By Jeremy Olson
Star Tribune
BELLE PLAINE, Minn. — Shannon Peterson had a lot of people to thank, even though they were strangers to her.
The 39-year-old was unconscious when she went into cardiac arrest on March 13 at her home in Belle Plaine, so she didn’t remember the 911 dispatcher who taught her fiance CPR in real time, or the paramedics who kept her alive, or the cardiologist who raced by helicopter to restore blood flow to her lifeless body.
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But they all greeted one another like family on Wednesday during a reunion at the Belle Plaine Fire Department to celebrate Peterson’s survival and applaud a new program that is extending life-saving cardiac emergency care to the fringes of the Twin Cities.
“Great to see you again!” said Dr. Jason Bartos, the interventional cardiologist who treated Peterson.
“Nice to meet you!” she replied. “Can I hug you?”
M Health Fairview launched its air mobile program last summer to meet the challenge of serving people who don’t live close to major medical centers. A medical helicopter flies Bartos and a portable, artificial-heart pump to remote locations to restore blood flow in cardiac arrest patients before they can die or suffer disabling organ or brain damage.
Cardiac arrest happens when the heart suddenly stops pumping blood. Surviving it is no sure thing, even in the best circumstances.
Only about 10% of cardiac arrest victims survive long enough to be treated in hospitals and discharged, according to a U.S. registry. However, that rate improves to 37% when bystanders offer aid and the arrests are caused by abnormal heart rhythms that can be shocked with defibrillators back into proper cadence.
The helicopter team has been dispatched 10 times in the past year and placed seven patients on an emergency treatment called ECMO, or extracorporeal membrane oxygenation, to mechanically pump oxygen to their blood. Peterson is one of three survivors.
“She is joining a small but growing community of people who’ve survived cardiac arrests like this,” Bartos said, “and we hope to see a lot more in the future.”
The goal is to beat the clock and restore circulation within an hour. Survival is likely if patients can be placed within 30 minutes on ECMO, which provides artificial blood flow while patients’ heart and lungs heal, Bartos said. Every minute of delay beyond 30 minutes increases the odds of mortality by about 2.5%, research has shown.
It was around 9:20 p.m. when Peterson gasped and her husband found her unresponsive and rigid. What caused a cardiac arrest in someone so relatively young is unclear, but a norovirus that sickened her two daughters could have played a role along with Peterson’s smoking and family history of cardiac disease. Her mother’s recent death had added stress.
Within seconds, 911 dispatcher Michaela Allen knew Peterson needed CPR and that she was going to have to teach Peterson’s fiance over the phone.
A co-worker called for the helicopter while Allen explained where Travis Piele needed to place his hands and how hard he needed to press on Peterson’s chest.
“We’re going to do that about 600 times,” she told him. “It’s a pattern of 1,2,3,4 ... 1,2,3,4.”
They got to 362 when medics arrived and took over, she said. It was 9:31 p.m. , and the Life Link III medical helicopter was more than a half-hour away.
When M Health Fairview launched the mobile ECMO program last summer in the north metro, the protocol was for the helicopter to land at hospitals in Princeton and Wyoming, Minn., and for ground ambulances to bring the cardiac arrest patients to their emergency rooms.
Neither community is large enough for the hospitals to invest in their own on-site ECMO technology, but both have enough residents to make cardiac arrests likely at some point.
A different approach was adopted when the program expanded this year to Ridgeview Medical Center in Waconia . Instead of taking patients to hospitals, Ridgeview paramedics were trained to prep them in ambulances at emergency scenes to receive ECMO. The approach can be faster, as long as the helicopter pilots can find somewhere to land.
A Ridgeview paramedic supervisor, Aaron Hoover, was familiar with Peterson’s neighborhood in Belle Plaine and advised the helicopter and ground ambulance to meet on an undeveloped cul-de-sac.
The helicopter landed at 10:12 p.m., 48 minutes after the 911 call, and the flight medics hustled into the ambulance to place Peterson on the artificial pump.
Flight nurse Shaylah Montgomery said Peterson was the first in the U.S. to be placed on ECMO by a helicopter team.
“There was a moment where the team had an emotional pause, when we realized the gravity of what we accomplished,” said Montgomery, whose Life Link team landed in the parking lot of the Belle Plaine Fire Department on Wednesday to join in the celebration.
The mobile ECMO option will stretch farther westward later this year, when Hutchinson Health joins the program. More doctors are being trained so that Bartos isn’t the only cardiologist on the response team.
Peterson was groggy when she awoke at the University of Minnesota Medical Center in Minneapolis, five days after her cardiac arrest. Surgeons had removed obstructions in her heart and inserted a stent in one artery to restore blood flow.
Nobody knew if she had retained her memory and cognition until she started asking for ice chips and making jokes. Doctors credited the rapid CPR in addition to the emergency medical response for preventing brain damage.
Peterson returned home after 10 days and started rehabilitation sessions to restore strength. The prolonged CPR broke one of her ribs, so she is healing from that as well.
Peterson has made progress but is only medically cleared now to lift 8 pounds, meaning she can’t do laundry or carry her 7- or 2-year-old daughters. She is looking forward to driving again and taking a (doctor-approved) trip to Las Vegas this month to celebrate her 40th birthday.
“I want to be the mom again and take care of the kids like before,” she said. “They can’t jump on me right now.”
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