Fort Wainwright, Alaska - Each shift in the Bassett Army Community Hospital emergency department starts the same way – the team gathers to assign roles in the case of an emergency such as cardiac arrest or an obstetric emergency. Whether assigned as the team lead, in charge of I.V. medications, or as the scribe, each member of the six-person team is integral to providing the care necessary to deliver life-saving medical care.
However, in an emergency department which primarily sees acute care patients rather than true emergencies, the team does not often get to put their life-saving training and skills to the test. That was not the case the morning of December 1.
Spc. Ashliey Walker, a medic assigned to the unit since January 2022, manned the front desk checking in patients when an active duty Soldier walked into the waiting room. Walker recognized the Soldier was in distress and set into motion all the right events to get him triaged, diagnosed, stabilized and out the door to a higher-level of care well under the standard of time to treat a heart attack.
The team quickly assembled and like a well-choreographed ballet, they began performing their individual tasks while communicating the status of the patient, and steps they were taking in their respective roles.
“The medics really set us up for success,” said Capt. Mara Zedick, a nurse on team who was experiencing her first code. “The EKG was done as soon as the patient was brought back, two I.V. lines placed to administer medication, and simultaneously Spc. Jimmy Hearne and Sgt. Wayne Williams were working on the patient while I started running medications for the RN, [registered nurse] Kelsey Meyer.
During this time a page went out to radiology for an urgent x-ray to check for dissections and other issues with the heart. Spc. Grant Mayer quickly made his way to the emergency department with a portable x-ray machine to get the images needed for, Dr. Linda Meyers, the provider on duty.
“20 minutes after the patient walked in the door, Kelsey made the call to Fairbanks Fire Dispatch to get a transfer running and we had him in the ambulance headed to Fairbanks Memorial Hospital in 29 minutes,” said Zedick.
Zedick explained there are national standards when it comes to providing care for a patient with a heart attack.
“National standards for a heart attack are 90 minutes from the time of the patient enters the emergency department to the patient being in the cath lab [Cardiac Catheterization Laboratory],” said Zedick.
Without cardiology services at Bassett ACH, this 90-minute window is severely shortened to ensure the patient can be transferred to FMH and prepared for the cath lab where a cardiac team can treat blockages and other problems in the arteries.
“The standard tells us 90 minutes, said Sgt. Wayne Williams, a paramedic in the department. “Really, our window here at Bassett is 45 to 50 minutes max. By getting the patient transported there within 30 minutes we gave FMH a full hour to get everything done to ensure the best outcome for the patient.”
The Bassett emergency department may not often see cardiac emergencies, but the response by the team was not luck. The quick, coordinated response was the direct result of many hours of focused training and monthly drills to ensure team readiness.
In addition to being a paramedic in the emergency department, Williams is one of two lead trainers for Cardiac Advanced Cardiac Life Saving Classes at the hospital.
“We do monthly trainings in the ER,” said Williams. “During these trainings we throw different scenarios at the team and have them run through their assigned roles, find the cause, and run through treatment options. We then back brief the event so we can learn from each other and the scenario.”
Zednick was impressed with the team’s ability to put their training to the test in a real-world scenario.
“To see the team react the way they did even when we don’t see a lot of real emergencies was great,” said Zednick. “Knowing we have people here who are not only ready to react, but ready to react appropriately, is fantastic.”
Col. Jimmy Watts, Medical Department Activity – Alaska commander, was also impressed with the team’s response.
“This is a win for our team, and we ask why this is so important,” said Watts. “To meet the time requirements in treating a cardiac event, team cohesion, communication and performance in this small unit is necessary. It also means leadership in the section is creating an environment that supports the team coming together to complete a complex task to save a life.”
“This is important because winning matters, and today, winning meant saving a life.”