The Beat Goes On

May 13, 2011

Physicians, emergency rooms and Johnson County emergency medical services (EMS) providers have forged an invaluable partnership of action when a 911 call is made. Consider Elizabeth Kupchin, who can now add “survivor of cardiac arrest” to her life’s resume.

Following a dramatic near-death experience more than 12 months ago while on the job at an Overland Park telecommunications company, Kupchin has gratitude for the chain of responders whose quick reactions helped save her life. That chain includes two co-workers who knew CPR; paramedics answering the 911 call; a fast-acting Menorah Medical Center Emergency Department team of nurses and physicians; and a cardiologist who administered the revolutionary Code ICE protocol on Kupchin.

Though she can’t recall what happened following her sudden collapse amidst a sea of cubicles, Kupchin vividly remembers waking up at Menorah Medical Center—part of HCA Midwest Health System, Kansas City’s largest healthcare network—five days later to hear a miraculous story pieced together by her physician, Ujjaval M. Patel, MD, FACC, and her husband.

“The last thing I remember is heading to the on-campus clinic at work on April 15, 2010, because I had been complaining of not feeling well all week,” says Kupchin. “The next thing? I’m looking at my husband on April 20, asking him why I’m in the hospital.”

Dr. Patel, a cardiologist with Midwest Cardiology Associates, a Midwest Physicians practice, says by the time an unconscious Kupchin arrived at Menorah’s Emergency Department the EMS responders had defibrillated her eight times. Dr. Patel administered an external shock once more in an attempt to stabilize Kupchin’s irregular heart rhythms.

Next Dr. Patel started Code ICE on Kupchin.

“Because Elizabeth was being actively resuscitated, they couldn’t start Code ICE in the field,” says Dr. Patel. “Cardiac arrest patients must meet certain criteria for Code ICE.”

An extensive external cooling system protocol approved by the American Heart Association, Code ICE gradually brings the core body temperature from normal to less than 33 degrees Celsius.

“The implementation of pre-hospital therapeutic hypothermia (Code ICE) allows paramedics of the Overland Park Fire Department and Johnson County MED-ACT to provide the highest level of post-resuscitation care to patients suffering from a cardiac arrest in the city of Overland Park,” says William F. Toon, battalion chief-training for Johnson County EMS: Med-Act. “It’s another way we are partners with the healthcare professionals at Menorah Medical Center.”

Only about 100 EMS providers out of more than 24,000 nationwide use the treatment, according to EMS Magazine. Paramedics with Johnson County EMS: Med-Act and the Overland Park Fire Department are trained in Code ICE.

“I was concerned about reducing Elizabeth’s potential adverse neurological effects and preserving vital systems and major organs of an out-of-hospital cardiac arrest,” says Dr. Patel. “Code ICE helps provide more positive outcomes. Once Elizabeth arrived at Menorah she was treated with the internal cooling system which rapidly, safely and effectively manages the core body temperature.”

Dr. Patel discovered that Kupchin’s left artery was 100 percent blocked during surgery. Kupchin, who has a history of family heart disease and smoked for 20 years, emerged from the surgery with no neurological damage.

“They knew I was going to wake up, but worried that I might have lost brain function,” says Kupchin, who suffers from no cognitive damage. “Dr. Patel and Code ICE helped save my life.”

The 46-year-old Kupchin has readjusted her lifestyle, including eating a healthy diet and exercising. “Dr. Patel said it would take a long time for me to feel normal,” says Kupchin. “I went through cardiac rehab at Menorah for three months and continue to see Dr. Patel. “

Kupchin’s gratitude for expert medical care, the EMS responders’ partnership with the physicians and nurses at Menorah Medical Center and the advanced Code ICE technology that helped save her life and brain function during a heart attack has translated into an urgent message she shares with everyone in her life.

“If you don’t feel well, pay attention,” she says. “Don’t ignore signs and symptoms.”

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