Andy Hoang eagerly began her first nursing job this year in New Hampshire, with a desire to specialise 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 Centrer, Hoang, 23, started to feel dizzy and nauseated.
She felt she needed to sit down.
"That's the last thing I remember," she told The Associated Press in an interview. "I woke up to a room full of doctors and nurses."
It turned out that she, herself, had gone into cardiac arrest and needed help immediately. Her colleagues sprung into action — instead of practising chest compressions on a mannequin in a simulated environment, they went to work on her.
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"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 centre," Davenport said.
"We train for them all the time."
Davenport shouted for help. Luckily, the Lebanon hospital's 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.
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.
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"It worked out, but it was pretty frightening for all of us," she said. "You just don't 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, couldn't believe what had happened either.
"I would say I'm your pretty average, healthy 23-year-old," she said. She goes to the gym four times a week, runs, and eats well.
"I'm on my feet 12, 13 hours a day at work, so I want to make sure that I'm 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.
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 a thickened heart muscle or cardiomyopathy, heart failure, arrhythmias and more.
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According to information compiled by the National Heart, Lung and Blood Institute, a person's 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 women's risk increases after menopause.
