HCWHighlights

EMERGENCY DEPARTMENT TEAM

HUGH CHATHAM MEMORIAL HOSPITAL

This week’s “Hugh Chatham Way Highlight” is a very special edition, as we recognize the heroic efforts of a multidisciplinary team whose care for an ED patient was truly life-changing.

This day began like many for this patient – running errands, out and about. While driving, the patient noticed a tingling in her arms, shoulder blade pain, became nauseous, and began to profusely sweat. She did the right thing, pulling over immediately and calling 911. EMS met her on the roadside and immediately brought her to the Hugh Chatham emergency department.

Once the patient arrived, our team rolled into action. Kristie Loggins, triage nurse, went to her bedside for the EMS report and handoff, and decided to prioritize hooking her up to a monitor based on her overall presentation. She just didn’t look right, according to Kristie, who also initiated a 12-lead EKG, intravenous access, and alerted the team. Kim Boyd, nursing assistant, took over administering the EKG as Dr. Wright arrived to evaluate the patient. Kristie proceeded to get additional IV access while Dr. Wright placed orders. Shortly afterwards, with Kristie and Kim at the bedside, the patient coded at which point Kim and Kristie initiated CPR and activated Code Blue. Dr. Wright immediately returned along with Tommy Testerman, Rob Porter, and Wendy Matthews from respiratory therapy, who respond to codes as a team to alternate bagging and compression duties, and to assist the ED provider with intubation. Elizabeth Welborn, Kayla Walton, Misty Speaks, and Nikki Lovill – all Emergency Department RNs – assisted with care and contemporaneous documentation of the code. Brandy Farmer, LPN, assisted with medication. Bunny Brown, RN, nursing supervisor was on hand as well.

Coincidentally, Monica Keener, interim ED Manager, had been conducting a virtual 1:1 round with Roger Horton, a PRN ED paramedic whose primary job is with Aircare. Monica immediately shifted focus to support the team, mixing and administering Activase – the same medication we often give stroke patients. Meanwhile, the patient kept going into v-fib and was defibrillated repeatedly in an effort to break her rhythm into “normal sinus rhythm”, and to regain a pulse.

Approaching 40 minutes in duration, the code was about to be “called” when the patient’s mother arrived. She began pleading with her daughter to push through, to survive the event. With compassion and calm, Dr. Wright began explaining the likely prognosis to the patient’s mother. Just as the team was concluding a final round of care, 51 minutes after the code began, Tommy Testerman noted that the patient’s pulse had returned, sustaining on its own. The team worked on stabilizing the patient, who then was transferred via air care, with our very own Roger Horton on board to care for her during flight. Exhausted, but knowing they had given this patient and her desperate family hope, the team took a collective sigh, disassembled, and returned to care for the many other patients in need of their caring and expertise.

The rest of this story? Two days post-transfer, we received a report that notwithstanding many significant cardiovascular issues, the patient had “purposeful movement”, was able to follow commands, was clinically stable, and opening her eyes spontaneously (not having to be prompted). One week out from this traumatic event, the patient remained in an ICU bed on minimal oxygen, fully alert and oriented, and slated for transfer to a medical bed. As it turns out, the next day the patient was discharged home!

It is always our PEOPLE who make the difference. And for this patient, the responsiveness, skill, teamwork, and caring of this team made a life-saving difference.

Please join me in celebrating these exceptional team members (some, pictured here)!!

-Paul