As Mick Monahan celebrated at his best friend’s bachelor party on a farm west of Lake City on a Sunday afternoon, he became light headed. “I thought I was coming down with something,” remembers the 24 year old livestock farmer. Earlier that day, he felt tired, nearly exhausted, when helping put chairs away after service at St. Mary’s church. Despite not feeling 100%, Mick arrived at the party honoring Daniel Smith. After visiting with friends briefly, he suddenly collapsed. When his buddies Adam Reynolds and Colby Davis couldn’t find a pulse, they started cardiopulmonary resuscitation (CPR) and Daniel called 911. “It felt like everything was in fast-forward,” says Daniel.
Mick remained unresponsive and the young men continued CPR. When Calhoun County EMS arrived, they assessed Mick. While time seemed to stand still for Mick’s friends, Heather Olberding and Nicole Winter reached the group within minutes. They used a monitor defribrillator and shocked Mick’s heart.
The defribillator was one of eight units placed in ambulances in Lohrville, Farnhamville, Lake City, Rockwell City and Manson and in the emergency department at SMCH, as part of a project in 2013. Calhoun County EMS received funding from the Calhoun County Board of Supervisors for each $40,000 unit. The monitor defribillator gives feedback on the cardiopulmonary rescusitation as it’s being performed. The data is then later analyzed for quality improvement, training and review. “The monitor provided real-time feedback while CPR was being performed to maximize appropriate rate and depth of compressions. It also provided the defibrillation that basically restarted Mick’s heart,” explains Kerrie Hull, Calhoun County Emergency Service coordinator.
The ambulance crew loaded Mick and were en route to Lake City eleven minutes after they were dispatched. They brought him to Stewart Memorial Community Hospital.
Within five minutes of Mick’s arrival to the hospital an electrocardiogram (EKG or ECG), a test that checks for problems with the electrical activity of the heart, was administered. Dr. Susan Hornback and certified physician assistant Danni Anderson were the medical providers in the emergency department that day. Dr. Hornback says, “When we looked at the EKG, the delta wave showed Wolff-Parkinson-White.”
Mayo Clinic defines Wolff-Parkinson-White (WPW) syndrome as an extra electrical pathway that exists between a heart’s upper and lower chambers and causes a rapid heartbeat. Mick’s heartbeat was too fast, essentially becoming a quiver rather than a beat, and stopped pumping blood.
The team at SMCH stabilized Mick and conducted a CT scan to check for head injury after Mick’s fall. They communicated with LifeFlight and the medical providers in Des Moines. Commenting on the textbook string of events that led to Mick’s recovery, Dr. Hornback says, “It happened just like it should. That day was a beautiful example of perfect coordination of care.”
After receiving word of Mick’s collapse, Jerome and Dorene Monahan, Mick’s parents, and his sister, Jamie, rushed to the Lake City hospital. “Initially, we were told that Mick had had a seizure. While we were concerned, we didn’t think it was critical,” recalls Dorene. When they were only a mile away, they got a call explaining that the helicopter would arrive in five minutes. Suddenly, the situation became more frightening.
“When we arrived at the ER, everyone from the bachelor party was there. Some were visibly upset. Danni met with us right away and explained what was happening. She told us he was stable and sedated and they were preparing him for transport,” says Jerome.
With so many people in the ER waiting room, anxious for word about Mick, Heather Cain, SMCH CEO, met with the family and friends and coordinated efforts to help them get through the difficult situation. She says, “I received a call from our team saying they needed all hands on deck to help with communication to the family. I was grateful to be here to assure Mick’s family and friends that he was in great hands and our team was giving him the best possible care.”
When the helicopter arrived 34 minutes after Mick reached SMCH, he was airlifted to Des Moines. “It was amazing how smoothly the transfers went between the EMS, SMCH, LifeFlight and the hospital in Des Moines! Everyone was prepared, informed and ready for the situation,” exclaims Mick.
Mick’s cardiologist chose to treat Mick with radiofrequency catheter ablation. Thin, flexible tubes (catheters) were threaded through blood vessels to his heart. Electrodes at the catheter tips were heated to destroy (ablate) the extra electrical pathway causing his condition. When the first attempt was partially successful, a second procedure was scheduled after his six-week checkup.
Following surgery, Mick is feeling better and very grateful. “The reason I’m still here is that my friends reacted. Even though none of them are trained in CPR, other than what they’d seen on TV, they didn’t let that stop them. Everything they did counted.”