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Every Minute Matters

Comprehensive emergency care made a difference for patient Julie Kirtland

Julie Kirtland 260×180

Every morning, Julie Kirtland and her golden retriever, Dylan, take an hour stroll around her Encinitas neighborhood.

But, on March 23, 2010, their regular walk was abruptly interrupted. Only a few blocks from home, Julie’s heart stopped beating.

As Julie lay in the street experiencing cardiac arrest, her dog frantically ran in circles trying to get the attention of passers-by. Within minutes, citizen responders were administering cardiopulmonary resuscitation (CPR).

Emergency CPR minimizing long-term neurological damage

Julie Josland, a labor and delivery nurse at Scripps Memorial Hospital Encinitas, was among the first to provide assistance. By chance, she was driving through the neighborhood. It was her day off, and she was returning from her daughter’s poetry reading.

“When I arrived, I continued CPR that had been initiated by another man. As I did compressions, Julie’s coloring immediately improved and the blueness in her face faded away,” she says. “That’s how I knew her blood was circulating and our efforts were making a difference.”

Soon, paramedics were at the scene. Using a defibrillator, they restored Julie’s heartbeat and continued rescue breathing.

“One of the paramedics looked at me and said, ‘You saved someone’s life today,’" says nurse Josland. "It was the first time during my 15-year career of being a nurse that I administered CPR. It’s a critical skill that everyone should learn,”

Julie was transported by ambulance to the emergency department at Scripps Memorial Hospital Encinitas. CPR not only helped save her life, it was the first step to minimizing long-term neurological damage.

Therapeutic hypothermia protecting neurological tissue

According to the American Heart Association, fewer than five percent of people survive sudden cardiac arrest and many who survive often experience neurological damage.

Time is vital and every minute counts. When the brain is denied oxygen for more than three minutes, it begins to die and damage can be irreversible. As Julie received seamless emergency care at Scripps Memorial Hospital Encinitas, not a second was wasted.

Once her heartbeat was restored, physicians began a new procedure, therapeutic hypothermia, to protect Julie’s brain.

“The goal of the innovative therapy is to slow down brain function and reduce metabolism,” says neurologist Michael Lobatz, MD, vice president of medical affairs at Scripps Memorial Hospital Encinitas. “The process allows for recovery to occur without swelling and inflammation.”

Intensive care physicians and staff surrounded Julie’s body with special cooling blankets, quickly lowering her core temperature to 33 degrees Celsius (91.4 Fahrenheit). She was put into a drug-induced coma for 24 hours before gradually being warmed back up to normal body temperature.

This process slowed the initial rush of blood to Julie’s brain, helping to prevent injury to vital neurological tissue.

Cardiac catheterization, stent placement for Julie

Diagnostic tests were conducted to determine what had sent Julie into cardiac arrest. X-ray images illuminated the source of her heart problem — a significant blood clot in her left anterior descending artery.

To open the obstructed artery, Scripps Encinitas cardiologists Martin Charlat, MD, and Roy Avalos, MD, performed a cardiac catheterization procedure and implanted a stent to open the artery and decrease the chance of another blockage.

A healthy recovery and grateful perspective

“I was in the best place I could have been. Scripps Memorial Hospital Encinitas saved my life,” she says. “My life was in the balance as I was rushed to the emergency department. Five days later, I walked out of the hospital, went home and felt great.”

Julie was discharged from Scripps Memorial Hospital Encinitas, returned home and reunited with her dog, Dylan. Amazingly, she showed no signs of neurological damage.

“I evaluated Julie a few weeks after she was discharged. Her neurological function was good, with no impact to her speech, balance and reflexes,” Dr. Lobatz says. “It was as if nothing had ever happened.”

Today, Julie continues her active lifestyle, beginning each day with a walk around the neighborhood with Dylan.

“Life is a gift and I’m thankful to be here,” she says.