DVIDS – News – USU Alumni Save Hiker with cardiac emergency at 4000 feet

Army Captain Patricia Vu and her husband Captain Sean Scott, both medics at Madigan Army Medical Center in Tacoma, Wash., Were enjoying a day off over Memorial Day weekend from their care duties to patients. The couple decided to hike the five-mile Putrid Pete’s Peak Trail in the Cascade Mountains near North Bend, Wash.

Vu, graduated from USU in 2020, then accepted a transitional intern for a preventive medicine residency, and Scott, 2018 alumnus of the University of Health Sciences Uniform Services (USU) and resident of second year in emergency medicine, headed for their destination. , but their GPS had other ideas. Instead, he directed them to the trailhead of the Ira Spring Memorial Trailhead, a six mile trail near Snoqualmie Pass and North Bend. Rather than turn around, they decided to continue their hike on the Ira Spring Trail.

The first half of the trail was uneventful and both reached the top of the 4,200 foot trailhead in just under two hours. Based on the map, they could have continued to Mason Lake and then taken another trail to their car, but after rating the trail below, which was covered with more than a foot of snow, Vu urged her husband to turn around because she didn’t feel safe walking down the steep trail without proper snow gear. They wore sports clothes and walking shoes.
At the start of their descent, they were reported by two hikers who asked for help. Nearby, a man was sitting shirtless on a rock, taking sips of water from his hydration pack. Vu said he appeared extremely tired and had an increased breathing rate. One of the hikers said she met the man and believed he was suffering from heat exhaustion. So she asked him to take off his t-shirt, fill his bag with water and give him two electrolyte tablets. She asked Vu and Scott if they could take over and help the man back down to the parking lot, then disappeared along the trail with his companion, leaving him to be their responsibility before they could respond.

Vu and Scott asked the man to describe his symptoms, which he reported as chest pain, nausea and shortness of breath. The couple exchanged glances, both concerned that they were suffering from myocardial ischemia (blockage of a coronary artery) and / or myocardial infarction (heart attack).

“I immediately felt compelled to ask him about his medical history, medications and social history to try to determine his risk factors and communicated to him that my biggest concern was that he was having a heart attack and that we had to treat him properly. evaluated in a hospital, ”Vu said.

Scott asked the man if he was able to walk so they could get him to a shaded area. It took him a few minutes, but he was able to stand; however, he could only walk several meters before he started to feel the pain in his chest again. They asked him to sit down and lean against his backpack along the mountain. Scott and Vu thought he needed an ambulance, but they knew it would probably take several hours to get back down to the parking lot with the man, given his inability to take more than a few steps at a time. Vu urged Scott to call a helicopter to evacuate the hiker and explained to the man that they were exploring options to get him down the mountain, with his safety being their top priority. The man thanked them and accepted the call to notify the emergency medical services (EMS).

Scott called 911 and, using his GPS and trail map, provided the coordinates of their location. He also gave them trail information and road conditions leading up to the parking lot and trailhead.

Vu admitted that she felt absolutely unprepared for the situation. “We didn’t have Zofran, aspirin, heparin, intravenous fluids, a sleeping bag or even an umbrella to cover us. But, this feeling of helplessness triggered a survivor instinct that my refugee parents had passed on to me, and I immediately started to think about what I could do to make up for what we didn’t have, ”he said. she declared. She asked Scott to use items of their clothing to protect the man from the sun and provide padding against the rocks, and to use their ice water to help ease his nausea. Scott helped the man put on his shirt and offered him chunks of ice from their gourd. They stretched Scott’s flannel shirt to create shelter from the sun for the man.

While he was in pain, they tried to distract him by telling him about his job, his family and his cat, but the chest pain had started to radiate in both of his arms and he couldn’t get rid of the nausea.

The man reached out his hand in fright and Vu told him he could hang on to his leg for more comfort. “I would have liked to hold his hand, but I needed to hold the flannel shirt taut to give him adequate sun protection,” she said.

The man asked Vu to call his eldest daughter while the couple asked if he had a designated medical decision maker, in case he needed one. He also asked her to call his neighbor to make sure his cat was well looked after.

As other hikers passed by, they stopped to offer help. A couple pulled out their first aid kit and asked for what they needed. Vu and Scott indicated that they were both resident doctors and asked for aspirin, explaining their concern about the human heart and that having aspirin would make a big difference. Sadly the couple didn’t have any aspirin but they started asking every hiker that passed by and were ultimately successful. Scott asked the man to chew the aspirin and within minutes he said he felt some relief from the pain. At this point, Vu and Scott knew they were correct in their preliminary diagnosis of myocardial infarction.

Two hours after the EMS call, the volunteer search and rescue team, dressed in red t-shirts, was visible on the runway. They took the man’s medical history and used their radios to communicate with firefighters and other EMS crews on the way. Another hour passed before medics arrived at the scene with a portable EKG machine one had carried up the mountain on his back. The results showed a significant pattern of changes in the electrical signals produced by cells on the left side of the heart in response to an injury that was relayed to the helicopter team that was also en route. About 30 minutes later, the helicopter appeared just below them, above the tree line. Scott and Vu walked away from the scene to give EMS teams the opportunity to help evacuate the man by plane, but before leaving the man asked them to take pictures of him taking pictures of him. be hoisted up to the helicopter. He joked that he had never been in a helicopter before and it could be a once in a lifetime event for him. They obeyed and he was evacuated to Seattle for treatment.

“As we walked down the trail to get back to our car, I finally let the adrenaline fly and joked with my husband that I didn’t need an EKG or troponins to diagnose a myocardial infarction, ”Vu said. “Being the kind and fair man that he is, he allowed me to take all the credit for myself for being the first to make the diagnosis. I had never felt more like a doctor despite over seven years of study and training. I finally had a real opportunity to practice my clinical judgment without a safety net and apply what I learned from my years at USU by attending military and disaster medicine conferences to take care of myself. of a patient in an austere environment.
Once back at their car, Vu contacted the man’s daughter to inform her of what had happened. Later that evening, the girl texted Vu to say her father was okay. The man himself texted Vu several days later. “I want to express my most sincere gratitude to you and your husband for the care and kindness you have provided me. The quality of my health and recovery is attributable to your expertise and prompt intervention. I received a stent and am on my way to a full recovery. Fast too. Everyone says it was a miracle that you and your husband found me immediately during the event… Thank you from the bottom of my heart to you and Sean for saving my life! I wish you good luck and hope that our paths will cross again on the trails… but not under the same circumstances! he said.

Vu herself had a thank you on her and Scott’s behalf and a call to action for others.

“I wanted to express my gratitude to the military medics at USU and Madigan Army Medical Center (MAMC) who taught us and challenged us to use our knowledge of clinic and ward medicine and apply it to lesser environments. than ideal. I also want to challenge everyone in our daily lives to be better prepared for disaster management. Sean and I made the mistake of bringing nothing more than water and a few snacks. If it had not been for the older couple who found the aspirin, the man would not have received anything until the EMS arrived, which took over two hours, ”said Seen. “We realized we were complacent in thinking we were young and invincible and that doing a six mile hike would be a simple task despite years of disaster, public health and global health training. We should all carry basic medical items like aspirin, pain relievers, a tourniquet, and items to protect someone from the environment, in addition to an adequate supply of water and food. As a future preventive medicine physician, I hope to work more closely with emergency medicine staff and residents to emphasize wild medicine in our training at MAMC.

Date taken: 08.03.2021
Date posted: 08.03.2021 09:33
Story ID: 402294
Place: BETHESDA, MD, United States

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