What if your heart stops and you are on a vent Are you still alive until you are taken off the ventilator?

Answer 1

A person can go into 1. cardiac arrest (heart stopping) or 2. respiratory arrest (not breathing), or 3. full arrest which is both heart and lungs.

If your heart stops, doctors must re-start the heart FIRST through CPR and injection of medications that support heart function. If CPR fails to re-start the heart, paddles are used to shock the heart; this is also used if CPR re-starts the heart but the heart has an electrical pattern that is inconsistent with life, for example, prolonged fibrillation where the heart muscle cannot properly contract.

When a person's heart stops, they also need supportive respiration because if the heart stops for very long, then respiration will also stop. When the heart cannot beat and the person is not then able to breathe on their own, then the paramedics and/or nurse will "bag them", meaning, an ambu bag is placed over the mouth and nose and air is manually pushed into the person's lungs. (An ambu bag looks like a clear, hard plastic mask with a tube sticking out from the center, above the mouth and nose. A rather stiff, sturdy "bag-like" apparatus attaches to that tube. The worker squeezes the bag to force air into the person through the nose and partly open mouth.) Artificial breathing with an ambu bag goes on at the same time as / but in-between chest compressions. The ambu bag is a tool used in hospitals and ambulances, and replaces mouth to mouth rescusitation in CPR.

In such a full code situation, a tube may be inserted over the tougue, through the mouth, down the throat, past the vocal cords, and into the main brochus, and into the lungs. This is often referred to as the shortened, "tubing" the patient. This tube is important in many "full code" situations. If the lungs have wheezing or rales (a really bad sound), air-opening medications can be directly placed through the tube. Nebulizer meds for Asthma can be forced through the tube, helping the lungs tissue to open and allow more exchange of CO2 for O2. During CPR in the ER, the breathing tube is often placed early to help the person faster. In conditions resulting from a severe reaction (anaphalaxis) from an allergic reaction or from meds, smoke inhalation, burns, or chemical inhalation, a breathing tube is required before the throat closes off -- which would then require a tracheotomy (a surgical incision through the neck into the windpipe).

Just because a person's heart stops, it does not mean the person automatically goes onto a ventilator (a "vent"). Sometimes a person without heart attack is put on a vent before respirations stop in order to support the lungs and prevent arrest. For example, in a severe drug overdose, a breathing tube and ventilator may often be used for 1 to several days until the drug clears through the kidneys and liver.

All persons are technically "alive" while on a ventilator, even if brain tests show that there is major brain damage and there is no hope of recovery. In brain death, doctors must leave the person on the ventilator until the family agrees to have the ventilator stopped. Lay persons often refer to the decision to remove life supports as "pulling the plug". But the process of discontinuing life support is a little more complicated, and the primary decision-maker in the family must sign permission papers before any action is taken. It may take some families many days to work through thoughts and emotions before they can sign any permission to allow their loved one to die.

But, a large percentage of very alive, brain-functioning patients are put on ventilators every day as supportive or lung-protective measures. For example, after some surgeries patients may awaken to find their breathing is assisted by a vent. Patients who have overdosed, have been severely hurt in a car accident, who have a heart rhythm abnormality, or have had trauma to the neck, chest, diaphram, or upper abdomen may be placed on ventilation.

It is important to note that all patients are sedated -- usually a heavy sedation -- before the breathing tube is placed. Doctor shows on TV talk about "Suxs" which is a short name for Succinilcoline, a paralytic medication (causes paralysis) used for endotracheal intubation. The patients (almost all) have normal brain function and might even be able to breathe without assistance, but certain situations have medical protocols for using intubation and ventilator.

In surgeries or other limited conditions, intubation and ventilator are used short-term -- hours to days. The person is slowly weaned from mechanical ventilation by lowering the sedation, then lowering the settings on the vent which allow the patient to take over the work of breathing as they continue to "wake up". On patients who have had ventilation for a while, the vent settings may be set more intermittently, so that the vent only does the work if the patient's lungs don't do enough to support life. "Weaning" a chronically ill patient who has been on a ventilator for a long time may take weeks.

Again, patients are always "alive" while on a vent. Many patients only need ventilator support for a short time. Doctors are careful to check for the patient's efforts to breathe on his/her own and to wean the patient from the vent as soon as possible. When these patients are taken off the vent, they are very much alive-- just as they were when on the vent.

Those patients who are medically "brain dead" still are considered "alive" as long as the heart circulates blood and the blood is oxygenated blood. When a vent is removed from a "brain dead" patient, the patient may never take another breath from the moment the vent is turned off-- at that point of no respiration and no heartbeat, the person is declared to be "dead".

However, depending on the severity and location of the brain injury, a 'brain dead" patient's brain may attempt to send signals to "breathe". There are many patients who are believed to have no higher brain function and they can continue breathing when off the vent (these cases are at the heart of "Right to Die" crusades). But if a person's brain stem is damaged, which controls respiration, as soon as the vent is removed they may have a few ineffective breaths--or no breaths--and when there is no heart beat/pulse or respiration, the person is declared "dead".