Thursday, March 13, 2014

Twice born @ 41

In India we see people around us who are (as per tradition) twice born or dwija. Here is an example of an actual twice born person.

Sardar Sanjit Singh was dead. For 90 minutes. And he has come back to life. Congratulations. 

One important point about protocol that should not be overlooked. It helped that Sardar-ji was part of the medical community, CPR was continued well beyond the normal 30 min time limit (in India), how about in the west? Dr Tungikar (see below) is recommending a 60 min CPR at least. Food for thought.

A 41-year-old Aurangabad man, who was clinically dead for 90 minutes after suffering a heart attack, was revived with continued cardio-pulmonary resuscitation (CPR) that was given to him manually about 100 times.

Medical experts said his rare revival was possible because of his age and general health. It was also possible because doctors didn't give up and he got immediate medical attention.

Sardar Sanjeet Singh, an x-ray technician at the Mahatma Gandhi Mission (MGM) Charitable Hospital, complained of chest pain, giddiness and sweating while on duty at the medical institution on February 2. Doctors found he had suffered a heart attack. His heart rate and blood pressure had dropped when he was admitted to the casualty ward. A while later, his heart beat stopped.

"On examination, we found he had no pulse or heart beat. He was clinically dead and the ECG monitor showed single straight lines indicating there was no heart activity," said Prashant Udgire, intervention cardiologist with MGM. Singh was instantly put on mechanical ventilation and a temporary pacer was inserted to start his heart beat. Since there was no heart activity, doctors started manual cardio-pulmonary resuscitation (CPR) by rotation for about 100 times while simultaneously keeping a watch on the blood flow to the brain and other vital organs. "After a long-drawn effort of 1 hour 30 minutes, the patient's heart started beating again," Udgire said.

An emergency coronary angiography conducted immediately showed one of the main arteries was totally blocked. The blood clot was removed using a special thrombus extraction device known as export catheter. Subsequently, coronary angioplasty with one stent was performed.

"Singh regained full consciousness after four days and was taken off the ventilator. Fortunately, he showed remarkable recovery without any neurological damage. This is a rare case of successful revival of a heart attack patient through cardio-pulmonary resuscitation for one-and-half-hours. The recovery was without any neurological deficit," the doctor said.

Singh recalled, "I had collapsed while on duty. I came to know much later from relatives and friends about the serious condition I was in. I've got a fresh lease of life."

Independent medical experts said such a revival was not impossible. Cardiologist Anand Deodhar said the doctors were able to diagnose the cardiac condition and begin treatment immediately while maintaining the constant flow of blood and oxygen to brain and vital organs, which led to Singh's revival.

Former cardiologist at Government Medical College and Hospital, Sudhir Tungikar, observed, "This was a case of witnessed arrest. In such cases, cardiologists should make an effort for more than an hour to revive the patient. They should not give up in 30 minutes, which is the usual practice."


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