Twenty minutes after emergency care began on the basketball court, Ryan’s ED care team is able to stabilize his heart rhythm. Once stabilized, Ryan’s physician reviews his history, EKG, X-ray, echocardiogram and lab results including his cardiac enzyme study. He confirms that Ryan has suffered sudden cardiac arrest as a result of ventricular fibrillation. Ventricular fibrillation often begins as ventricular tachycardia — as the EMTs mentioned — and in Ryan’s case, can result in sudden cardiac arrest.
The physician explains to Ryan’s mom that because of his excessive caffeine intake, Ryan’s heart began to beat in an extremely rapid rhythm called ventricular tachycardia. More than likely, Ryan began experiencing the tachycardia while on the court, but did not know it because of the intensity of the game. As his heart continued to beat rapidly, it became more disorganized and began ineffectively pumping blood to his brain. Without enough oxygen, his brain shut down and he fainted. The physician tells Ryan’s mom that Ryan is fortunate that his coach knew CPR and correctly utilized the onsite AED and that the EMTs arrived quickly — these treatments saved his life.
Although Ryan’s heart rhythm is stabilized and oxygenated-blood is restored to his brain and other vital organs, he is still in danger of brain damage. To protect his brain, the physician suggests to Ryan’s mom that they place Ryan in a drug-induced coma and therapeutic hypothermia for the next 24 hours. The physician explains that Ryan will be placed in an “arctic-suit” where pads with cool water running through them are on Ryan’s chest and thighs. This will cool his body temperature to 33 degrees Celsius (91.4 degrees Fahrenheit), which prevents the brain from overreacting and releasing harmful cell-destroying toxins that could lead to brain damage. Because Ryan is unconscious and under the age of 18, his mom gives permission to perform this treatment.