-to-be high school senior. To be sure his heart would not stop again, he wore a special monitor for 6 weeks until it was determined he had been completely cured.
Now enjoying life as an active high school senior, Cody has become a passionate advocate of the use of CPR and the AED that helped save his life. He has worked with his school district to get its teachers certified in CPR and make sure AEDs are available where they're needed. He is also planning to travel to Washington DC with the American Heart Association in 2010 to lobby for CPR Training, the availability of Automatic defibrillators and the availability of Therapuetic Hypothermia in hospitals. He and his mother are grateful for the life-saving care they received at Doylestown Hospital.
"I really don't know how to thank the doctors and nurses at Doylestown Hospital," said Alisa. "I can only say how incredible they are!"
She credits the cardiologists and staff at the Heart Institute for diagnosing and repairing the WPW. She is especially grateful for the compassionate care she received while her son was in Intensive Care.
"A very special thanks to Eugene (Vallely) and all of the nurses in ICU and IVU, who are the kindest, warmest, most competent and most caring staff I have ever met," said Alisa. "I think of them everyday."
Cody had this to say to his caregivers at Doylestown Hospital. "I would like to thank you for giving me a renewal at life and for giving me the opportunity to experience college and everything else that is in my future. I was in the absolute right place at the right time. I cannot thank all of you enough. You are all amazing."
Cody and his mother were joined by Doylestown Hospital EP specialist Robert Sangrigoli, MD, and Eugene Vallely, RN, AND shared this amazing story on the Good Day Philadelphia show on Fox 29 on Nov 30, 2009.
