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DIY or die: How an Australian outback nurse diagnosed his own heart attack and saved his life

Melissa Healy, Los Angeles Times on

Published in News & Features

Once those runs begin, Osborne says, the nurse's likelihood of dying rises by 10 percent with every minute that blood flow remains blocked.

If the patient survives, Osborne adds, the scarring and damage to his heart muscle will likely weaken it -- increasing the prospects that his heart will fail before too long.

But the patient is undaunted.

He sinks an IV line into his own arm, chews a full-strength aspirin, and puts himself on a trio of first-line medications for heart attack: a tablet of the anti-platelet drug clopidogrel (known commercially as Plavix), a dose of nitroglycerine under the tongue, and an IV bag of the blood thinner heparin.

Then, he assembles a McGyver-esque toolkit of emergency cardiology medicines.

There's a clot-busting drug called tenecteplase, which is in limited use nowadays as cardiologists make wider use of clot-retrieval devices in hospital cath labs. Syringes of adrenaline, atropine and amiodorone are prepared to stimulate and stabilize the faltering currents of a heart muscle starved of oxygen. An opioid pain medication is added to the mix, because things could go south in a hurry.

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Finally, the ailing man attaches defibrillator pads to his own chest, ready to shock his heart back into rhythm if that becomes necessary.

But then a reprieve: The tenecteplase, a so-called thrombolytic drug bioengineered from the ovarian cells of Chinese hamsters, seems to have succeeded in dissolving the clot. There was only a 50-50 chance that this would work.

Even better: The nurse has not suffered bleeding in the brain, the drug's most fearsome side effect. This occurs in 5 percent to 7 percent of patients and can cause a potentially devastating stroke.

"Do not try this at home, kids," warns Dr. Osborne.


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