A Christmas miracle in Louisa for Pegasus crew: School employee saved thanks to quick thinking, fast chopper
By Jimmy LaRoue
Dianna Carter thought it was a bad case of heartburn.
Working in the Louisa County High School cafeteria, Carter, 63, who also drives a bus, had just finished the second lunch shift on Dec. 7 when she told Patti Kemp, her manager, that she wouldn’t be able to continue working. She attributed her ill-health to working too hard on a short schedule.
“I’ve got this strange congestion in my chest, and I don’t think I’m going to be able to serve these kids on this next shift,” Carter said.
Go see the nurse, Kemp told Carter.
“Actually Patty, I don’t feel like going over there,” Carter said. “Why don’t you give me a bottle of water, my Pepsid AC? I’ll get over in the corner somewhere.”
Kemp immediately called school nurse Delores “Dee Dee” Toombs. Rushing to the auxiliary cafeteria near the front entrance to the school, Toombs quickly surmised that something was amiss.
By that time, Carter’s pain had shot up from her chest to her left shoulder and she had broken out into a cold sweat. The color was fading from Carter’s face–she was in the midst of a full-scale heart attack.
‘Put me in the wind’
Toombs called 911 and within two minutes, Kelly Staymates, a firefighter/medic with the Louisa County Department of EMS, and Buddy Hopkins, a medic in the same department, were at the school.
Because of Toombs’ alert thinking, Staymates and Hopkins, responding from Company 2 in Mineral, were able to put her on a stretcher and take her immediately to an ambulance. Toombs had already taken Carter’s vital signs and had given her oxygen.
“It makes a difference,” Staymates said. “I mean, that’s all time that I would have had to take to get the stuff off the truck. We came in with a stretcher. I took one look at you and it was, ‘Get her on the stretcher and let’s go.’”
In the ambulance, she took Carter’s 12-lead electrocardiogram, or EKG. It’s an electrical recording of the heart. After looking at Carter’s EKG, Staymates knew. “Once we saw that, I told Buddy, ‘Put me in the wind.’” “It scared us,” Hopkins said.
Staymates surmised from Carter’s condition the need to alert Pegasus – a critical care helicopter unit – to meet them at the designated landing spot at the Zion Crossroads Dialysis Center, both part of the University of Virginia Health System. They were at the school for about 10 minutes, and to Zion Crossroads in about 20 minutes.
On the way to Zion Crossroads, Staymates gave Carter critical care medicine in the back of the ambulance and told her how sick she was.
“Can you call my husband and tell him how much I love him,” Carter asked Staymates. “And I said, ‘Well I will, but I’ve never lost anybody in the back of an ambulance; today’s not your day,” Staymates told her. Everything that needed to be done was done.
Now, it was up in the air – literally.
Mike Wasilko, a paramedic and Mona Snow, a flight nurse, were the two on the Pegasus flight crew that day who took Carter to the University of Virginia Medical Center in Charlottesville, where a series of events there unfolded that would aid in saving her life.
UVA initiated its STEMI procedure for those coming in with a severe heart attack. STEMI is an acronym which stands for ST segment elevation myocardial infarction.
Carter was in the middle of that myocardial infarction–or severe heart attack. It happens when a coronary artery suddenly becomes at least partially blocked by a blood clot.
The heart muscle was dying, and so was Carter.
Initiating ‘an incredible series of events’
Dr. Larry Gimple, the director of clinical cardiology for the University of Virginia Health System and the surgeon who operated on Carter, said the STEMI procedure sends off about 12 pagers in the hospital. Those 12 people, he said, immediately head to the emergency room. Usually the patient is already there, but in this case, when Pegasus was notified about Carter, the hospital initiated the procedure.
Carter arrived at 2:04 p.m., Gimple and his team initiated a cardiac catheterization, moving Carter into a specialized lab for just that purpose. Looking at a picture of her arteries, Gimple saw that her right coronary artery was completely blocked.
“That was why she was having the heart attack,” Gimple said.
The medical team opened the artery with a balloon and a stent, which they finished by 2:24 p.m.
The procedure involved numbing a small area at the top of the leg. Doctors then inserted a catheter into the femoral artery in the leg, which is connected to the aorta and goes directly to the heart.
At that point, doctors took pictures of the artery of the heart to make a diagnosis. They then passed a thin, soft flexible wire through the blocked coronary artery and use a small balloon to restore blood flow before putting a coronary stent to help keep the artery permanently open.
In Carter’s case, Gimple said it took about 30 minutes from start to finish.
“The catheterization went very nicely,” Gimple said. “As soon as we opened up the artery, her pain went away within a minute or two.”
At that point, her EKG went back to normal and Carter went to the coronary care unit, had dinner and was able to visit with her husband and children.
“She was just a person in central Virginia,” Gimple said. “And because she was in trouble, she was able to initiate an incredible series of events. It’s really a unique attribute of the University of Virginia.” Gimple said that first hour before Carter even arrived at the hospital was vital. “If you can get to people in the golden hour, you can very often save them when you couldn’t save them otherwise,” Gimple said. But everyone else involved in saving Carter’s life credits Toombs. “I think she was the critical link in a long chain,” Gimple said.
‘My Christmas miracle’
When former President Dwight Eisenhower had his heart attack in September 1955, it was seven weeks before he left the hospital, and not until February that doctors reported his recovery.
“He was basically in bed for six months because that’s what [doctors] thought was best,” Gimple said.
Carter, who was up and walking by the third day following her heart attack, is pushing to get back to work by Jan. 6, or about a month after hers.
The goal, according to Gimple, is to have her back to full activity within four to six weeks. She said she’s watching her diet, and is about to start a cardiac rehabilitation program.
“There was a lot of people that was pulling for me,” Carter said. “The big guy up there says, ‘I’m not ready for you yet. I’ve got something else for you.’ And I’m still here.”
She “looked wonderful” even hours after the heart attack, Staymates said, and has only gotten better.
Carter said it would be an extra special holiday for her, her husband and two children. She said she’s blessed for the help of so many people.
“Everyone keeps saying I’m a miracle,” Carter said.
“She’s my Christmas miracle,” Staymates said.
“Time was not on your side,” Staymates told Carter, holding back tears while at a gathering of those involved in the rescue effort, “And we made it on your side.”
Buddy Hopkins, Dianna Carter and Kelly Staymates stand outside the Pegasus helicopter. Hopkins and Staymates, of the Louisa County Department of Emergency Management Services, transported Carter to a similar helicopter after she suffered a heart attack on Dec. 7. Carter was then transported to the University of Virginia Medical Center in Charlottesville, where she was treated and was up and walking around three days later.
Buddy Hopkins of Louisa County Department of Emergency Management Services (l to r) stands with Patti Kemp, Louisa County High School cafeteria worker; Dianna Carter; Delores “Dee Dee” Toombs, LCHS nurse; and Kelly Staymates, EMS. Hopkins and Staymates responded to a call from Kemp after she recognized something was wrong with Carter, who suffered a heart attack on Dec. 7 following a lunch shift.