Isak Bester is lucky to be alive after his girlfriend Sarah Glass of Napier saved his life by performing an emergency trachyotomy after Isak choked on a piece of steak.
The manager of the Hastings crematorium and cemetery would have landed in the crematorium himself last month had it not been for the quick thinking of those around him.
Isak Bester and his girlfriend Sarah Glass were enjoying a barbecue with friends at their farm near Waimarama Beach last month when he started choking on a piece of steak.
"I couldn't breathe so they tried back blows and Heimlich manoeuvres but they didn't work. I started turning purple and then fainted so they started doing CPR," he said.
Their attempts to clear his airway were futile however and, with the steak firmly lodged in his throat, and he went into cardiac arrest.
At this point Glass, a midwife, did the unthinkable and grabbed a knife for an impromptu operation.
"There was no pulse or anything. She couldn't watch me die, and asked for a knife," he said.
Glass said she told her friends, several of whom were medical professionals, she was going to cut him and discovered they were thinking the same thing.
"A friend raced and grabbed a Stanley knife blade from the workshop and I cut into his throat with very small, narrow slices just below his Adam's apple.
"I then, this is a bit gross, put my finger in his trachea to try and see if there was anything blocking the airway going down so I had to fish that out."
By sheer chance, the midwife and her colleague had home birth kits with oxygen tanks on hand and they used tubing to keep oxygen flowing to Bester's brain.
Bester said he was "way under" for a good two hours and medical professionals said he could have had brain damage or organ failure.
The crematorium manager was an induced coma for nearly three days and wasn't released from hospital for a further week.
Now just over a month later he is on the road to a full recovery.
Ambulance staff treating Bester. Photo / Supplied
"I've still got a cut in my throat but other than that I'm good. All the tests are good," he said.
Glass said the experience wasn't as frightening as one might think.
"I knew we were a long way from help and without getting oxygen in he was dead anyway. His heart was no longer beating on its own and we had nothing to lose.
"I also actually felt quite confident that it would work, and quite confident in doing it. I didn't find it frightening it was just the next thing that had to happen if we were going to keep him with us."
She said her midwife training hadn't prepared her for such an experience but she did own a book titled The Worst Case Scenario Survival Handbook in her 20s.
"I think that's where I read it. It's the only place I can think I might have seen it - and it worked. He was without oxygen for a very short period of time, which is why there is no brain damage."
Otago University Professor of Emergency Medicine Michael Ardagh describe Glass' actions as "heroic" but warned it should only be used as an absolute last resort - even by doctors.
The procedure, known as a cricothyroidotomy, was "relatively easy" if you knew what you were doing, he said.
"But it's not easy if you don't.
"The key thing is that it is an intervention of last resort. When everything else has been tried and the person is going to die for want of an airway - the person is on death's door and has lost their pulse. I think everything lined up in this situation. There was absolutely no other choice."
Bester said was a "very lucky man" and was pleased to be back at work already.
"Obviously for her to make the decision to cut; people don't do that sort of stuff. That decision and all the others who were there giving CPR all that time; they just never gave up."
"There's a lot of things that could have gone wrong but there was no pulse, I was in cardiac arrest, I was a goner so there was nothing to lose."
