On the afternoon of July 24, 35-year-old Latoria Johnson made two phone calls — one to her family; the other to 911. She was experiencing crushing chest pain and didn’t know what to do.

Columbus Division of Fire Dispatch received her call at 1:41 p.m. and paramedics from Columbus Fire Station 20 were en route one minute later. Upon arrival, they found Johnson sitting on her couch when she told them “something’s wrong,” then began having a grand mal seizure. The medics quickly transferred her to their ambulance, placed her on oxygen and began cardiac monitoring. Johnson went into a second grand mal seizure, this time deteriorating into ventricular fibrillation (V-Fib). The medics quickly delivered one shock at 200 joules and started manual chest compressions. ACLS protocol began. The medics made the rapid decision to continue manual compressions and load and go with Johnson rather than wait on scene for the responding supervisor’s arrival with the mechanical compression device. They arrived at Ohio State East Hospital’s Emergency Department at 1:59 p.m., just 12 minutes after walking through Johnson’s front door.

Upon arrival to the Emergency Department, medics remained to assist ED staff as ACLS continued. CPR was briefly paused and Johnson was found to have pulses, but, shortly after, she deteriorated into V-Fib  and was defibrillated once more. Nurses and PCAs assumed care and continued ACLS protocol while the doctor intubated her. An ECG revealed anterior-lateral ST segment elevations — Johnson was having a heart attack. Finally, on the third shock, at 360 joules, she regained and sustained a heartbeat with pulses. The ED staff worked quickly to adjust medications and prepare her for the cath lab.

When Johnson arrived to the East Hospital catheterization lab, nurses, CV techs and doctors were already scrubbed in and ready to assume care. She was in cardiogenic shock and on multiple pressors. Talal Attar, MD, soon discovered a 100% thrombotic occlusion.

A thrombectomy was performed and a stent placed, restoring circulation to the left side of Johnson’s heart. She remained critically unstable and in cardiogenic shock. Dr. Attar placed an intra-aortic balloon pump (IABP) to help her severely stressed heart pump blood. Johnson also had significant pulmonary edema and was transferred to the Ohio State Ross Heart Hospital for extracorporeal membrane oxygenation (ECMO) support. Her condition was critical.

On August 6, Johnson was discharged home in good condition. She returned to work at the end of August and continues to improve. Her neurological outcome was outstanding, in large part because of the excellent, manual compressions provided by the crew on board CFD Medic 20.

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