Inside an emergency response

Every day, medical emergencies like trauma, heart attack and cardiac arrest happen in communities throughout San Diego. When cardiac arrest occurs, survival depends on a coordinated chain of highly skilled first responders and hospital teams. On the night Imperial Beach resident Glen Baniqued, 52, went into sudden cardiac arrest at home with his wife, that chain worked exactly as rehearsed.

“Our family had gone to the San Diego County Fair the day before,” remembers Edna Baniqued, Glen’s wife. “We had a great time and couldn’t have imagined what would happen the next night.”

Feeling unwell, Glen woke Edna several times during the night. After the last time, they both got out of bed. When Edna returned to the room, she found Glen unconscious and called 911.

“The 911 dispatcher said he was sending help immediately, and he walked me through how to start CPR,” Edna says.

Edna beginning CPR within five minutes of cardiac arrest was the first successful link in Glen’s survival. Deputies from the San Diego County Sheriff’s Office arrived quickly, followed by paramedics from Imperial Beach Fire-Rescue, who took over CPR while an ambulance with the Chula Vista Fire Department was on the way. As each agency arrived and transitioned Glen’s care to the next, the chain continued to hold.

In the ambulance, Imperial Beach paramedics determined Glen was a candidate for extracorporeal cardiopulmonary resuscitation, or ECPR — the process of placing a patient on an extracorporeal membrane oxygenation (ECMO) machine. They made the lifesaving decision to take him to Sharp Chula Vista Medical Center, the only ECPR Receiving Center in the South Bay, rather than the closest emergency room.

“The paradigm has shifted — thanks in part to the creation of the San Diego Resuscitation Consortium,” says Jonathan Goldstone, MSN, RN, ECMO coordinator at Sharp Chula Vista and Sharp Memorial Hospital. “Our emergency management system (EMS) partners have become very skilled at recognizing patients who may be candidates for ECMO, and knowing to bring them to the nearest hospital with ECMO capabilities rather than any closest hospital.”

When Glen arrived at Sharp Chula Vista, the hospital’s ECMO team was ready and continued resuscitation. After 91 minutes of CPR, Glen was successfully placed on ECMO, stabilized and transferred to Sharp Memorial Hospital, where he received continued care, was weaned from the ECMO machine and then had cardiac rehabilitation before going home.

“In what we do in the ER, we don’t always know how something is going to turn out, but we do know that if we do nothing, there will be no survival,” says Dr. Sow Kobayashi, ECPR medical director, Sharp Chula Vista. “Fortunately, a lot of things fell perfectly into place for Glen.”

One month later, Glen and Edna met the first responders and Sharp caregivers who saved his life during a special reunion at the Imperial Beach fire station. There were smiles and hugs all around, including an emotional moment between Edna and Cameron Littlecreek, the San Diego Fire-Rescue 911 dispatcher who answered her call that night.

“We started holding these reunions to give our EMS partners the chance to see and celebrate good outcomes,” says Dr. Saul Levine, ED physician at Sharp Memorial Hospital. “Any break in the chain of survival could be disastrous, so it takes a lot of rehearsing and practice, and we couldn’t do what we do without them.”

“There are a lot of bad days in a long career in this line of work,” adds Ehren Kahle, fire captain, Imperial Beach Fire-Rescue, who was one of the first on the scene the night of Glen’s cardiac arrest. “Moments like this mean everything. We’re so glad Glen made it home.”

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