Pharmacist Helps Save a Life at O'Hare
When Amber Lucas came around a corner inside Chicago's O'Hare International Airport in early May, she saw a scene that stopped her in her tracks: A man lying on the concrete floor and a woman trying to revive him.
"She had just started doing chest compressions on a person on the ground. And there was nobody else . . . helping her," said Lucas, a clinical pharmacist in neonatology, obstetrics, and cardiology at Olathe Medical Center in Kansas.
"I walked up, dropped my stuff, told her, 'I'm certified, can I help you?' And she said, 'Yes, please, I will not be able to do compressions for long,'" Lucas recalled.
Lucas said she's maintained her basic life support (BLS) and advanced cardiovascular life support (ACLS) certifications for two decades, but she had never used the training outside the hospital.
The woman doing the initial chest compressions, Lucas later discovered, was a physician assistant in emergency care. She told Lucas that the man, a pilot, had "stopped cold in his tracks and fell forward like a tree."
The pilot's face had hit the concrete floor, and he was bleeding profusely from his nose and mouth.
And he had no pulse.
As Lucas prepared to take over the chest compressions, a man arrived on the scene with a portable automated external defibrillator (AED). So he and Lucas removed the pilot's shirt and placed the AED pads on his chest.
"The AED indicated he needed to be shocked; he was in a fatal heart rhythm," Lucas said. "So we shocked him and resumed compressions."
A fourth person who identified herself as a nurse approached the group and, using the mask in the AED kit, performed rescue breathing.
"Because he had so much blood in the back of his mouth and his throat, we were worried about aspiration," Lucas said. "But we still needed, per the BLS algorithm, to provide breaths."
The second round of chest compressions produced a very faint pulse, Lucas said. And as the four volunteer responders started a third round of chest compressions, the pilot began to sit up.
"We got him back down. He began to resume consciousness, and color came back to his face. He opened his eyes. He was, clearly, very disoriented," Lucas said. But his pulse was stronger, and the AED indicated no need for an additional shock.
Lucas said the pilot knew his name and where he was. And he could move and feel his legs, which lessened the group's concern that the fall might have injured his spine.
Soon after that, she said, the police and emergency medical service personnel arrived on the scene, and the patient was taken to a nearby hospital.
The whole incident probably took about 10--20 very long minutes, Lucas recalled.
According to the American Heart Association, nearly 360,000 people have an out-of-hospital cardiac arrest each year. And Chicago's airports, it turns out, are a good location for surviving such an event.
In 1999, AEDs were installed throughout O'Hare and Midway International Airport with the goal of making the devices available within one minute after a cardiac arrest, according to the Occupational Safety and Safety Administration (OSHA).
OSHA stated that 14 cardiac arrests occurred at the airports during the first 10 months of the AED pilot project, and 9 of the 14 victims survived. Since then, similar public access defibrillation programs have spread throughout the country.
O'Hare and Midway are home to 114 AEDs, and the airports offer free "HeartSave" cardiopulmonary resuscitation (CPR) training to employees and contractors, according to the Chicago Department of Aviation. The department reported in February that more than 20,000 people have completed HeartSave training since 1999, and the lives of 93 people suffering a cardiac event at the airports have been saved.
O'Hare in February installed an interactive CPR kiosk with a lifelike rubber torso that allows users to practice chest compressions and receive immediate feedback about their technique. The kiosk is located in Terminal 2, where Lucas had her encounter with the pilot.
Lucas said she has done chest compressions on hospitalized patients during "code blue" emergencies, though her usual role is medication administration during those events.
She described the experience at O'Hare as "a little bit surreal," because she had blocked out everything except what she had learned in her BLS and ACLS training.
"We just all knew what we needed to do, and everybody executed the resuscitation seamlessly," Lucas said. "Everything followed the resuscitation algorithm to a T."
"It wasn't until I was in my car driving home that I realized that I didn't know anybody's name," she said. "And I couldn't tell you what anybody looked like."
Nor did she know what had happened to the pilot after he was wheeled out of the terminal.
"When you're in the hospital, . . . you know what the outcome is," Lucas said. "You know where they're going to go, you can follow up."
Three days after the event, Lucas contacted the airport and learned from the HeartSave staff that the pilot had spent two days in an intensive care unit and was aware that the four volunteers had saved his life. Lucas was told the pilot's first name and minimal information about the others who had helped him at the airport.
Lucas said both the police officer who took her report and the HeartSave staff seemed surprised to learn that she was a pharmacist.
"They thought I was a nurse; somebody else thought I was a doctor. And I clarified; I said, 'My formal name is Dr. Lucas, I have a doctor of pharmacy degree. But I am a pharmacist,'" Lucas said.
She said the incident reinforced to her the value of maintaining BLS and ACLS certifications.
"You're supposed to recertify every two years. And keeping those skills current is critical to being able to provide effective resuscitation," she said.