With the patient in sinus tachycardia (high elevated resting heart rate), Poland and Abercrombie began coordinating with the ski patrol to get him down the mountain to the ski patrol aid room.
According to Poland, “once we were fairly certain that the patient was not going to re-arrest, we decided to get him out of the cramped lift shack and into the ski patrol aid room at the base of the mountain.
The patient was then transported by sled to the base, a decision Abercrombie said was not made lightly.
“We elected to ski the patient down the mountain on a sled and perform Advanced Life Saving (ALS) interventions in the stable environment of the ski patrol aid room. This was a risky decision that was either going to pay off dramatically or had the potential to miss quick compressions, defibrillation and airway management if the patient re-arrested.”
Once at the bottom of the mountain, Poland and Abercrombie established several IVs, sedated, paralyzed and intubated the patient. Using the MRx, they were able to monitor end-tidal CO2 levels, run a 12-lead EKG and stabilize the patient.
Mother nature was not cooperative
Far from a typical rescue, the elements and terrain were as challenging for medics and ski patrol, as was the patient’s deteriorating condition.
“We had light snow all day,” Abercrombie said. “This prevented the ambulance from being able to respond and provide a quick transport time. It’s an unnerving feeling when you suspect that the patient is likely to arrest again.”
After an hour, the ambulance arrived and transported the patient to Good Samaritan Hospital.
Poland sums up the challenges of the steep mountainous terrain. “You need to strike a balance between making sure that the patient is stable enough to transport to a good location to provide meaningful stabilizing care, without providing so much care that you interfere with your ability to safely get him down the mountain.”
No one knows how the weather and landscape can affect a rescue better than Andrew Longstreth. As the Paramedic Program and Advanced Life Support Team Supervisor for Crystal Mountain, he is responsible for administering all the medical programs and training.
Although Longstreth wasn’t on the mountain that Christmas day, he is not surprised about the outcome of the rescue.
AED’S are part of our care team
“We have nine Philips AED’s located strategically for ease of access and in highly-populated areas of the mountain,” he explains.
Adds Poland, “A large portion of our terrain can be time consuming to access from a single location. By having multiple AEDs located strategically, we can be sure that in the event of a Sudden Cardiac Arrest (SCA), we can provide timely defibrillation by trained responders. The AED’s are typically located in the ski patrol ‘shacks’ at the top of lifts where they can be a central access point should anything happen.”
For Longstreth, these devices are a critical part of the care teams. “The HeartStart MRx monitor/defibrillator and the HeartStart AED’s make a good team. We don’t have to switch pads and the functions are easy to use.”
In fact, he says, “four out of the six times we’ve had to use the AED’s, the patient has survived to the hospital. Three of those patients are still alive today.”
Happy New Year, indeed
Both the medics and ski patrol team agree that the AED helped save the patient’s life.
Six days later, on December 31st, the patient was released from the hospital. Thanks to quick thinking, dedicated first responders and well-placed AED’s, what started as a fight for life on Christmas Day, ended with so much to celebrate in the New Year.