It was the day after New Year’s Day and a man from Maryland, Richard “Ricky” Bryan, had been enjoying a week-long camping and fishing trip with three of his closest friends in the Florida Keys. After some early-morning fishing, the group had returned to their Stock Island campsite. The last thing Bryan remembers was taking a shower and brushing his teeth.
“I also remember hearing a helicopter,” said Bryan, 47, of Perryville, Md.
The helicopter he heard was a Monroe County air ambulance. Bryan, who had just suffered a massive heart attack, was being rushed to the emergency room at UHealth Tower, UHealth-the University of Miami Health System’s flagship hospital in Miami, as part of UHealth’s new helicopter cardiac rescue program.
“Ricky had just come out of the shower, and he was complaining of a toothache,” said Bryan’s longtime friend, Sean Harrison, a former volunteer firefighter from Lewes, Del. “The next thing I knew, he was face down in the grass. I rolled him over, and I could tell he was having a heart attack — he wasn’t breathing, and had no pulse.”
Harrison yelled to another friend to call 911 while he and a worker from the campground started doing chest compressions in a desperate attempt to save his best friend’s life. Monroe County EMS technicians — trained by the Michael S. Gordon Center for Research in Medical Education at the University of Miami Miller School of Medicine — arrived within minutes and successfully restarted Bryan’s heart before transporting him to a hospital in nearby Key West.
Recognizing that Bryan would need advanced life-saving treatment, they dialed UHealth’s dedicated line for cardiac arrest patients in the Keys and called in an air ambulance to fly him to Miami. UHealth interventional cardiologist Dr. Carlos Enrique Alfonso, associate professor of medicine at the Miller School of Medicine and director of the Cardiovascular Fellowship Training program, was on call that day and mobilized his team in preparation for Bryan’s arrival.
Since UHealth’s helicopter cardiac rescue program began six months ago, the number of rescue transports has greatly increased. Rafael Rios, the air ambulance pilot who flew Bryan from Key West, says his team makes two to three trips a day to Miami, on average.
The program was started out of a need to provide prompt, highly specialized care to patients in the Keys suffering from cardiac arrest or exhibiting symptoms of cardiac distress, according to Stephanie Moss, D.N.P., APRN, ANP-BC, executive director of clinical operations for cardiovascular services at UHealth.
“When the call comes in, our highly skilled interventional cardiology team mobilizes on a moment’s notice and is ready and waiting to meet the patient at the helipad to provide advanced life-saving care,” Moss said. “This helps significantly improve response-to-care and patient outcomes.”
The Gordon Center has also played a major role in the program’s success by training EMS workers in Monroe County — as it also does in Miami-Dade County and across the state — to recognize symptoms of cardiac arrest and to provide the first line of medical care.
Once aboard the Monroe County rescue helicopter, Bryan wasn’t out of danger yet, however. Shortly after lifting off from Key West, his heart stopped once again. The flight nurse was able to revive him en route to Miami, and 50 minutes later they touched down at UHealth Tower, where Dr. Alfonso and his team were waiting. Bryan was alive but in critical condition. He was raced from the helipad to the emergency room and, after being stabilized, he was moved to the Cardiac Catheterization Lab, where Dr. Alfonso went to work.
“When he arrived, Mr. Bryan’s right coronary artery was completely blocked, and his heart function was at about 10 to 15 percent,” said Dr. Alfonso, “We unclogged his artery with a small balloon and implanted a stent to prop it open.”
Just five days later, Bryan was sitting with his family in a UHealth Tower conference room, in front of a group of television news crews, thanking his best friend as well as the UHealth cardiologists and the Monroe County first responders for saving his life.
Mauricio Cohen, M.D., professor of medicine at the Miller School and director of UHealth’s Elaine and Sydney Sussman Cardiac Catheterization Lab, displayed images of Bryan’s heart before and after the successful angioplasty.
“It takes a system of care, starting with the 911 call and CPR in the field, to help a patient survive sudden cardiac arrest,” Dr. Cohen said. “Everyone in this room played an equally important role in Mr. Bryan’s survival.”
It was an emotional moment for everyone as Bryan exchanged hugs with all those who helped save his life on that fateful day.
“I feel so blessed,” Bryan said. “I thank all of you, from the bottom of my heart.”
“Actually, from the right side of your heart,” quipped Angel “Al” Brotons, director of training operations in the Gordon Center’s Division of Prehospital and Emergency Healthcare, who helped train the first responders who saved Bryan’s life.
There is a history of heart disease in Bryan’s family, according to his mother, Peggy, whose husband died of a heart attack at age 56. When she got the call that her son was in the hospital, she immediately flew down from Pennsylvania with her two daughters to be at his bedside.
“We were so worried — we couldn’t believe this was happening to our family again,” she said. “But we’re so grateful for everyone here and in the Keys who helped save Ricky’s life.”
While something went very wrong with Bryan’s heart that day, a lot of things went very right in terms of the life-saving care he received, starting with the cardiopulmonary resuscitation (CPR) he received from his best friend. Had Sean Harrison not known how to perform CPR and keep Bryan’s heart pumping until EMS workers arrived, the story would have ended right there at the campsite.
Had the EMS crew not been trained by the Gordon Center, they may not have been able to restart Bryan’s heart. And had UHealth not established a helicopter cardiac rescue program with Monroe County, Bryan likely wouldn’t have survived the three-hour-plus ambulance ride from Key West.
“Coronary disease is the number one cause of sudden cardiac death in the middle-aged population, and out-of-hospital cardiac arrest still remains a major cause of death,” Dr. Alfonso said. “But thanks to the care he received at every step along the way — from his friend and first responders to the flight crew and the team here at UHealth — Mr. Bryan is alive today, and his prognosis is excellent.”
Written for Inventum by Peter Laird