41-year-old Leroy Miller had just finished a hearty lunch at his family’s Amish farm on Saturday, December 4th, 2010 when he abruptly fell to the floor, lifeless. His startled family immediately called for help and Leroy’s brothers began CPR. Firefighters and EMS arrived and defibrillated Leroy within 13 minutes. After three defibrillations and a short period of asystole, Leroy’s heart started to beat again on its own. EMT-Paramedic Kim Jarrett of Parkview-LaGrange EMS started an intraosseous (IO) line and intubated Leroy. Her partner EMT-Basic Mike Yoder, assisted.
Limited by weather constraints to the south, Kim called WMAC to fly Leroy quickly to Bronson Methodist Hospital in Kalamazoo. By the time Air Care landed in one of the Millers’ farm lots, Kim and Mike had performed an ECG, started a peripheral IV, and instituted neuroprotective post-arrest cooling measures with cold normal saline. During Leroy’s flight with Air Care, the crew continued cooling measures with cold saline, ice packs, and temperature monitoring. They also administered sedation and neuromuscular blockers to prevent shivering which reverses cooling. Leroy was placed on mechanical ventilation and his vital signs were closely monitored including end tidal CO2 readings. When the medical crew performed follow-up ECGs, they discovered why Leroy had suddenly collapsed: the ECGs were positive for Wolff-Parkinson-White Syndrome, a rare and often lethal dysrhythmia. Leroy was met in the ED by emergency, cardiology and critical care physicians along with many nurses and other assisting personnel. Air Care’s medical crew provided full report and Leroy was eventually moved to the Medical Intensive Care Unit for continued treatment.
A few days after his cardiac arrest, Leroy was doing well. He had been extubated and was getting up to walk. His broken ribs from the effective CPR he received were painful, but it was a small price to pay for such a good outcome. Later during his stay at Bronson, Leroy went to the cardiovascular lab and received an “ablation”, in which the small portion of the heart responsible for the dysrhythmia was treated with a laser. This procedure prevents lethal heart rhythms from recurring. On Friday, December 18th, the Miller family invited all the rescue crews to return and celebrate by preparing another hearty Amish meal!
Our hats off to the rescuers from Parkview-LaGrange EMS and Shipshewana Fire, and also Bronson Methodist Hospital for their partnership in improving patient outcomes.
Leroy’s attending flight crew:
Flight Nurse Dawn Johnston,
Flight Nurse Kevin Ferguson, and Pilot in Command Shawn Maxwell
By Dawn Johnston, RN, NREMT-P, CFRN
West Michigan Air Care