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Stanford’s Revive Initiative for Resuscitation Excellence Celebrates First Responders Who Helped Save Teen’s Life

After sudden cardiac arrest, rapid resuscitation efforts contribute to local teen’s full recovery

“We are forever thankful and grateful for everyone’s help and assistance in what we recognize is a truly remarkable result, given our daughter’s cardiac arrest in the Burgess Park pool on June 28th.”
—Parents of Menlo Park teenager

Revive

Like typical parents, Mark and Holly cannot imagine life without their active teenage daughter. Yet on June 28, they came face-to-face with that distinct possibility. Swimming competitively since the age of 9, their 14-year-old daughter had just finished two laps of her favorite stroke, the backstroke, winning the heat in a preseason meet at Menlo Swim & Sport. At the edge of the pool, she took off her goggles. Then, without warning, she lost consciousness and slipped under the water, following a sudden cardiac arrest.

Mark and Holly were not at Menlo Swim that day. But friends have told them that the atmosphere on Friday afternoon during the summer league meet was lively, with more families around and more activity than usual. With the weekend nearly under way, the swim club was crowded with parents timing their kids, young children playing, and swimmers in the pool or behind the blocks, readying for races or hanging on to the pool rim.

It is uncertain who first noticed that the teenager was drowning. What is clear is that the immediate response by those nearby was lifesaving.

Springing into action to save a life

Within seconds, off-duty fire captain–paramedic Eric McGlennon, whose son was competing on an opposing team, dove into the water to pull her from the bottom of the pool. Once she was out, he immediately began cardiopulmonary resuscitation (CPR). Peter Meaney, MD, of Stanford Children’s Health, also rushed over to join the CPR efforts, helping to coordinate the resuscitation. Johnathan Martinez, head lifeguard at the Burgess Park pool, performed CPR, as did Julie Cohn, aquatics head coach. Others called 911, called the teenager’s family and provided support as the resuscitation continued.

EMS arrived four minutes after the emergency call, and took over the resuscitation efforts. The fire department—Menlo Battalion 1, Menlo Engine 1 and Menlo Truck 1—was first on the scene, with 10 paramedics total.

When Holly arrived at Menlo Swim, she saw her daughter on the stretcher, en route to the ambulance. A neighbor, Brooke Cotter, MD, drove with Holly to the Emergency Department and helped her navigate the hospital. When Holly called Mark from the car, he was at work in Palo Alto. It felt surreal, he remembers; he couldn’t figure out exactly what Holly was saying. Mark understood that his daughter had been involved in an accident at the pool, but he didn’t understand what had happened or what her condition was.

Once Mark got to the Stanford ED, he saw the Menlo Park fire trucks outside. A firefighter told him that his daughter was alive. A nurse asked if he was the father, then quickly whisked him to the emergency room. Holly was already there.

Comprehensive pediatric resuscitation care

In the Stanford ED, Mark recalls, a great number of doctors, nurses and other medical personnel were working to stabilize his daughter. While Mark and Holly waited, she was fading in and out of consciousness. “You begin thinking,” he says, “your daughter is alive, but you don’t know how long her brain went without oxygen.”

Now, he says, it’s easier to understand that their daughter’s life was in jeopardy. Looking back, Mark and Holly recognize that they were in a situation with an extreme amount of uncertainty. That night they focused on the moment, on every improvement. By 3 a.m., their daughter was squeezing Holly’s hand and wiggling her toes. By 4 a.m., she had awakened and was responding to them. As the hours passed, further test results came in that pointed to a very positive result. Both her brain MRI scan and an MRI of her heart came back without any issues. Within three days, it became apparent to Mark and Holly that she was going to have an amazing outcome.

Speedy recovery—giving credit

“It’s extraordinary how many people were involved in getting this outcome,” says Mark. “The firemen who came so quickly and gave so much care. The ER doctors and nurses who did an extraordinary job. The doctors and nurses in the pediatric ICU were incredible; and then the specialists, the neurology team.”

Neurologists credit the high-quality CPR the teenager received at the pool as the driver behind her incredible recovery.

Her cardiologist, Anne Dubin, MD, agrees. “Given her then-undiagnosed heart arrhythmia, often the first event can be fatal. Her speedy recovery is due to the fact that she got such excellent CPR in the field.”

Within 36 hours she was doing quite well, says Kevin Kuo, MD, who was attending the day after she was brought to the ED. “She was texting her friends from her hospital room,” he says. “It was very fortuitous that so many people who knew CPR were there, including Dr. Meaney, who was able to resuscitate and defibrillate her.”

The following day, she was transferred from the PICU to the Cardiovascular Intensive Care Unit (CVICU), where her breathing tube was removed and she began breathing on her own.

Treating life-threatening arrhythmia

According to the American Heart Association, the survival rate for cardiac arrest outside a hospital is less than 12 percent. But CPR can double or triple the chances of survival. In children and adolescents, sudden cardiac arrest is relatively uncommon. In rare cases, it is caused by ventricular fibrillation, an abnormality in the heart’s electrical system.

In this patient’s case, factors point to catecholaminergic polymorphic ventricular tachycardia (CPVT), an inherited heart rhythm abnormality that develops into life-threatening arrhythmia, which can lead to sudden death. Before the teenager was discharged from the hospital, she received an implantable cardioverter defibrillator (ICD), which helps regulate a heartbeat when it’s too fast or too slow. The ICD has a battery life of 10 to 11 years, so it will need to be replaced every decade once she is an adult. She was also prescribed beta-blockers, which work by blocking the effects of the hormone epinephrine, also known as adrenaline. To ensure that she doesn’t have adrenaline spikes, she will need to monitor her activity level.

Although she won’t be able to swim competitively due to the associated risks, she is already thinking of taking up archery or golf. In her first year of high school, she is continuing as a middle school junior swim coach, a role she held last year, and she is also a swim instructor at the Burgess Park pool. Barely three months after her cardiac arrest, she’s able to return to living her life.

Revive Initiative for Resuscitation Excellence

Revive, led by Lynda Knight, MSN, RN, and Revive’s medical director, Marc Berg, MD, with founding support from Felice Su, MD, trains health care professionals and emergency response teams at Stanford and throughout the wider community, providing them with the lifesaving skills needed to promote survival with the best neurological outcomes in the event that an infant or child suffers a respiratory or cardiopulmonary arrest.

Knight, whose personal and ICU experience drives her passion for the program, emphasizes that Revive’s simulation trainings are based on actual cases and practiced in their own clinical environments to ensure efficient and effective teamwork.

“During the last annual training held for the Menlo Park Fire Protection District, the Revive team trained paramedics using a rare previous case that was very similar to this patient,” says Knight. “This training is imperative, as these are very rare occurrences but extremely high-risk events, and health care professionals must practice to sustain these lifesaving skills.”

Revive’s mission is aligned with the American Heart Association’s to have millions trained in CPR, especially bystanders, who most frequently are the first to witness these events that occur outside the hospital. The chance of survival diminishes by 10 percent for every minute that goes by without CPR, so beginning CPR right away, as in this case, saves lives.

“The community came together that day. Everyone is wanting to celebrate and highlight all of the first responders’ heroic efforts in saving this young lady’s life.”

On Sept. 26, Revive presented recognition awards to the 18 first responders who contributed to the resuscitation efforts at Menlo Swim. Lynda Knight, RN; Marc Berg, MD; Peter Meaney, MD; and Chief Harold Schapelhouman were among the speakers at the event. Menlo Park’s mayor, Ray Mueller, thanked the entire Menlo Park community.

Note: The patient asked that her name not be included in the story.