What makes a survivor?
The Chain of emergency & cardiac care
It was winter break for college sophomore Thomas Thibeault, and he and his sister were enjoying a workout together at a Timonium fitness club near home when the unimaginable happened.
Thomas, a varsity lacrosse player in peak condition, collapsed.His sister called 9-1-1 followed by a frantic call to their parents who rushed over from their nearby offices.
In four minutes, Baltimore County EMS arrived and began emergency care on Thomas, who was slipping in and out of consciousness.
“He was extremely sweaty, and his lips and hands were blue,” describes EMS Lt. Kim Glaze. “We put him on oxygen, gave him IV fluids, and put him on a 12-lead heart monitor to see if he was having a heart attack.” Thomas wasn’t having a heart attack, but “he was really sick, and we called ahead to St. Joseph Medical Center to be ready for him,” says Lt. Glaze.
“The EMTs did an excellent job,” recounts Thomas’ mother Trish. “We all realized something was seriously wrong.”
“The ambulance rushed him to St. Joseph’s Emergency Department,” continues Trish. “The nurses and doctors were waiting at the door for us. By then, he was very much in pain.”
Soon she and her family would be hearing a heart surgeon state, “His life is in danger. We need to operate right now!”
Upon Thomas’ arrival, emergency physician Dr. Neal Frankel and the ER team sprang into action. Dr. Frankel quickly assessed an apparently healthy young man with no known risk factors,
ordering an immediate CT scan. Upon seeing the results, Trish recalls that Dr. Frankel declared, “This is bad. His aorta is bleeding.” And, “within ten minutes, a heart surgeon was walking through the door,” she adds.
The surgeon who rushed to their service is Dr. Stewart Finney, chief of Cardiac Surgery at St. Joseph. “Thomas suffered a dissection and rupture of an aortic aneurysm,” explains Dr. Finney. “He was declining quickly.
“What happens is that the aorta quietly enlarges until the wall gets so thin that it tears and bursts. Thomas’ aneurysm was similar to that of actor John Ritter who succumbed when his aorta ruptured. Aneurysms can be caused by uncontrolled high blood pressure and weakness in the aorta wall, but in Thomas’ case it was related to a congenital abnormality,” explains Dr. Finney.
“It’s a credit to St. Joseph’s ER, cardiac surgery, intensive care unit and post-op recovery staff that we can handle this type of grave situation,” he adds. “The team is very experienced.”
Following six hours of open heart surgery, during which Thomas had his aorta and aortic valve replaced, Thomas received intensive care and monitoring on St. Joseph’s Cardiac Surgery Unit.
When he awoke, he had an immediate sense of well being,” says his mother.
“This whole experience has given me a much greater appreciation for how incredible medical care can be,” says Thomas. “Dr. Finney is a great doctor —he saved my life. The staff
at St. Joseph really cared for me as a person and for the well-being of my family.”
Although Thomas will be on blood thinners for life, he says, “I feel very lucky to have survived a physical defect that no one knew about. The mechanical valve I have is very strong.” Just three months after heart surgery, he was assisting coaching lacrosse at his former high school, Boys Latin.
“Thomas has shown a lot of maturity and grace through all this,” says Dr. Finney, a former lacrosse player himself.
Innovators in Emergency Care
Recently, St. Joseph embarked on a campaign to highlight the hospital’s innovation in ER care, “which has resulted in decreasing treatment time by 25 percent,” explains Dr. Gail Cunningham, head of St. Joseph’s Emergency Department. By increasing efficiency and enhancing patient care, St. Joseph’s ER won the “Top Innovator of the Year Award” in 2009 from the Daily Record.
Innovation is a St. Joseph tradition: its ER has the longest standing group of emergency physicians in the U.S., who founded one of the first ERs in the country in 1966. “We are always striving to improve the care we give,” assures Dr. Cunningham.
“We have quality, experienced, specifically trained ER physicians and nurses. We are in a unique environment, working shoulder to shoulder daily, and know each other so well that we can anticipate how care is going for each patient.
“A lot of care is initiated even before the patient sees the doctor. We are very motivated, getting their tests started, blood work, x-rays or CT scans and even the administration of certain medicines done as soon as we can,” she says.
St. Joseph’s ER is a vital partner in the Chain of Survival advocated by the American Heart Association. (See illustration below.)
“It begins with the lay person doing CPR and calling 9-1-1,” says Captain Steven Adelsburger of Baltimore County EMS. “Then EMS does their part; we treat and stabilize at the scene of the emergency and deliver the patient to the ER where the cardiac team is waiting. With our LifeNet system, we even transmit a picture of the patient’s heart to the ER, so the team is a couple steps ahead before the patient arrives. We have great confidence in the cardiac care at St. Joseph Medical Center.”
