17th October 2018
An ICU nurse had to use all her 20 years of experience when she awoke in the early hours of the morning to her husband having a cardiac arrest in the bed next to her.
Following the traumatic experience that saw Geraldine Bolger perform CPR for 30 minutes, she is urging people to learn the technique.
Restart a Heart Day was founded with the support of the European Parliament, and is held on October 16th every year. The aim of Restart a Heart is to raise awareness about out-of-hospital cardiac arrest (OHCA) and to promote training in CPR.
Geraldine, who works in St Vincent's Hospital in Dublin, was asleep in her Stillorgan, Dublin home last July when she woke up and noticed some unusual breathing by husband Derek at around 12.40am.
“I gave him a dig in the ribs and asked him was he okay. I got no response, so I gave him a bigger dig and shouted ‘Derek are you okay?’ When I still didn’t get a response, I sat up and turned on my bedside lamp, glanced at Derek, lifted my mobile and dialed 999. I told them I needed a cardiac ambulance, that my husband was having a cardiac arrest,” recalls Geraldine.
“Derek was now a purple black colour with dilated black pupils staring up and to the left. He had a good pulse though. I yanked him off the bed with a thud and started CPR. He remained unconscious with foaming at the side of the mouth.
Geraldine explained to the paramedic at the end of the 999 call that she was a nurse and knew what to do. Despite her medical knowledge, she insists that the call-taker was crucial to keeping her calm and focused on the CPR.
“On my first thrust of compression I heard a crunch. I knew I'd broken cartilage, but I thought that's good I'm in the right place and doing it hard enough,” she says.
She put the phone on loudspeaker on the bed beside her and continued to do chest compressions for 20 minutes. The medic on the phone continued to encourage her and keep her going. When the ambulance was nearby he instructed her to run downstairs, turn off the alarm, open the front door and turn on the lights before running back up the stairs to ‘get back on the chest’.
When the ambulance arrived they took over the job of trying to save Derek's life and that is when Geraldine noticed there was ‘a river of sweat’ running down her face.
“It was absolutely exhausting but I couldn’t stop. The guy on the phone was so important though. He counted me through the compressions and kept me focused and not panicked.”
After 20 minutes a doctor came down to the kitchen to speak to Geraldine.
“He told me they had shocked Derek nine times, given him adrenaline and other drugs and that they had ‘done everything’. It dawned on me that they were going to stop working on him,” she reveals.
“So I pointed up the stairs and said ‘well get back up there and keep going, keep going, keep going’. The doctor resumed work and about 15 minutes later he returned to confirm that Derek had finally an output.
He was was brought to Geraldine's place of work, St Vincent's, where he was placed in the ICU ward she knew so well.
Derek was sedated and because he had been under cardiac arrest for so long there were concerns about the levels of oxygen starvation to his brain.
A couple of days later, a nursing colleague burst in to the waiting room to tell Geraldine that her husband was awake and after he was taken off life support, Geraldine went in to see him.
“He looked at me and asked me, ‘Am I dead?’. I told him, ‘No you’re not.’ Then he looked for his watch on his arm and asked was he late for work. But it was such a relief to see him awake and talking. He couldn’t remember a thing.”
Geraldine explains that Derek had been experiencing shoulder pain in the days before his cardiac arrest. She insisted he go to his GP to get it checked out, suspecting heart problems. He was due to be fitted with a blood pressure monitor the morning of his attack and had had a normal ECG test the previous day.
“He was a totally healthy 53-year-old who was very physically active. But sometimes the fitness can mask the heart problem. There was a blockage there that doesn’t show up until it’s completely blocked. Even if he had an ECG three minutes before the attack, the blockage wouldn’t have showed,” she says.
After about a week in the Cardiac Care Unit, Derek returned home and is now completely fine.
“He was extremely lucky. Most people would have just died in their sleep. And it is very rare for a person who was ‘under’ for more than 20 minutes to survive without any brain damage. He was down for about an hour but I’ve been told that the CPR I did helped keep the oxygen flowing to the brain and it was vital for him.”
She admits that she still experienced panic at the situation, despite all her training and experience.
“It is so important that people are trained in CPR. We need to be training our secondary school students in particular. The chest compressions are the really important thing. I didn’t do any mouth-to-mouth at all, it was all just about the compressions, about keeping the blood flowing to the brain,” says Geraldine, who has recently been promoted to Resuscitation Consultant in the ICU at St Vincent’s.
“And remember to call for help. That is vital. I needed that voice at the end of the phone to talk me through it. I needed him every second of the way, and I’m an ICU nurse.”