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By NorthShore – Edward-Elmhurst Health
The Saturday morning in April started out well. A man in his late 40s did a workout, chatted with a friend, then headed home from the gym.
“I was feeling a little sick as I drove home. I thought I had food poisoning,” the man said. “I vomited at home, told my wife I wasn’t feeling well, then went upstairs to lie down.”
When his wife came up two minutes later with a glass of water, she found him unconscious and gasping for air.
She immediately called 911 and started chest compressions.
As the ambulance and fire engine raced to the scene, Dr. Ben Feinzimer, watched them pass as he finished putting gas into NorthShore University HealthSystem’s Physician Response Vehicle (PRV). He jumped in the vehicle and joined them on scene.
Dr. Feinzimer, EMS Medical Director for Illinois EMS Region X - Highland Park, developed the rapid-response PRV program, which allows a doctor in a specially equipped vehicle to respond to emergencies alongside firefighters and paramedics, providing advanced medical care at the scene.
The situation was grim when Dr. Feinzimer arrived at the patient’s house that spring day.
“Paramedics immediately placed him on a cardiac monitor. It showed ventricular fibrillation or VF, a fatal arrhythmia,” Dr. Feinzimer said. “They shocked him and started cardiopulmonary resuscitation. With tremendous relief the crew noticed his heart started beating on its own.”
Dr. Feinzimer administered medication he had in his PRV that could reduce the recurrence of VF, and joined the paramedics in the ambulance to the hospital. On the way, he called an interventional cardiologist to ready the cath lab.
The patient got the treatment he needed and walked out of the hospital a few days later.
“For me, the program was literally a lifesaver,” the patient said. “I would not have the opportunities I have today [if it wasn’t] for the coordination of the team, the fire department and Dr. Feinzimer. It’s been a remarkable experience. And as a result, I get to make more memories with my family.”
Physician-level care in the field
The Physician Response Vehicle strengthens the care continuum by adding an emergency physician into the pre-hospital setting.
Funded by donations from the Alvin H. Baum Family Fund and Hatzalah Chicago, NorthShore University HealthSystem acquired a Ford Explorer and transformed it into the Physician Response Vehicle, complete with emergency lights, sirens, communications capabilities and lifesaving medical equipment.
The program means patients in the field get a higher level of care sooner. It also means the EMS physician can call ahead, alert various hospital personnel and specialty teams, and maximize patient care in the most efficient manner possible.
“I literally couldn’t form the words”
Another patient, a man in his 60s, was taking a shower on what started out as a normal Tuesday in June.
But something was weird.
“I was rinsing my hair and suddenly my right hand was just slapping the side of my face. It wasn’t doing what I wanted it to do,” he said. “I got out of the shower and tried to dry myself off and I felt drunk. I tried to reach for the toothbrush and knocked it over.
“Fortunately, my wife was there. She asked, ‘Are you ok?’ I said no I’m not, but it wasn’t until I said that I realized I couldn’t speak. The words were coming out, but slurred. I literally couldn’t form the words because the right side of my face wasn’t working,” he said.
His wife noticed that his face was drooping and, having lost her brother to a stroke two years earlier, immediately gave him an aspirin.
She called his primary care physician, who directed them to go to a hospital. The couple debated driving to the nearest hospital, then realized they weren’t sure where to go and called 911.
An ambulance and Dr. Feinzimer’s PRV responded to the call.
“When we arrived, it was clear he was suffering a stroke,” Dr. Feinzimer said.
A deeper evaluation sparked concern about large vessel occlusion, a specific stroke akin to a heart attack.
The crew and Dr. Feinzimer decided to take him to Evanston Hospital, a comprehensive stroke center, bypassing any closer hospitals, for potential neurosurgery intervention.
While they drove, Dr. Feinzimer called the hospital stroke nurse practitioner, stroke neurologist and a neurosurgeon. They got the patient to CAT scan immediately and mixed clot-busting medication during the scan.
Criteria were met to deliver this potent and, in this case, lifesaving medication. He received the medicine in what was the fastest “door-to-needle” time ever recorded at Evanston.
A few days later, he had returned to his pre-incident self and is now living his life, happy and healthy.
“Because we called 911, they knew I was having a stroke, they were able to prepare, wheel me in exactly where I needed to go, and knew to have the doctor ready to approve the clot-busting medicine,” the patient said. “Within 45 minutes of me first realizing my right hand didn’t work in the shower, I was in the hospital getting that clot-busting medicine.”
“Although it was very, very scary for 6 or 7 hours until I could speak again, I’m incredibly lucky,” he said. “For any future medical emergencies, I will call 911 immediately and hope Dr. Feinzimer comes.”
Learn more about the Physician Response Vehicle program and emergency care at NorthShore University HealthSystem.
Benjamin Feinzimer, DO, is an emergency medicine physician with NorthShore Medical Group. View his profile and schedule an appointment.