Cardiac training turns life-or-death when NH nurse stricken – Lynchburg News and Advance

CONCORD, N.H. Andy Hoang eagerly began her first nursing job this year in New Hampshire, with a desire to specialize in cardiac care.

She was excited about attending a November practice session on how to respond to someone in cardiac arrest. But as things were getting under way at Dartmouth-Hitchcock Medical Center, Hoang, 23, started to feel dizzy and nauseated. She felt she needed to sit down.

Thats the last thing I remember, she said. I woke up to a room full of doctors and nurses.

Andy Hoang, a recent nursing graduate, center, stands Tuesday with co-workers Lisa Davenport, left, and Justina Terino at the spot where she was stricken recently during a cardiac training session at the Dartmouth-Hitchcock Medical Center in Lebanon, N.H.

It turned out that she, herself, had gone into cardiac arrest and needed help immediately. Her colleagues sprung into action instead of practicing chest compressions on a mannequin in a simulated environment, they went to work on her.

One checked her carotid, one her femoral (arteries), and she did not have a pulse, instructor Lisa Davenport said.

The nurses started CPR and a code blue, or medical emergency, team was called.

What was really stressful about the situation was that we never had a real code blue in the center, Davenport said. We train for them all the time.

Davenport shouted for help. Luckily, the Lebanon hospitals critical care team was nearby, attending a separate session. More nurses came in, hooked Hoang up to defibrillator for monitoring, inserted an IV line and placed her on oxygen. A doctor and nurse from another department rushed in with crash carts.

Andy Hoang with a training mannequin in a patient bedroom training lab at Dartmouth-Hitchcock Medical Center. After she, herself, went into cardiac arrest, her colleagues sprung into action and saved her.

Hoang was waking up by the time an emergency team arrived. Davenport estimated 15 minutes passed from the time Hoang slumped over to when they got her on a stretcher and sent her to the emergency department. But it felt longer.

It worked out, but it was pretty frightening for all of us, she said. You just dont expect that to happen with someone as young as Andy.

Charmaine Martin, one of the nurses at the scene, agreed it was a scary moment, but also one where I saw and felt supported and we all worked as a team, she said in a statement.

Hoang, who recently returned to work, couldnt believe what had happened either.

I would say Im your pretty average healthy 23-year-old, she said. She goes to the gym four times a week, runs, and eats well. Im on my feet 12, 13 hours a day at work, so I want to make sure that Im in shape for that.

Cardiac arrest the sudden loss of heart function causes more than 436,000 deaths in the United States each year, according to the American Heart Association. It is different from a heart attack, which happens when blood flow to the heart is blocked.

Andy Hoang, a recent nursing graduate, left, chats Tuesday with clinical nurse supervisor Justina Terino in a cardiac training lab at the Dartmouth-Hitchcock Medical Center in Lebanon, N.H.

A person can suffer cardiac arrest after having a heart attack, but the association says other conditions can also disrupt the heart's rhythm and lead to cardiac arrest, including having a thickened heart muscle or cardiomyopathy, heart failure, arrhythmias and more.

According to information compiled by the National Heart, Lung and Blood Institute, a persons risk of cardiac arrest increases with age. It is rare in someone younger than 30. Genetic arrhythmias, problems with the structure of the heart or coronary arteries, heart inflammation and substance abuse are the main risk factors in younger people. Most cardiac arrests also occur in men and womens risk increases after menopause.

Hoang said before the day she suffered cardiac arrest, she had passed out twice before. The first time, she hadn't eaten and her blood sugar was low. The second time was preceded by a sharp pain in her abdomen.

So, nothing like this, nothing to this extent, she said.

Hoang, who grew up in Vietnam and came to the United States in 2016 as a student, said her family has no history of heart problems. She had been living with a family in Montana before she got her nursing degree in Michigan, and then headed to New Hampshire.

While recovering, Hoang wore a patch that recorded the electrical activity of her heart. Doctors hope to learn more from the data.

The experience has strengthened her relationship with the other nurses Hoang now regards them as best friends. We basically went through this whole life-or-death experience, she said.

I am so grateful for Andy and her courage. She is an excellent nurse and someone I call friend, Martin said.

Hoang said she feels like she's part of a family at work, not just an employee. Her family said they are extremely grateful that she was surrounded by medical personnel when she went into cardiac arrest.

It was care given by nurses to her grandfather, who died a couple of years ago, that made Hoang want to switch her career focus from graphic design to nursing. But she never expected she would become a patient.

It really changed my perspective on how I view life, like Hug your family a little longer, she said. Tell them that you love them, because it might be the last time you get to say it to them. And just cherish life for what you've been given. It's precious, and I didn't realize how precious it was until I nearly lost it."

More than a half-century after federally sponsored segregation limited access to homeownership for Black Americans and contributed to the deterioration of redlined neighborhoods, communities are still feeling the impact.

Redlining, implemented by the federal government after the Great Depression, graded and color-coded streets based on their proximity to neighborhoods populated by Black people. The Federal Housing Authority decided that property values in these areas would only decline, making mortgage loans in those areas economically risky. It led to systemic disinvestment in these segregated neighborhoods, where residents were more likely to have health problems, including severe asthma.

Northwell Health partnered with Stacker to examine data from numerous government and academic studies that showed the health disparities among people who live in redlined neighborhoods.

A study published in the Journal of the American Medical Association in May 2023 found veterans living in redlined areas are 14% more likely to have a major heart attack or stroke than people living in higher-graded areas. The study tracked long-term health outcomes among veterans over a four-year period but was adjusted for demographic factors such as race and gender.

Even when comorbidities such as smoking and obesity are taken into account, the difference in health outcomes remained significant, researchers found. That's because these neighborhoods are more likely to be near landfills and other pollutants, while people who live there lack access to things like health care, fresh foods, and green space.

Lending discrimination in the U.S. still exists today, especially against Black and Latino people who want to buy a home. In 2021, the Biden administration announced a new initiative to stop the unofficial practice of redlining. Some local and state governments have also stepped up; in May 2023, New York's governor announced an eight-step plan to reduce housing inequality in that state.

Not only are residents of lower-graded neighborhoods more likely to have heart problems, but they also have a 13% higher risk of death overall, according to the JAMA study.

Because they tend to have less access to health insurance and public transit, people in redlined neighborhoods are less likely to see a doctor. A decrease in wellness visits means health issues are typically caught later, and therefore may be more severe.

However, investing in these communities does not necessarily provide a cure-all for these issues. When a formerly redlined neighborhood becomes gentrifiedsuch as by erecting a new grocery store or luxury apartmentsresidents are more likely to experience stress and anxiety from rising living costs and potential displacement, which can exacerbate physical health issues.

Kidney diseases are one of the leading causes of death in the United States, according to the Centers for Disease Control and Prevention. When the kidneys cannot filter blood properly, waste remains in the body and can lead to other issues like heart disease and stroke. More than 37 million American adults have chronic kidney disease, but most don't know it.

Diabetes is also a risk factor for heart problems. People with diabetes are two times more likely to have a stroke or heart disease, according to the CDC.

People who live in redlined areas are more likely to deal with risk factors for heart diseases, including obesity and smoking, though that is largely by design.

Businesses that typically promote healthy living (such as grocery stores, pharmacies, and gyms) avoid leasing space in these neighborhoods, while reputedly predatory businesses (like check cashing stores, liquor stores, and smoke shops) proliferate. Because they are exposed to more tobacco marketing, children in redlined areas begin smoking sooner.

People of lower socioeconomic status are more likely to smoke tobacco products, according to a 2020 U.S. Surgeon General report. Smokers are more likely to have cancer, as well as heart and respiratory diseases.

The report also found quitting smoking is beneficial at any age and can improve health and reduce the risk of death. To increase the likelihood someone will quit smoking, it recommends comprehensive insurance that covers FDA-approved prescription drugs and counseling, along with anti-smoking media campaigns and raising the price of cigarettes.

Story editing by Ashleigh Graf. Copy editing by Tim Bruns.

This story originally appeared on Northwell Health and was produced and distributed in partnership with Stacker Studio.

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Cardiac training turns life-or-death when NH nurse stricken - Lynchburg News and Advance