May 15, 2023
“I have three memories from that morning – I arrive at the pool, I joke with Ian, and I have one flash of consciousness in the ambulance,” explains Dr. Brandon Schaufele, Director, Ivey Energy Policy and Management Centre, and Professor of Business, Economics and Public Policy at the Ivey Business School at Western University.
One morning in March, Brandon showed up at the pool to train with his swim team. What happened next, no one would have predicted. Mid-practice, he lay on the edge of the pool after going into cardiac arrest.
Dr. Ian Ball, Critical Care and Trauma Physician at the Critical Care Trauma Centre (CCTC) at London Health Sciences Centre (LHSC) is a member of the swim team and acted quickly. Mackenzie Salmon, head coach, who has considerable first response training, and teammate Tristan Squire-Smith, who is trained as registered nurse and is a formed LHSC staff member, responded just as swiftly to assist Dr. Ball in providing life-saving measures to Brandon.
They all knew how serious the situation was and knew what to do – they called an ambulance, went to find an AED (automatic external defibrillator) and performed CPR.
“I have responded to cardiac events many times throughout my career, but never with someone I knew well,” explains Dr. Ball. “I was trying to balance my emotions with the knowledge that Brandon may die and try to remain calm and manage the emotional reactions of myself and those around me.”
After mere seconds, Dr. Ball, Mackenzie and Tristan fell into a rhythm – their teamwork just clicked. The first responders arrived after they had performed five rounds of CPR and shocked Brandon three times with the AED. It was on the third shock that Brandon regained consciousness.
“The incredible response from the paramedics, police and firefighters helped save Brandon’s life,” Dr. Ball says. “I rode in the ambulance with Brandon to the hospital where his vitals were already showing as normal, and after about 15 minutes, he was trying to speak, but was perseverating.”
When a person is perseverating, it means they are repeating words or phrases. Dr. Ball said Brandon was repeatedly asking, ‘what happened?’.
“I would tell him what had happened, he would react to the news and then we would sit in silence for a few moments before he would turn to me and ask again, ‘what happened?’,” Dr. Ball explains. “This can happen after someone experiences a head injury. With cardiac arrest, there is a possibility of brain damage, so at this stage I began to worry less about him surviving, and more about his ability to function at the level he was before.”
Brandon’s heart health
Brandon is a fit 43-year-old. He’s a triathlete with no family or personal history of heart disease; this incident is something medical professionals call “idiopathic” – a condition that spontaneously arises without any known cause.
From the ambulance to being transported to the Emergency Department and CCTC at Victoria Hospital, LHSC, then being transported and treated at LHSC’s University Hospital to continue cardiac-specific care, Brandon has no clear memories of the day until he was in the Coronary Care Unit (CCU).
“I had a series of tests and scans, and no cause was found,” Brandon says. “I now have an ICD in my chest as a precautionary measure in case this ever happens to me again.
An ICD is an implantable cardioverter-defibrillator – a device inside his chest that will act to restart his heart, very similar to an external defibrillator, if another cardiac event occurs.
Brandon has no damage to his heart and his blood flow is normal. He has even pushed himself when exercising to maintain a higher heart rate, and there is no exhaustion – physically, it is almost as if the episode never happened. Dr. Ball notes that unexplained sudden cardiac arrest such as this are very unusual.
Mental wellness after a critical incident
Mentally, Brandon hasn’t had a lot of time to reflect on the incident. “It’s a lot to process in many ways. I feel physically well, I have three kids and a wife and we have a busy life, so I haven’t given much time to think about how I feel about it all. I will get to it.”
As a trauma physician, Dr. Ball knows how important it is to debrief about a critical incident as soon as possible. “Mackenzie, Tristan and I knew how important it would be to the teammates to talk about what happened. We had everyone over the night of the event, people brought food and drinks and had the opportunity to share their perspectives and experience. Some shared that this event was triggering flashbacks or memories of similar events with family members. At the end, everyone felt better for coming together and going over what happened.”
Brandon’s outcome is relatively rare. While he has an ICD, there is no lingering damage or complications to his heart, his vitals are stable and all tests show his heart and blood flow are operating normally.
Key lessons from this emergency response
This incredible outcome is likely a result of the quick action taken by Dr. Ball, his teammates and first responders.
“There are two key lessons to take away from this event – one is to have a highly visible AED onsite with someone trained to use it. The other is to have someone trained in first aid to administer lifesaving measures until first responders arrive,” Brandon summarizes.
Dr. Ball reiterates the importance of those two important points to keep in mind, “An AED can never be too visible and it is important to have someone trained to respond in a medical emergency onsite to ensure the best possible outcome for a person after experiencing a medical event.”
What’s next for Brandon
In the six weeks since his cardiac arrest, Brandon has gone for two runs and biked ten times. He has not gone back in the pool yet, but he has been advised he can resume all normal activities next month.
Brandon is exceedingly grateful to Dr. Ball, Mackenzie and Tristan for their fast response. Friends throughout the City of London have likewise offered support that has been a huge help to him and his family. With June just around the corner, Dr. Ball, Brandon and the team are looking forward to the opportunity to swim together once again.
“After all of this, I’m looking forward to getting back to the pool with Brandon and the team,” Dr. Ball says.
