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A Chilling Solution

A skilled ED team with advanced technology buys time for heart attack victims

Randy and Car
As an active member of the Rovers Unit of the Antioch Shrine, Randy Abshire drives this flashy car to “bring a smile to the little kids” at parades across west central Ohio.

Randy Abshire, 68, doesn’t remember much about that morning in 2009 when his “heart went haywire.”He doesn’t remember breakfast at his favorite diner or driving to work. He doesn’t remember collapsing at his desk or his son’s 911 call.

But what he does remember, he knows for fact: he owes his life to the speed and skill of Good Samaritan Hospital’s Emergency Department.

The chain of care began the moment the Harrison Township Fire Department arrived at Randy’s office. Communicating with the physicians at Good Sam, paramedics began CPR, restarted his heart with a portable defibrillator and inserted an artificial airway to restore Randy’s breathing.

Keeping First Responders Sharp

“The EMS Departments are an extension of the ED,” says Bill Mangas, EMS Liaison & Outreach Coordinator. “We work together very closely.” Last year, Good Sam conducted over 150 training sessions for EMS in 10 counties. The hospital also hosts monthly programs on stroke, cardiovascular events, infection and orthopedic injuries, for example, to promote collaboration between subspecialists, ED staff and EMS responders.

Although Randy’s heartbeat was restored by the time he reached Good Sam, “Getting the pulse back is just the tip of the iceberg,” says Kindra Engle, DO, the emergency medicine physician who treated him. “The next step is figuring out what caused the problem, how to fix it and what damage control we need to do.”

Innovative Therapies

Tests ruled out a major heart attack. So suspecting an irregular heartbeat, Dr. Engle immediately paged a cardiologist and began applying innovative Arctic Sun® temperature management pads to cool Randy’s body.

“The body wants to heal itself,” says Dr. Engle. “But it has so many demands – to supply oxygen to the brain, the heart and the rest of the body. By cooling the body, you slow those metabolic demands and let the body do its healing work.” A 2009 study found that cooling increased heart attack survival rates by more than one-third.

Unlike ice packs and water blankets, the Arctic Sun system lets doctors precisely control body temperature by circulating chilled water through the pads. And it avoids the risk of blood clots or perforated vessels linked to the use of invasive cooling catheters.

Expert Team on Call

Dr. Engle
In the ED, Kindra Engle, DO, administers the Arctic Sun cooling therapy, assisted by Jewell Strawn, RN, BSN, CEN, ANM at the computer and Mark Messaros, RN.

Knowing that Randy needed vigilant monitoring, Dr. Engle mobilized the Acute Changes Team (ACT), specially trained nurses who support the ED staff.

The ability to draw on so many resources to help patients receive the best possible emergency care is testament to the department’s teamwork, Dr. Engle says.

In a critical situation, “You can never say one person saved a life,” she says. Whether it’s the doctor giving orders, the respiratory therapist setting up the ventilator, the pharmacist pulling medications from the crash cart, the secretary paging the subspecialist or the nurses charting and giving medications, “Everybody has a role.”

Throughout, communication is vital to keep the patient’s loved ones abreast of what is happening.

“The folks at Good Sam were wonderful,” says Randy’s friend, Michele Freemon, who was in the ED. “Five or six doctors and nurses came in to tell us in layman’s terms everything that was going on. Randy was hooked up to quite a bit of stuff, but they went through it all – what they were doing and why. It really gave us confidence.”

Randy spent the next few days in a semi-coma. He was moved to the intensive care unit where he remained in a cooled state for 24 hours before his body was gradually warmed. A few days later, he went home with a pacemaker and defibrillator in his chest to prevent another such event.

This fall, Randy Abshire headed to the Smoky Mountains to watch the leaves turn. It’s a sight he might never have enjoyed if it weren’t for the team in the Good Sam ED.

“The quality of emergency care at hospitals varies widely and we believe Good Samaritan is one of the nation’s quality leaders in emergency medical care. We are very proud that our emergency department employees and our medical staff, in partnership with EMS teams across the region, are ranked in the top 5 percent of all emergency departments in the nation. We remain committed to improving the lives of the community we serve that need emergency medical care,” says Craig Self, Vice President.

Randy seconds that. “I can only say the greatest things about them.”

Learn more about Good Samaritan Hospital’s Emergency Department.

<< Samaritan HealthTalk Fall 2010

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