Arresting Development

By Peter Sirovatka

A rare cardiac arrest that could have easily ended in death instead shined a bright light on the teamwork and professionalism of the Mid-Columbia Medical Center staff.

Last spring, Peter Sirovatka was enjoying his usual Sunday morning breakfast in MCMC’s Atrium Falls cafeteria with his wife, Sharon, a hospital switchboard operator, when he suddenly fell over.

Sharon shouted for a cafeteria worker to call a code blue (the signal for a cardiac arrest) over the intercom. The first nurse to arrive assumed Peter was choking and started performing the Heimlich maneuver.

Hospitalist Dr. Tom Nichol arrived quickly and cleared Peter’s airway, expecting him to take a big gasp and begin breathing on his own.

Instead, 65-year-old Peter laid lifeless without a pulse, while his wife looked on helplessly.

An MCMC nurse and respiratory therapist began CPR and Peter began to respond as soon as they stopped the chest compressions, he stopped breathing and talking.

By now, a hospital team had flooded the cafeteria to lend support. Nurses arrived from the ER, ICU and operating room. A pharmacist brought the necessary medications.

The team hooked up Peter to a monitor and discovered his heart was in ventricular fibrillation. They shocked him with paddles.

“Normally, with one shock, they come back, but he didn’t,” Dr. Nichol said.

That would begin 49 minutes of work on Peter, alternating with CPR, medication and defibrillating his heart. It was twice as long as a team would generally administer CPR, but the staff couldn’t kick-start his heart and generate a pulse.

As they began to run out of options, they moved him upstairs to the emergency room. Dr. Nichol walked with Sharon, telling her he didn’t think the medical staff could do much more.

Finally, a seventh shock in the ER produced the heart rhythm and pulse they were seeking. Everyone was relieved. It appeared their co-worker’s spouse had been saved, without damage to his kidneys and heart.

However, 45 minutes later in the ICU, Peter was in trouble again. His blood pressure dropped to a profoundly low level and his heart beat erratically. He’d gone into atrial fibrillation.

Once again, everyone pitched in and they were able to stabilize Peter. “I was so proud of our hospital staff. The amount of effort by everybody was amazing. We worked beautifully as a team,” Dr. Nichol said.

As the doctor took a short break, he realized how emotional the ordeal had been. “I felt the tears well up because I realized how easily we could have lost him,” Dr. Nichol said.

It was the first time since Dr. Nichol joined the MCMC staff in 1989 that he’d cared for a non-patient experiencing sudden cardiac death at the hospital.

If Peter had been anywhere else that morning, his chances of survival would have been dramatically reduced. It’s a fact Peter is well aware of — two of his brothers died of cardiac arrest before they reached the age of 65.

“I can’t express the debt of gratitude I have for the team of MCMC professionals that didn’t give up,” Peter said. “It’s an incredible resource we have in this community.”

Sharon said she was impressed with the compassion and skill displayed by the staff. “The care we got was amazing,” she said.

After a weeklong stay at MCMC, Peter was transferred to Oregon Health & Science University in Portland for further tests. They confirmed the cardiac arrest was an electrical issue in his heart, not the result of clogged arteries or valves.

The staff there inserted an internal cardiac defibrillator in his chest. If he should go into cardiac arrest again, the device will activate and shock his heart back into a rhythmic operating mode.

Sharon continues to take calls on the switchboard and meet her husband at the hospital cafeteria for their standing Sunday morning breakfast date.

Dr. Nichol hopes the sharing of this story will inspire others to take CPR courses because the chest compressions saved Peter’s life.