A near-death experience from anaphylactic shock

Ben Johnston was just going in for routine surgery. The 36-year-old Navy veteran and father of two needed a small cyst removed from his ankle, and the procedure at a non-Sharp-affiliated outpatient surgery center was supposed to take only an hour.

But during surgery, Ben experienced anaphylaxis, also called anaphylactic shock — a severe, potentially life-threatening allergic reaction. He was rushed by ambulance to Sharp Memorial Hospital.

“The last thing I remember was getting anesthesia for my cyst,” says Ben. “I can’t believe I almost died.”

An unexpected reaction
Ben, who works in logistics for a medical device manufacturer, had never experienced an allergic reaction before the surgery. Common triggers, such as peanuts or anesthesia for dental work, hadn’t been an issue for him.

So, doctors aren’t sure what triggered Ben’s allergic reaction during the ankle surgery. Along with general anesthesia, he received cefazolin, an antibiotic given to surgical patients to help prevent infection.

Near the end of the procedure, Ben’s oxygen level suddenly plummeted. A special mask that kept his airways open during the surgery was removed so that he could be intubated. However, nothing would bring Ben’s oxygen level up, prompting a call for the ambulance. On the way to the hospital, Ben went into full cardiopulmonary arrest.

“When I first saw Ben in the ER, he had a pulse, but dangerously low blood pressure — only 60/40,” says Dr. Joseph Bellezzo, an emergency medicine doctor at Sharp Memorial. “The paramedics had given him medicine and tried CPR, with no response. He was in profound shock.”

Dr. Bellezzo and the Sharp care team had to act fast. Ben’s airway was clenched tight, preventing his blood from receiving enough oxygen. Dr. Bellezzo examined Ben’s heart with an ultrasound and listened to his chest. He heard no sounds of breath because no air was getting to his lungs.

“The brain will die without oxygen, so I tried to give Ben medicines that would pump more blood into his vital organs. They had no great effect,” says Dr. Bellezzo. “To treat the anaphylactic reaction, we also gave him steroids and antihistamines through an IV, but his heart was still not getting enough oxygen. His blood pressure remained so low that he was close to experiencing irreversible brain damage.”

A lifesaving decision
With medications not helping, Dr. Bellezzo decided to connect Ben to a venoarterial extracorporeal membrane oxygenation (VA-ECMO) machine. The device helps struggling hearts and lungs by rerouting oxygen-starved blood out of the body to an external machine that adds oxygen into the blood then delivers it back to the body. This type of bypass machine can be used for many conditions in which either the lungs or heart fail. Sharp Memorial was one of the first hospitals in the nation to pioneer the technology in emergency settings.

At Sharp Memorial, this life-support machine has been used to treat patients with heart attacks, pulmonary embolism (a blood clot in the lung), hypothermia and more. In Ben’s case, the VA-ECMO machine gave his body the chance to fight the allergic reaction. Over six hours, his blood pressure slowly returned to a normal level, eventually turning his gray-tinged body bright red and revealing hives — a common sign of anaphylaxis.

The next day, Ben’s doctors slowly woke him and explained what happened. After four days of recovery, Ben was able to go home. Today, he’s returned to work and coaching soccer and softball for his son, 15, and daughter, 5.

“I’m so glad to be with my family,” he says. “As a former Navy explosive ordnance disposal technician, I know what it’s like to help others. I’m especially thankful that Sharp was there to help me when I needed it.”

For the news media: To talk with Dr. Bellezzo about Ben’s story, contact Erica Carlson, senior public relations specialist, at erica.carlson@sharp.com.