Twenty-six-year-old electrician Lungani Mbatha is living proof of the critical importance of the continuum of care, also known as the ‘chain of survival’.
Mr Mbatha was working on a construction site near Durban when an unexpected disaster struck. “I have never had a serious electrical shock before, and I can’t remember much of what happened. All I know is that we were busy connecting wires, I shouted out and I don’t remember anything after that until I woke up in Netcare uMhlanga Hospital,” he says.
Pic: Marc van Heerden, general manager of Netcare uMhlanga Hospital who worked as an advanced life support paramedic for over 20 years, says that excellent communication between the Netcare 911 paramedics and the hospital's emergency department played a significant role in Mr Mbatha’s recovery. Pictured with him are (back) advanced life support paramedic, Shaun Paul, and intermediate life support paramedics, Isaac Pillay and Collin Krishnalall.
According to Netcare 911 advanced life support paramedic, Shaun Paul, Mr Mbatha owes his life to the streamlined emergency medical care he received, starting with a Good Samaritan who recognised that Mr Mbatha was not breathing and did not have a pulse after he collapsed from the shock then immediately initiated cardiopulmonary resuscitation (CPR), as well as the early activation of emergency medical services (EMS) to attend to Mr Mbatha.
‘Chain of survival’ is a principle of emergency cardiac care, which includes early recognition of cardiac arrest and activation of appropriate EMS, including commencing CPR as soon as possible, early defibrillation, as well as advanced cardiac life support and in-hospital treatment for post-cardiac arrest care.
“The chain of survival certainly made all the difference in this patient’s survival. The early intervention of the bystander, who initiated CPR before paramedics arrived, probably made the difference between life and death for Mr Mbatha. If the Good Samaritan had not started CPR, it is probable that the patient’s heart would not have been in a rhythm that was responsive to treatment,” Paul says.
Physician, Dr Nitin Ghila, who later received and provided treatment to Mr Mbatha in the emergency department of Netcare uMhlanga Hospital, explains that the electrical shock caused ventricular fibrillation, a severe disruption of the heart muscles’ natural electrical impulses that control the heartbeat. This resulted in cardiac arrest, as his heart was unable to pump vital oxygenated blood through the body.
Paul, as well as intermediate life support paramedics, Isaac Pillay and Collin Krishnalall, arrived on the scene three minutes after receiving the call, to find a crowd of anxious on-lookers surrounding Mr Mbatha and the man performing CPR on him. The paramedics immediately took over the resuscitation efforts.
“Using a manual defibrillator, we administered one electric shock and then continued performing chest compressions and ventilations. We had to administer another dose of electric current with the manual defibrillator at a higher setting, and managed to get a pulse,” Paul says.
He commended Pillay and Krishnalall for the level of co-operation between them in delivering life-saving care. “Their actions were synchronised, and they remained focused on establishing a pulse,” Paul adds.
“The patient started to regain consciousness and was rather disoriented, which is not uncommon following resuscitation after a cardiac arrest. His breathing was, however, still laboured and we had to put him in a medically induced coma and intubate him to ensure he was well oxygenated and his airway was maintained prior the journey to hospital.”
Given the nature of Mr Mbatha’s condition, the Netcare 911 team decided that the emergency department at Netcare uMhlanga Hospital was the most appropriate facility to provide him with definitive treatment.
“Netcare uMhlanga Hospital was deemed appropriate as it has the relevant cardiac expertise to assist a patient with such a medical condition, and we alerted the hospital that we were on our way. The handover was streamlined, and the trauma team knew exactly what to do, so that care could continue seamlessly,” Paul observes.
Dr Ghila recalls that when Mr Mbatha arrived at the hospital, he was on a ventilator and restless but stable. “The pre-hospital care he received was exceptional, and this is of the utmost importance in a medical emergency,” he notes.
“The paramedics and the bystander who initiated CPR certainly helped to save Mr Mbatha’s life. In any resuscitation, time is of the essence, and Mr Mbatha was fortunate that someone was on hand to recognise that he needed CPR and perform it until Netcare 911 arrived to provide definitive treatment.
“Fortunately, we found that the patient sustained no serious burns or fractures in the accident. We have been closely monitoring his heart and he has done very well so far. Mr Mbatha was soon transferred from an intensive care unit to a general ward, and has since been discharged home.”
The general manager of Netcare uMhlanga Hospital, Marc van Heerden, recognises the importance of an efficient ‘chain of survival’ for patients faced with an emergency cardiac event.
“Having worked as an advanced life support paramedic for over 20 years, I know that each aspect of the continuum of care is vital to achieving the best possible outcome for a patient. The high level of expertise and excellent communication between the paramedics and our emergency department certainly played a significant role in Mr Mbatha’s recovery,” Van Heerden observes.
Pic: Netcare 911 advanced life support paramedic, Shaun Paul, and intermediate life support paramedics, Isaac Pillay and Collin Krishnalall, attended to Mr Lungani Mbatha, an electrician who suffered cardiac arrest after a severe electric shock.
Mr Mbatha expressed his gratitude to everyone who helped him in his time of need. “I am so thankful to be here today. To the person who made the call to Netcare 911 and to the man who gave me CPR, I do not remember any of this, but I am told that they helped to keep me alive so I would like to say thank you very, very much. I am so grateful to the paramedics, doctors and nurses, and I would also like to thank Netcare for all the support they have showed me,” Mr Mbatha concluded.
Issued by: MNA on behalf of Netcare 911 and Netcare uMhlanga Hospital
Contact: Martina Nicholson, Graeme Swinney, Meggan Saville and Pieter Rossouw
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