July 12, 2013
by Linda Friedel | Reprinted courtesy of KC Nursing News
In honor of National EMS Week, Menorah Medical Center acknowledged first responders and staff members in the emergency department (ED).
“We take the opportunity to recognize the EMS in their role as part of our team,” said Tina York, EMS relations director with HCA Midwest Health System. “The EMS crew is like the superheroes.”
York, a former paramedic of 17 years, said her unique role allows her to create a healthy relationship with the hospitals’ emergency departments and EMS professionals in the field. First responders often are unsung heroes, York said. She launched “Great Save” events several years ago to acknowledge first responders and the teamwork it takes to save lives.
“I wanted to show what they do, that they make a difference in people’s lives,” she said. “We have these events throughout the year.”
Health care professionals such as first responders, physicians, nurses and technicians are acknowledged during the Great Save events. York held a Great Save on May 21 during National EMS Week. It is a chance for patients, EMS personnel and emergency department staff members to have a chance to meet, she said.
“I know that they rarely get a chance to know what happens to their patients after they drop them off in our facility,” York said.
Some rescues stand out more than others, York said. Such was the case with Eric Matt, York said, who had an opportunity to meet his superheroes during the Great Save event in May.
“Everything went right,” York said. “Everything was so amazing from start to finish.”
Matt, of Overland Park, had just finished running a half marathon on April 14, 2012. Matt lived with nearly a lifetime of chronic pain due to a football injury as a teen. Mostly he feels pain in his spine, he said. When his wife drove him home from the race that day, additional pain coursed through his body. It was nearly unbearable. Was it his usual pain, dehydration or something else, he wondered? Matt does not remember but said his wife told him later that he cried out in the car from pain in his chest.
“Even then we weren’t thinking heart attack,” Matt said.
Once home, Matt made his way to the bedroom. Then his wife heard a thud on the floor. He was in full cardiac arrest by then, said Chad Oliver, first responder with Overland Park Fire Department. Matt’s wife called 9-1-1, Oliver said, and then began chest compressions on Matt. Oliver’s team took over moments later, he said. They worked on Matt for more than 14 minutes, first with cardio cerebral resuscitation for six minutes, then with standard CPR. Within fifteen minutes, Matt had a pulse but still was not breathing, Oliver said. Already intubated, the first responders performed a procedure to save his brain. They added a cool saline solution through an IV line, then placed ice packs behind his neck, arm pits, knees and groin. The protocol, Code ICE, quickly cooled Matt’s internal system to manage his core body temperature. His temperature changed from normal to less than 33 degrees Celsius.
“It really is a huge brain-saving tool, I think,” Oliver said.
Using Code ICE in the field requires a mini-refrigerator with a saline solution installed inside the ambulance, Oliver said. Overland Park Fire Department has used the protocol for four to five years, he said. The brain-saving measure is becoming more common among first responders, Oliver said, but is still relatively new to the field of emergency responders. Oliver has initiated Code ICE eight times during his 11-year career as a first responder, he said. Patient outcomes, especially those with stroke or STEMI heart attacks, fare better with responders who follow the Code ICE protocol, Oliver said.
“We’re talking about the people walking out of the hospital with normal function,” he said.
Oliver said he has seen several other Code ICE patients like Matt respond with amazing outcomes. Oliver said his team learns about their patient outcomes 25 percent of the time. Once his team answers a call, they move on to the next, he said.
“Working in EMS, we’re used to working behind the scenes,” Oliver said. “You get used to this.”
Oliver moves out from his comfort zone at events such as the Great Save, he said. He will tell you he was just doing his job. The recognition is a sweet reward, however, he said.
“It’s kind of hard to accept it,” Oliver said. “It was amazing. I really enjoyed it.”
Meeting patients after a rescue personalizes their work, Oliver said. To keep his focus, Oliver says he has learned to distance himself while helping patients in the field. Meeting someone like Eric reminds him why he climbs into an emergency vehicle day after day.
“It helps you to really realize why we love what we are doing,” he said. “You were one of many people to give someone their life back. Obviously we don’t always have these outcomes. It really makes you realize how precious life is when you meet someone like him.”
Oliver said he loves his work. He lives by his first partner’s advice. Keep your job and home life separate, his partner told him.
“You have to be 100 percent every day on that ambulance,” he said. “I really took it to heart.”
Shandon Anderson, RN in the Emergency Department at Menorah Medical Center, helped with Matt the day he wheeled into the ED. The former paramedic switched to nursing a year ago, but says he thrives in the emergency environment.
“I still get to use a lot of the same skill set,” Anderson said.
Anderson said the emergency department staff prepared the room when they received the call from the first responders. They readied the hospital’s Code ICE system.
“Everything was ready – IVs, EKG machine,” he said. “Our machine basically wraps him up. It was pretty seamless.”
The Code ICE principle is based on drowning patients in cold water, Anderson said. They have better outcomes, he said. Code ICE cools the whole body and slows the metabolism. The body does not need as much energy. Matt was sedated and remained on Code ICE for several days, then his temperature was gradually warmed.
“Teamwork is what makes or breaks a call or new arrival,” Anderson said. “Everybody needs to know what needs to be done. We have to be skilled in all aspects.”
Anderson said he enjoys working with the same team of professionals on a daily basis in the ED. They lean into one another’s strengths. He likes the fast pace and variety of patients he meets. Anderson said first responders provide an amazing feat on every call.
“It’s knowing what needs to be done,” he said. “I’m a big fan of recognizing people. It was nice to know that the hospital recognizes (personnel) in the field.” Matt’s recovery did not come overnight.
“My brain is still recovering,” Matt said.
Matt’s cardiologist told him to expect up to 18 months for his brain to fully recover. The self-employed soft-ware developer called on an extra set of hands to help him run his company. He has had to work through psychological and physical challenges resulting from a 14-minute heart failure, Matt said.
“Your brain takes a shock when the heart stops,” he said. Matt is running again, but not as fast and not as far, he said. He went back to work right away after his heart attack and started running four weeks later.
Matt says he is thankful to be alive and thankful for the help from strangers. He remembers precious little from those painful days after his heart failed, but his wife continues to help him to piece the moments together.
“It just takes time,” Matt said.
In addition to attending the Great Save event, Matt said the team of first responders came to visit him several weeks after they had received his call. They answered his call in a brand new ambulance equipped with the Code ICE system. They wanted a chance to meet Matt and his wife, he said, but also to create a training video showing the impact of the new equipment.
“There are not many people that are even qualified to use this equipment,” he said. “That’s what saved my brain.”
Matt said he was thankful to meet the EMTs on both occasions. They spent 15 minutes working to save his life, he said. They didn’t give up.
“Very rare to that have that kind of opportunity to have that follow-up,” Matt said. “It was an honor.”