On a Thursday at Riverside High School, Shelby Morgan learned CPR. That Friday, she learned how to use an automated external defibrillator, which can deliver a lifesaving shock to the heart.
The following Monday, she saved her grandpa.
A lot of other people saved Dick Morgan, too: the first responders who arrived at his Shadle home on Feb. 10 and shocked his heart back into rhythm, the hospital crew who treated him, cooling his body to slow neurological function and protect his brain after his cardiac arrest, and reporting his prognosis to his family in terms of if – if he recovered, not when.
But Dick Morgan’s “chain of survival” started with Shelby, which is why she was among people honored Friday at a Lincoln Center reunion of cardiac arrest survivors and the people who helped them. The 15-year-old helped make the first “community save” that Spokane Heart Rescue – a network of emergency medical responders, doctors and others who’ve been working to strengthen that chain – can connect directly to their effort.
They’ve been focusing on the links among us. Potential lifesavers include high school students and anyone else they can lure into CPR training sessions. In the case of cardiac arrest – when the chances of survival decline 10 percent with each minute that passes before the victim’s heart is shocked – sometimes a lifesaver is somebody who just happens to be there, and who knows what to do.
A 10th-grader at the Riverside Achievement Center, an alternative school in the Riverside School District, Shelby Morgan does most her schoolwork at home. She was at the high school – among three schools in a program launched by Fire District 4 to teach CPR to students – for the training.
It was fresh in her mind when her grandfather collapsed in his kitchen.
“You know how sometimes you just go into a mode of just doing what you have to do? She sure kept her cool,” said Arena Morgan, Shelby’s grandmother.
“It was a key to his survival,” she said.
Shelby’s mother, Deborah Morgan, died in April 2012 of cancer. She lives with her father, Gregg Morgan, in Chattaroy but spends a lot of time at her grandparents’ house.
Diana Bostrum, a teacher at the alternative school who’s known Shelby for about 10 years, called the save “an amazing thing,” but not surprising.
“There’s this calm, mature girl, being adult again,” Bostrum said. “There she is. Composure … that is huge in the heat of the moment, to be able to do it after you just learned it – on a person that you absolutely adore.”
‘Churning on the inside’
Most people who suffer cardiac arrest die – roughly nine of 10 victims, nationally. But in Spokane County, more of them are surviving, as the network of doctors and others working to improve the odds has focused especially on two factors proven to make a real difference: good CPR and the use of defibrillators. The survival rate rose from an estimated 20 percent in 2010 to 51.2 percent in 2012, among victims considered savable.
Among their efforts was the pilot program launched about three years ago by Fire District 4 to teach CPR to students at the three high schools in its coverage area, Riverside, Mt. Spokane and Deer Park. Gov. Jay Inslee has since signed a law requiring all high school students in Washington to learn CPR, starting with this school year.
In the Feb. 6 and 7 sessions, Shelby said she and other students watched videos and pressed the chests of dummies and learned how to use a defibrillator. It seemed like a fine use of her time, she said, but nothing she’d really ever have to use.
But Feb. 10 was a snowy day, which meant Dick Morgan, 78, spent the morning outdoors with his snowblower.
He remembers coming inside from the cold, through a back door into the kitchen.
“I told my wife, ‘Honey, I’m getting too old to do this anymore,’ ” Dick Morgan said. “I always do my neighborhood. Most of the people are old. So am I, but I didn’t know that until this happened.”
Arena Morgan was in the kitchen, too. Shelby was in the adjacent family room.
Arena remembers her husband leaning against the kitchen table.
“I almost said, ‘Tough one today, honey,’ ” she said, “and he reached for a chair, and he just toppled over backwards and quit breathing.”
Arena yelled for her granddaughter to call 911. “She said, ‘I already have, Grandma,’ ” Arena said.
Those minutes after her grandfather toppled over went by in a blur, Shelby said. At the same time, the minutes until professional rescuers arrived seemed to last an hour, forever.
She said she asked someone on the phone, a dispatcher or a paramedic, whether to start CPR, and they said yes and talked with her as she pressed her grandfather’s chest.
Shelby remembers he was wearing a lot of layers – a coat, sweatshirts, a vest, a T-shirt. The layers made it difficult. Looking back, she said, she thinks she did a better job on the dummy at school.
But her grandmother said the professionals who treated Dick Morgan have credited Shelby with saving him.
“They’re saying that’s what kept him going,” Arena Morgan said. “I kind of went into hysteria, panic, and she just kept her cool. She said she was really churning on the inside, but you would have never known it.”
Buying crucial time
The Morgans’ experience demonstrates the potential impact of CPR training, said Dr. Joel Edminster, medical director for Fire District 4 and an emergency department doctor at Providence Sacred Heart Medical Center.
“This is a perfect example of sudden cardiac arrest that would have resulted in a fatality or severe neurological dysfunction” without CPR, he said.
The result of an electrical problem that disrupts the heart’s rhythm and pumping action, cardiac arrest stops perfusion, or blood flow to the heart and brain. Heart attacks and cardiac arrest aren’t the same, although heart attacks – when a blood clot blocks blood from flowing through a coronary artery – often cause cardiac arrest.
Not everyone in cardiac arrest can be saved. Some bad heart rhythms cannot be corrected by an electric shock.
But when a victim can be saved, CPR is key. While that used to mean alternating chest compressions with rescue breaths, research has found hands-only CPR – resuscitation without mouth-to-mouth breaths – is more effective.
By pushing hard and fast in the center of the victim’s chest, a bystander can re-establish blood flow to the victim’s heart and brain, buying time until they can be shocked.
On Dick Morgan, rescuers had to use their defibrillator just once, said Ryan Schaefer, a registered nurse and the electrophysiology coordinator at Sacred Heart. Schaefer nominated Shelby for her Young Hero Award.
“With one shock they were able to restore his normal rhythm,” he said. “That is ideal.”