Not a Minute to Spare
The story of Annie Noguchi’s return to life after sudden cardiac arrest in August 2021 has many heroes, but in the end it was “a joint effort across the whole spectrum of care that made the difference in getting to the best outcome,” according to Providence Little Company of Mary emergency physician Brad Baldridge, MD.
The 43-year-old Redondo Beach grade school teacher’s memories of what had been an ordinary Thursday end shortly after she drove home from work. She has no recollection of collapsing to the floor during dinner with her husband, Brian, and their two daughters, who were 9 and 7 years old. Annie had gotten up from the table to get a glass of milk when her heart suddenly went into ventricular fibrillation (vfib), an abnormal rhythm that stops oxygenated blood flow to the body. “There was absolutely no warning,” says Annie. “No chest pain, no shortness of breath.”
Brian, who is a high school teacher, had taken multiple CPR classes, because he coaches school sports. He knew that immediate response was critical and began chest compressions and rescue breathing on his unconscious wife while their older daughter, Madison, called 911. Annie had no detectable pulse at that point, Brian remembers, and was completely unresponsive. She was, in other words, clinically dead. “I was in a panic,” he recalls.
Redondo Beach Fire Department paramedics arrived within five minutes. The team took over from Brian, using an automated CPR device called an AutoPulse that the department had recently purchased. During the 35 minutes they spent trying to resuscitate Annie, the paramedics also used a defibrillator repeatedly, trying unsuccessfully to shock her heart back into a normal rhythm. “It wasn’t looking good,” says Brian, “because there was no response.”
Without help, a person in vfib dies within a few minutes, but because Annie had been getting continuous CPR to keep oxygen circulating to her brain, there was still some hope. The paramedics put her on a gurney and began the five-minute trip to Providence Little Company of Mary Torrance, where, coincidentally, Brian had been born. Brian rode in the front seat of the ambulance, and it was during the trip that Annie’s pulse finally returned. “She was stable by the time we got to the hospital,” Brian says.
FROM THE ER TO THE ICU
Even though Providence Little Company of Mary is a STEMI Receiving Center, meaning that its staff is expert in treating patients with the worst kinds of cardiac crises, “the whole picture was disturbing,” recalls Dr. Baldridge. “Annie was young, she had young kids.”
Dr. Baldridge intubated Annie so she could have a ventilator breathe for her. She was then put into an induced coma and cooled from a normal body temperature of 98.6 degrees down to 91.4, to minimize damage to body tissues—especially the brain—that had been deprived of oxygen while Annie’s heart wasn’t beating. After five hours in the emergency department, Annie was moved to Providence Little Company of Mary’s intensive care unit.
Annie’s neurological condition—and whether she’d even survive—was still unclear. Clair Lakkis, MD, an intensivist with four specialties including critical care medicine, took over Annie’s case in the ICU and oversaw her rewarming after 48 hours. “The brain can be severely impacted in a situation like this, and then it just leaves the empty shell of the person,” Dr. Lakkis says. “Her children are similar in age to my children, so I can see myself in her.”
“Dr. Lakkis was amazing,” Brian says. “She was just so supportive. She was straightforward about what was happening, but also about what we were hoping for.” In a small gesture that ended up meaning a lot to Annie, the doctor took the time to carefully ease the wedding ring off Annie’s swollen hand rather than cut the band, which is the standard procedure in hospitals. “When I saw her months later, she thanked me for saving the ring,” Dr. Lakkis says.
IN GOD’S HANDS
Dr. Lakkis agrees with Dr. Baldridge that Annie’s eventual full recovery was a joint effort. “It’s never just one person’s actions,” she says. “It’s the whole continuum of care. And some of it is in God’s hands, honestly.”
All told, Annie spent six weeks at Providence Little Company of Mary. She began to show signs of awareness on Sunday evening, three days after she was admitted. “I whispered to her, ‘I love you,’ ” Brian recalls, “and her eyebrows lifted.” She didn’t regain full consciousness, however, until the next day, and then only briefly. “I was brought to tears when I found out she was responsive,” says Dr. Lakkis. “I’ve been blessed in my work with a few of these ‘wow’ situations.”
After 10 days in the ICU, Annie moved to the progressive care unit, where she could still be monitored closely and receive speech, occupational and physical therapy. She also needed to have a defibrillator implanted to make sure her heart didn’t fall out of rhythm again. “My body was weak,” she remembers, “but my mind was okay.” Although she had a lot of basic skills to relearn, “I always thought I would come back 100%,” she says. “The care I received was exceptional. The doctors and nurses were wonderful and attentive.”
For more information on Providence Little Company of Mary hospitals, call 844-925-0942.