No Breath, No Pulse, but Minn. Crews Revive Man

May 05--He wasn't breathing, and he had no pulse.

The man had collapsed Sunday on a sidewalk outside the Dorothy Day Center in downtown St. Paul, and police and firefighters who rushed to his aid desperately tried to save him.

CPR didn't work. Neither did the Heimlich manuever. Nor did a defibrillator.

So the rescue workers turned to a staple of TV medical dramas: They cut open his throat to get air into his blocked windpipe.

It worked.

On Monday, the 55-year-old man was in critical condition at Regions Hospital in St. Paul.

The emergency procedure used to save his life, called a cricothyrotomy, is a "high risk, low frequency" skill for paramedics, said Kenneth Adams, a St. Paul Fire Department captain and emergency medical services coordinator. Although paramedics regularly practice the procedure on mannequins, it's not often performed in the field.

And the young firefighters Sunday were doing it for the first time in their careers.

"There's a few procedures as a medic where you say, 'Oh boy, if I screw this up, someone's dead,' " Adams said. "If you slip, you have the jugular vein and carotid artery right next to where you're cutting. If you can't get the airway in, the guy is going to die."

About 4:50 p.m. Sunday, St. Paul police officer Nicole Oberstad was working off duty at the Dorothy Day Center when she was told a man was having a seizure outside the shelter, police spokesman Steve Linders said. Oberstad called for help and found the man.

His lips were turning purple, and something -- food or vomit -- was in his mouth.

Adams said it appeared the man had suffocated after choking and that had stopped his heart.

Oberstad began CPR with two other officers who had arrived, Ed Dion and Mike DeTomaso. Adams said the trio also tried the Heimlich and a defibrillator.

When fire department medic and engine units arrived, the man still didn't have a heartbeat. Paramedics continued CPR with a chest-compression machine. They also drilled a hole into the man's leg bone to attach a line to deliver fluid and medicine, and tried to suction out the man's airway, Adams said.

But they still weren't able to clear the blockage. So they decided to try a cricothryotomy.

"There on the sidewalk, they literally cut his throat," Adams said.

Jeremy Coy, a firefighter and paramedic, did the cutting. Tomo Klep, a fire equipment operator and paramedic, used a tool called a Sklar hook to pull the trachea out so a breathing tube could be inserted into an incision.

Within three minutes, the man's heart started beating again, Adams said.

Adams was on hand to help talk the paramedics through the procedure. The other firefighters there included Capt. Paul Barrett, firefighter/EMT John Hall, firefighter/EMT Luke Swaboda, firefighter/paramedic Kris Kauffman and Dorwen Bishop, a fire cadet on his last training ride before graduation.

"Everybody there was doing what had to happen to save that guy's life," Adams aid.

Richard Chin can be reached at 651-228-5560. Follow him at twitter.com/RRChin.

Copyright 2015 - Pioneer Press, St. Paul, Minn.