Going the Distance to Provide the Right Care

Wilderness camping destinations are named as such for a reason. They are intended to provide a peaceful experience for those who visit, far removed from the bustle of urban areas. 

Orange County, California offers a wilderness camp that covers 1,400 acres bordered by the Cleveland National Forest and the Anza-Borrego Desert State Park. It’s a scenic location nearly an hour away from ground ambulance service and a two-hour car ride from the nearest hospital. 

On most days, the camp’s remote location wouldn’t be an issue. But in the summer of 2019, it became a significant factor when a person at the camp suffered a medical emergency.

When the initial call for help was received at the California Fire Command Center, it was presented as an individual with chest pain and shortness of breath. Based on the critical nature of the complaint, a helicopter air ambulance was promptly dispatched—a response that would prove to make all the difference. While en route to the camp, the flight crew was notified that the patient had gone into cardiac arrest.

“It took us just 23 minutes from when the flight request was received to our arrival on scene,” according to pilot Evan Hurley of REACH Air Medical Services. “This is a testament to the great preparation and coordination we practice on a daily basis that enables us to serve at a moment’s notice.” 

When flight nurse Robert Goodfellow and flight paramedic Andrew Gallagher of REACH Air arrived on the scene, they were met by a pickup truck carrying an unresponsive individual in its bed. 

“Thanks to a volunteer nurse who was on hand at the camp, CPR administration was begun at the onset of the cardiac arrest and the patient had been shocked to regain pulses,” Andrew said. “When we arrived, the patient had unfortunately lost heart function again.”

Without appropriate measures, such as CPR, defibrillation and intubation, cardiac arrest is often fatal. Goodfellow and Gallagher placed the patient on a cardiac monitor to analyze heart rhythm and determined the patient needed to be defibrillated to encourage a normal heartbeat. IV access was then obtained, which allowed the crew to administer medications to increase blood flow to the patient’s brain and heart, and help pull the patient out of life-threatening arrhythmia. 

Shortly after these interventions were performed, the patient’s heart began beating again. The medical crew was able to intubate by inserting a breathing tube into the airway aided by a video laryngoscopy. With the high-tech scope on hand, Goodfellow and Gallagher had an enhanced view of the patient’s airway to better facilitate the successful placement of the breathing tube.

Once stabilized, the patient was air-transported to a hospital in San Diego County. During the 16-minute flight, the medical crew was able to maintain the patient’s pulses, place the patient on a ventilator, administer sedation medications to promote comfort, and monitor for any vital-sign changes. Once at the hospital, the patient underwent cardiac catheterization and walked out of the hospital just days later with normal cognitive function.

“In situations like this, the purpose our air ambulances serve is invaluable. This patient’s life would likely be very different today if not for the patient's access to viable medical treatment and timely transport to a medical facility,” Gallagher added. 

REACH 21 Viejas operates in partnership with the Viejas Fire Department and the Viejas Band of Kumeyaay Indians.

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