Abstract
A 53-year-old female nurse (Nurse A) collapsed suddenly during cardiopulmonary resuscitation (CPR) of an 83-year-old female resident who was experiencing cardiopulmonary arrest (CPA) in a geriatric health services facility near our hospital. Although Nurse A applied shock treatment using an automated external defibrillator (AED) available at the facility, CPR was required. When Nurse A happened to collapse during CPR, another staff member at the scene started CPR for Nurse A. While the resident was being transported to our hospital by Emergency Medical Service (EMS) personnel, the AED used for the patient was used for Nurse A. According to AED instructions, shock treatment for ventricular fibrillation (VF) was performed. Another EMS staff member continued CPR and transported Nurse A to our emergency room. As the AED monitor still showed VF on Nurse A's arrival, we performed electric shock treatment and administered adrenaline 1 mg intravenously, and her heartbeat was restored. After artificial respiration for 6 days and hypothermia for 3 days in the intensive care unit, her consciousness was fully recovered. An implantable cardioverter defibrillator was placed at Gifu University Hospital 2 weeks after initial admission and she was discharged without neurological deficits after cardiac rehabilitation. Nurse A had been diagnosed with hypertrophic cardiomyopathy at a medical check 8 years earlier. Following a review meeting, we placed two new AEDs in the nearby geriatric health services facility. Although there have been several reports of rescuer's fatigue during chest compression performed according to JRC Guideline 2010, we could find no reports of rescuer's CPA during bystander CPR. It is important to prevent rescuer's fatigue during CPR as well as to consider stopping CPR if rescuers develop significant symptoms while performing it.
