On January 1, 2018 at 8 p.m., Remote Medical International employees Dr. Bruce Dooley and Paramedic Lauren Hadley, providing contracted medical care on a remote Pacific Island, received a call about a 55-year-old man on the island who was complaining about chest pains.
After locating the patient, moving him to the clinic, and scanning for an EKG, all within 15 minutes of the call, Dr. Dooley discovered the patient was having a heart attack. Following Remote Medical International’s standard protocols for Advanced Life Support in remote locations, Dr. Dooley contacted Remote Medical International Assistant Medical Director Dr. Richard Misiaszek for consult. Once Dooley and Hadley administered the correct medication, both took four to six-hour monitoring shifts for the next 48 hours until the medevac could arrive to take the patient to Queens hospital in Honolulu, Hawaii.
“It was the first medevac I’ve had to do,” said Dooley. “And hopefully the last one.”
Heart attacks can lead to cellular damage around the heart, functional incapacity, or can cause an untimely death.
“I think they both did an outstanding job. The most important thing was recognizing that this man had an emergency medical condition,” said Dr. Misiaszek.
Following Remote Medical International protocols, Dooley and Hadley administered a clot busting medication called a thrombolytic, specifically in this case the medication Tenecteplase.
A mere twenty minutes after receiving the medication, the patient’s EKG was almost back to normal. The patient fully recovered with no residual health problems, just five days after close monitoring and evacuation to a nearest hospital.
“Things went really smooth,” said Dooley.
According to Dooley, if this event had taken place on the mainland, the patient would have been rushed to an ER in the United States and then monitored in an ICU just as closely because the first 48 hours after a heart attack are when individuals are most likely to go into cardiac arrest.
“There would have been nothing they could have done differently at the hospital than we did here,” said Dooley.
Although a heart attack on a remote island is not a common occurrence on a project site, Remote Medical International’s clinical team put in place protocols to ensure a patient would survive such an occurrence.
“Because of the procedures that Remote Medical International has in place, you feel you are not alone,” said Hadley.
Quick decisions can often mean life or death in a remote location and having protocols in place can help facilitate a high-stress situation such as a heart attack. According to Misiaszek, not all situations are black and white, but having specific protocol details written down can get you through them successfully.
“Having someone with a medical background to recognize symptoms and be able to treat them is hugely important to these remote settings because emergencies happen and [could] have bad outcomes as a result ,” said Misiaszek.
Learn more about the specific medical protocols our medical providers used for this patient in our case study.