A Quick Save - Response to Ruptured Aneurysm Shows Genesis System of Care at its Best      (Posted 4/21/06)

After 60 years of marriage, Robert Glaudel of Silvis knows his wife.  So the day she complained of a sharp pain in her back, he sensed he had a real medical emergency on his hands.

Ten years before, his wife, Marilyn, had a thoracic aortic aneurysm that was detected and surgically repaired before it ruptured.  This time, however, his wife's abrupt back pain signaled to him that something was terribly wrong.  He called 911, and an ambulance rushed her to Genesis Medical Center, Illini Campus. 

"We were sitting down to eat at the kitchen table, and she said, 'Oh, I've got such a pain in my back,"'  Mr. Glaudel says.  "We've been married for 60 years, and I know her well enough to know that she was in trouble.  When she said she had back pain, it popped into my head.  I thought it might be another aneurysm.  

Genesis At Its Best
What unfolded over the next hour on February 16 would show the Genesis system of care at its best. 

Thanks to a husband's quick action, the responsiveness of the Davenport and Illini Campus hospitals, an emergency helicopter and a quickly mobilized heart surgery team, Mrs. Glaudel's life was spared from a silent and instant killer. 

A thoracic aortic aneurysm - a bulge in the part of the aorta that runs through the chest - is a serious health risk because it can burst or rupture.  Once it bursts, severe internal bleeding can quickly lead to shock or death.  Only 20-30 percent of patients who get to the hospital with a ruptured thoracic aortic aneurysm survive, according to the Society for Vascular Surgery. 

Mrs. Glaudel's husband urged emergency room staff to call his wife's doctor, Richard Sadler, M.D., the cardiothoracic surgeon who had performed his wife's first surgery a decade ago. 

"She only had an hour at the most," recalls Dr. Sadler, who would perform Mrs. Glaudel's surgery at Genesis.  "She presented in shock to the Genesis, Illini Campus Emergency Room.  She had lost a significant amount of blood in her chest.  She was appropriately assessed and resuscitated at Illini by Dr. Joseph Danna, who did an excellent job.  She was then flown quickly by Med-Force helicopter and taken to the Operating Room at Genesis Medical Center, Davenport, 

"Med-Force cranked hard and got her there quickly.  The surgical team at Genesis was already tied up on another case, but the nursing supervisor was brilliant at mobilizing resources and, within minutes, pulled together a volunteer team.  it was a very difficult heart case and required an O.R. staff of veteran nurses.  It went as fast as it possibly could, and we had a great outcome.  Everything went optimally.  It really says a lot about the Genesis system of care." 

The first 60 minutes after an extreme medical emergency is called "the golden hour" - when timeliness and quality care mean the difference between life and death.  Quad City Med-Force, a regional air ambulance system supported by Genesis Health System, can provide emergency  care and transport critically injured or ill patients faster than any other mode of transportation around.  

"In a situation like this, time was of the essence," says Kevin Takacs, President and CEO of Quad City Med-Force.  "The rapid response to destination care helped save this woman's life." 

In addition to the EC135/T2 helicopter that can fly up to 150 mph, Med-force's rigorously trained crews have expertise in transporting cardiac, pulmonary, critical care and neurological patients.  Some of the medics, nurses and physicians on the Med-Force team also work within Genesis Health System, providing a continuity of care that results in better patient outcomes. 

"Our staff is rigorously trained at the critical care level," Takacs says.  "No only do we have the expertise in medical care, but we have the ability to cut transport time literally in half, if not more."  

"Miracle Patient"
Mrs. Glaudel, who is home now recovering after five weeks in the hospital, feels lucky to be alive after her medical emergency. 

"The nurses at Genesis called me 'the miracle patient'," she says.  "I feel very fortunate to have had the helicopter transport and very fortunate to have had a wonderful doctor like Dr. Sadler." 

Mr. Glaudel feels grateful as well.  He vividly remembers the day of his wife's emergency surgery.  "Dr. Sadler told us it was very, very serious.  The aneurysm was in a difficult spot, and her condition was bad.  'She has a chance,' he said, 'but it's not great.'  She had a very long surgery.  

"When Dr. Sadler came out of that Operating Room, his face was very drawn.  He told us the surgery went as well as could be expected, but that she wasn't out of the woods." 

Mrs. Glaudel was in Critical Care for 12 days.  "She had a tube down her throat and wires all over her.  She wanted to talk to me but couldn't, so she communicated by blinking her eyes and moving her toes," her husband says. 

"When a nurse gave us an alphabet board to use, my wife communicated with me by pointing to the letters.  The first thing she said to me was, 'Because you acted so quickly, you saved my life.'  As sick as she was, she was kind enough to say that to me." 

Approximately 25 percent of aneurysms in the aorta - the larges artery in the body - occur in the chest, as in Mrs. Glaudel's case.  The rest involved the abdominal aorta.  In February, about 400 Quad Citians signed up for reduced-cost ultrasound screenings for abdominal aortic aneurysm through Genesis - a cooperative effort of the Genesis Heart Institute, radiologists and vascular surgeons. 

Most thoracic or abdominal aortic aneurysms don't have symptoms but can have deadly consequences.  Typically, they are detected when chest x-rays, CT scans or MRI tests are being obtained for other health problems.  There are several things you can do to reduce your chance of developing an aneurysm: 

• If you have a family history of arterial disease, have regular medical check ups. 
• Do not smoke. 
• Have your blood pressure checked regularly. 

While most symptoms of stable thoracic aneurysms are vague, they produce dramatic symptoms when they rupture.  These include a ripping sensation within the chest, accompanied by severe pain in the back of the shoulder blades. 

"The estimated mortality of a ruptured thoracic aneurysm is 90 percent for the first 24 hours," Dr. Sadler says.  "When you have symptoms like Mrs. Glaudel had, you need to get help very, very quickly." 

-- Story by Linda Barlow, Genesis

About Quad City Med-Force
Med-Force is a non-profit helicopter service based out of Colona, IL, and West Burlington, IA.  It began providing services to the Quad Cities area in November 2000.  Genesis Health System and other area health-care and community organization support the service.  Genesis Medical Center, Davenport, serves as medical control for call originating in Iowa.  The Genesis Medical Center, Illini Campus, in Silvis is the resource hospital for all Illinois-based calls.  Medic EMS of Davenport handles dispatching.  

"Genesis has supported us from the start and was instrumental in helping to bring Med-Force to the Quad-Cities," says Kevin Takacs, President and CEO of Quad City Med-Force.  "It's another example of Genesis' commitment to quality health care in the community."

In October 2003, Med-Force unveiled the new EC135/T2 helicopter, a much larger, faster and better-equipped aircraft than the one that previously supported the region.  It can carry two patients and two medical attendants; boasts more advanced medical equipment; and can fly a wider range and as fast as 150 mph.