Culture-Negative Fibrinous Peritonitis in a Postpartum Female
Automated External Defibrillators Save Lives, If You Use Them
Feb. 20, 2024 – When Billy Frolick, 63, collapsed in the Charlotte Douglas International Airport in North Carolina, fate was on his side. It just so happened that Lauren Westafer, DO, an emergency room doctor, was catching a connecting flight at a nearby gate.
It was Friday the 13th, May 2022. Westafer, who works at the Baystate Medical Center in Springfield, MA, was coming out of the restroom when she heard a sound like someone was snoring nearby and saw a flight attendant scurrying away from her gate. She followed the noise and came across a man on the ground with agonal breathing – when someone is gasping for air, usually as a result of cardiac arrest or stroke. In a frenzy, some bystanders checked for a pulse while the flight attendant ran back with an oxygen mask.
Westafer knew that she needed to start CPR, and fast. She turned to the flight attendant and asked for the nearest AED -- an automated external defibrillator made for situations just like these.
The flight attendant said that the airport didn't have one.
"I was pretty rude and I said, 'This is an airport. There is an AED. I don't know where the nearest one is. Ask somebody, check the walls, run down the aisles until you find one,'" Westafer said.
All airports in the U.S. -- and other public places where large groups tend to gather -- are required by law to have AEDs. They are often red and kept in a white metal box attached to a wall. Westafer said the flight attendant returned very quickly with an AED in hand.
Automated external defibrillators are different from the defibrillators used in hospitals; Westafer calls them "essentially foolproof." There are clear instructions that show you step-by-step where to put the pads and what to do next.
During a cardiac arrest, there are four different types of EKG (electrocardiographic) rhythms that can occur. Only two of those are shockable, and part of the AED's job is to determine whether the patient should be shocked.
The stars aligned yet again for Frolick when the AED read "shock advised." This is what you want to see in this situation, said Westafer. "Then you have the best chance of getting somebody back."
Chest compressions were also an extremely crucial part of Frolick's resuscitation. Seven of his ribs broke in the process – which isn't unusual during CPR – one which cut his liver. Frolick had technically died for those 10 minutes, but every 30 to 45 seconds during CPR, he'd start to move his hands or flex his knees.
Ultimately, however, getting your hands on an AED is often a matter of life and death.
"The goal I had was getting a shock as quickly as possible because the longer your heart is in this funky rhythm and you can't shock, it's going to devolve into a rhythm you can't shock. Then your options are extremely limited," Westafer said. "That's why access is so important."
When medics arrived and hooked him up to a heart monitor, she was able to see that Frolick's heart was now in a normal rhythm. After they loaded him onto a stretcher, he was even able to tell the EMTs and Westafer his name.
Dr. Lauren Westafer, left, and Billy Frolick
As an emergency medicine doctor, it's not often that Westafer gets to see patients come back to life. Research has shown that the survival rate of out-of-hospital cardiac arrests is only about 10%, taking the lives of about 350,000 people a year in the U.S.
Before the ordeal, Frolick said he had been hospitalized three times for chest tightness. His doctors put a stent in, gave him a prescription for nitroglycerin, and sent him on his way.
"I was popping nitroglycerin like they were Tic Tacs" Frolick said. "In the Charlotte airport between flights, I felt the tightness, took the nitro, and it was the last thing I remember until staring up at three doctors from a hospital bed."
Cardiologist Paul Chan, MD, has been studying trends in AED usage and out-of-hospital cardiac arrest survival rates for years.
"In states that have laws requiring AEDs in gyms specifically, we see higher rates of bystanders even just applying the AED to individuals in cardiac arrest," said Chan. "But we'd like to see that percentage be higher. Ideally, we'd expect that, in those states, there would be mandatory training for staff to know where the nearest AED is."
Both Chan and Westafer said that when someone collapses due to cardiac arrest, some bystanders might freeze up. Chaos might ensue. But as long as one person gets an AED to the patient, there's a higher chance that someone will be able to step in and administer the shock, if advised.
"He was lucky he died in an airport," Westafer said of Frolick, because all 50 states require AEDs in airports. Even if staff isn't properly trained to know where they're located or when they need to be used, like in Frolick's case, someone will likely be able to find one pretty quickly.
After a week in the hospital, Frolick – indeed one of the luckiest unlucky guys out there – had recovered from his cardiac arrest. And nearly 2 years later, he and Westafer remain friends.
Still, usage of AEDs in public settings remains low (2%-5%), according to a CDC study, mostly because of a lack of knowledge, bystanders' reticence to put them to use, and limited access to AEDs in general.
You don't need to be an ER doctor to save a life, you just have to know what to look for.
I Spent Valentine's Day At The Bottom Of A Coal Mine. It Was The Highlight Of That Relationship.
Thanks for signing up!
Access your favorite topics in a personalized feed while you're on the go. Download the app
It was Valentine's Day, and I was taking a zipline into hell. Or rather, I was suspended from a swinging bicycle seat, descending into an active coal mine. "Whatever you do," our guide whispered, "don't panic," and then I disappeared into the yawning earth.
The coal mine was Jay's idea. We'd met at a hostel on the west coast of India three weeks into my semester abroad. It was perfect. I was heartbroken, and he was 6 feet tall. He had a motorcycle and wore non-prescription glasses. I was in love.
This was our first dateWe'd gone parasailing at the beach, and I'd ridden on his motorcycle without a helmet (sorry, Mom), but nothing had happened yet. We still hadn't gone on a proper date, with eating and kissing. I was starting to think that he didn't like me, that I'd have to spend the semester actually applying myself to my studies.
Then came the invitation: "Would I like to come to Jay's friend's cousin's guesthouse in the countryside this weekend?"
So, there we were, a full day's drive from my university. I was never given the why of the coal mine — presumably, this was the most exciting tourist attraction the cousin's rural town had to offer — but I was young and eager to prove my low standards for safety.
I wanted to impress himThere was no industrial elevator at the mine, just a doorway into darkness. A cable ran into the depths, with individual seats hooked on, to carry miners down in miniature ski lift fashion. I went first.
"Jay will be impressed by this," I thought. "He will see my adventurous spirit and become rapturously in love with me."
The little bike seat swung only a few feet above the tunnel floor, but the slope was perilously steep. I hung on as the cable took me down, and down, and down. Bare bulbs lit the way every so often. In between were wide stretches of perfect blackness, then a few bright red warning signs I couldn't understand, then more of the impossible dark until, at last, we reached the bottom.
"It's hot," I told Jay, stupidly as he stumbled off his bike seat. I'd expected the clammy chill of a cave, but it was properly, hellishly hot down here.
"Yeah," he said. He did not mention my adventurous spirit.
We followed our guide, the cousin's friends, and their heavily armed guard down a tunnel lit by the occasional bulb, then past a huge vent chundering sweet, room temperature air.
I fell into step beside him, hoping I could find some new and thrilling way to riff on the temperature, but the guide was pointing us down another narrow, bulb-less tunnel. It was pitch black beyond — then a light winked on, suddenly, followed by another. Floating circles of light, the whole way down, like cartoon eyes in the dark.
It wasn't as romantic as I thought it was going to beAs we drew closer, though, the floating lights dissolved into ordinary men wearing headlamps, most of them shirtless and sheened with sweat. Touring someone else's poor labor conditions was perhaps less romantic than I'd envisioned.
Our guide ushered us forward to see the tiny hole in the wall where explosives were squeezed in — then we were shooed out of the tunnel again to await the blast.
I stood by Jay. His arm brushed my side. Maybe it was just the large quantities of nitroglycerin in a confined space several hundred feet below the surface of the earth, but my heart hammered.
Then came the blast, a low-thrumming quake that shook the whole tunnel, and I grasped Jay's hand.
Looking back, I cringe (and hard) at playing tourist in an industrial job site — but I was 20.
We dated for four months. We never topped the heart-pounding thrills of holding hands in the mine. It turns out the bonds forged by claustrophobia and ecological guilt are not a great basis for long and enduring love, but it was, at least, one of my more memorable Valentines.
Only In Oklahoma: 'Reign Of Terror' Kills Osage Family
A crime spree in the early 1920s that became known as the Osage "reign of terror" left at least seven wealthy interrelated Indians and two others dead.
The victims were killed in a plot designed to allow the plotters to collect oil money from the government on headrights held by the Brown family, a group of Osages. Some newspaper accounts from that period at times indicated as many as 21 may have been killed, but later accounts set the figure at nine.
Three men, including wealthy rancher William K. Hale, once known as the "King of the Osage Hills," his nephew and a ranch hand, were sentenced to life prison terms for their roles in the killings -- one on a guilty plea and two after jury trials.
The series of mysterious deaths among wealthy Osage Indians began in May 1921 when the decomposed body of Anna Brown, holder of oil land valued at about $2 million, was found in a ravine near Greyhorse.
People are also reading…
The body of her cousin, Henry Roan Horse, also known as Henry Roan -- a .45-caliber bullet hole in his head -- was found frozen in his car in a ravine between Tulsa and Fairfax in February 1923. Another victim was Charley Whitehorn, Anna's cousin, who died of a gunshot and whose body was found near Pawhuska.
Next, George Bigheart, another of Anna's relatives, became ill and was taken to an Oklahoma City hospital, where it was discovered he had been poisoned. As he neared death, Bigheart called for his attorney, Bill Vaughn of Pawhuska, to come to the hospital for a conference.
After conferring with Bigheart, Vaughn started home on a train but when the porter went to wake him in his Pullman berth the next morning, he was missing, and the berth had not been used. Vaughn's body was later found with a crushed skull, on the track near Pershing (about 5 miles south of Pawhuska). Officers later speculated that he may have learned too much from Bigheart.
Victims six, seven and eight were W. E. Smith, his wife, Rita Brown Smith, and a white servant girl who died when their house at Fairfax was demolished by a nitroglycerin explosion on March 10, 1923. It was the first night the Smiths had lived in their house in Fairfax. They had moved there from a country house because they feared for their lives after Roan Horse had been killed.
Rita and Anna's mother, Lizzie Q, also died. At first it was believed that her death was caused by her age, but it later appeared to be part of the plot. Lizzie Q's death and those of the cousins left Mollie Brown Burkhart (Rita and Anna's sister and Lizzie's daughter) as the only member of the Brown family alive and gave her and, by extension, her husband control of the family's wealth. Her husband eventually admitted his role in the killings.
The murder cases remained unsolved until 1925 when federal agents entered the investigation because the killings occurred on the Osage reservation. Hale was accused of being the mastermind in the killings after Ernest Burkhart, Mollie's husband, and John Ramsey, one of Hale's ranch hands, admitted their roles and named Hale as the mastermind.
It also was discovered that Hale had a $25,000 insurance policy on Roan's life, though Hale insisted that he had taken out the policy because the Indian owed him money. He maintained his innocence even after serving 20 years in prison and being paroled.
Hale said he exhausted his fortune trying to prove his innocence.
Burkhart, the first to go to trial, told the district attorney after three weeks of testimony that he was tired of lying and wanted to plead guilty to the Smith murders. He was given a life prison term for murder.
Hale received a life term after a U.S. District Court jury found him guilty of murder for Roan's slaying. Ramsey was convicted after three trials in the Smith murders and received a life sentence.
All three were paroled later -- Hale in 1947, Ramsey in 1948 and Burkhart in 1959. Burkhart received a pardon in 1966.
Like this column? Read all the columns in the Only in Oklahoma series from the Tulsa World Archive.
Only in Oklahoma is a series from the Tulsa World Archive that was written by former Tulsa World Managing Editor Gene Curtis during the Oklahoma Centennial in 2007. The columns told interesting stories from the history of the country's 46th state. The Tulsa World Archive is home to more than 2.3 million stories, 1.5 million photographs and 55,000 videos. Tulsa World subscribers have full access to all the content in the archive. Not a subscriber? We have a digital subscription special offer of $1 for three months for a limited time at tulsaworld.Com/subscribe.
Users can customize the app so you see the stories most important to you. You can also sign up for personalized notifications so you don't miss any important news.
If you're on your phone, download it here now: Apple Store or Google Play
Patrick Prince
With a weekly newsletter looking back at local history.
Comments
Post a Comment