In Remote Western Australia, A Nurse Self-Treated A Heart attack

A heart attack is always frightening. Having a heart attack 1,000 kilometers( 621 miles) from the nearest major city and 150 kilometers( 93 miles) from a well-staffed medical facility has to be worse. When there is only one nurse at the local remote nursing post, things are looking grim. But when the patient is the nurse, most people probably figure they’re done for.

Ryan Franks, however, is made use of sterner stuff. Not only did Franks treat his own heart attack by self-cannulation, he’s the subject of a fantastically dry letter in the prestigious New England Journal of Medicine describing the lawsuit and depicting conclusions.

Just before Christmas, Franks was working in the small tourism township of Coral Bay, Western Australia, when he started suffering chest pain and dizziness. Knowing the other local nurses were all visiting the next town, but surrounded by modern medical technology, Franks performed an electrocardiogram( ECG) on himself and emailed the results to physicians in Perth using the Emergency Telehealth Service( ETS ), a system established to help those beyond easy reach of in-person medical assistance.

“I was find developments in the situation from both the patient and the nurse situation all the time, ” Franks said in a statement.

The first ECG showed multiple signs of an impending heart attack, while another taken 50 minutes later indicated the attack was well in process.

These are the two ECGs Franks took, which( ETS) Emergency Physician Dr Beatrice Scicchitano intepreted as an impending, and later an in process, heart attack. Lee et al/ New England Journal of Medicine

Using a combination of guidance over the ETS and his own extensive experience, Franks “self-cannulated both antecubital fossae for intravenous access and self-administered[ clotbusting medications] aspirin, clopidogrel, sublingual nitroglycerin, intravenous heparin, and opiates[ for the ache ], ” the working papers, written by physicians at the Sir Charles Gairdner Hospital, reports. “Preparations were induced for thrombolysis with tenecteplase, with real-time video interaction with the ETS. He attached his own defibrillator pads and prepared adrenaline, atropine, and amiodarone.”

Volunteers were on hand, and given instructions by the ETS in case Franks lost consciousness, but fortunately they were not needed. Eventually, the Royal Flying Doctor Service, an Australian institution that provides medical subsistence in locatings too remote to be attained speedily other than by air, arrived. They took Franks to the Charles Gairdner Hospital, where a stent was inserted and further medications administered. He was discharged 48 hours later.

“In the absence of other developed medical personnel or resources, the actions of this patient are likely to have had a substantial beneficial effect on the clinical outcome, ” the letter concludes, which is a nice style of saying that without his efforts, Franks would probably be dead. “However, a person’s self-management of a myocardial infarction cannot be considered medically appropriate if any other option is available.”

Presumably, this means they also think cut-along-the-dotted-line self-surgery is best avoided. Spoilsports.

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