Case Study

Dealing with a Health Emergency in a Health Care Environment

An ophthalmic technician has a heart attack on the job.

Sergina M. Flaherty, COMT, San Antonio, Texas

Kevin Phillips, COA, is a 42-year-old ophthalmic technician who started his career 10 years ago after 14 years as an operating room technician. Also a veteran of the US Air Force, he currently works at Stone Oak Ophthalmology in San Antonio, Texas. He assists Dr. Kristin Held and Dr. Allison Young in the operating room and performs all pre-op evaluations on our cataract candidates in addition to complete work-ups on our general ophthalmology patients.

When Kevin first joined our practice, his father had undergone a quadruple bypass procedure and had recovered with no further complications. I remember thinking at that time that heart disease runs in families, but gave it no further thought.

The Heartburn Sensation

Jump forward to the summer of 2012. On a Wednesday morning, I overheard Kevin complaining of heartburn. I asked him, are you ok? He said yes, but that he felt this sensation off and on for the past two weeks.

“I’ve taken different brands of antacids and it goes away. So, it must be heartburn because the feeling goes away,” he said.

“Gosh Kevin, are you sure?” I asked. “Yeah, yeah,” he said. “I’m okay.”

I thought to myself, could he be having a heart attack? Nah, I thought. I’m just overreacting.

Lisa Lenzy, COA, recounted Kevin told her “that day was different.” He remembered waking up in the middle of the night with the same heartburn, but also that morning his arm hurt. He blew that off by saying he must have slept on his it wrong.

Later, I walked past his office and saw him at the computer. He looked fine. An hour later, he stood in our patient dilating room and I saw Kevin clutching his chest and heard him telling Dr. Young, “I don’t feel well at all.” Dr. Young asked Kayley Kraft, an ophthalmic technician, to call 911. I asked Dr. Young, “Should I get Kevin some aspirin?” She said I should.

I went to the break room and grabbed the aspirin bottle and a glass of water and returned. Kevin swallowed two aspirins while Dr. Young listened to his heart with a stethoscope. Lisa had been checking Kevin’s blood pressure throughout the day and told Dr. Young that his blood pressure readings had been high. Kevin was breathing ok, but looked pale.

Enter the EMS

Suddenly, there was a bang on the back door of our office. EMS had arrived! They asked, “Where is the patient? I thought, “Kevin? The patient? My goodness, this could happen to anyone of us!”

When they reached Kevin, they asked questions, while setting up their equipment. I overheard Dr. Young tell them that Kevin’s father had heart disease. The EMS technician placed small patches onto his chest, attached electrodes, and then they looked at a small screen on their machine. Within a very short time Kevin was on the stretcher and being wheeled out of the office and into the ambulance. There was about a 10-minute delay before we saw the ambulance drive away toward the hospital.

While Kevin was on his way, Dr. Young, Lisa, and Kayley followed in their cars. Lisa called Kevin’s parents and soon they were on their way to the hospital, too.

I texted Dr. Held to tell her what was happening.

My text read: “Kevin is at the hospital. Chest pains this afternoon. We sent him off by ambulance. In heart cath lab now.”

“Thanks so much for the update. Dr. Young had called me. Keep me updated with any news. I am praying for him,” Dr. Held replied in a text.

Lisa texted me: “Doctor informed us he had two blocked arteries. Two stents.”

I copied and pasted same text to Dr. Held and she replied: “Thank God it is treated now. Wow, close call. God is good. Great job by you all. You saved his precious life.”

I texted back: “Thank God he was at work and Dr. Young acted quickly!”

Dr. Held replied: “Yup! Can you imagine if he had been home alone? No more foot-longs or double meat and cheese!

All of us worked together that day to get Kevin to the hospital in time. The doctors told him two more hours and, well, I can’t even write what they said. Perish the thought!

Not Quite the End

And that’s not the end of this story. One and a half weeks later, Kevin returned to work for about six hours. He went home early, he said he was tired. The next morning around 2:00 am he was returning to the hospital by ambulance, this time with his son in the front seat of the ambulance next to the EMS driver, and Kevin had a third stent placed in his artery later that morning.

After another week off and, finally, the correct combination of oral medication, a change in diet, and just taking better care of himself, Kevin was back seeing patients and performing as a valuable member of our team.

The National Heart Lung and Blood Institute website states: “Heart attack pain sometimes feel like indigestion or heartburn.”

Webmd adds, symptoms of a heart attack include:

■ Discomfort, pressure, heaviness, or pain in the chest, arm, or below the breastbone

■ Discomfort radiating to the back, jaw, throat, or arm

■ Fullness, indigestion, or choking feeling (may feel like heartburn)

■ Sweating, nausea, vomiting, or dizziness

■ Extreme weakness, anxiety, or shortness of breath

■ Rapid or irregular heartbeat

Increasing Awareness

I’ve always worried one of our elderly patients could have heart attack in our office. I never imagined a co-worker would! I share this story because we all should be aware that it could happen to anyone. Ophthalmologists, technicians, receptionists, office managers, anyone our offices. OP

Ms. Flaherty is a Certified Ophthalmic Medical Technologist at Stone Oak Ophthalmology in San Antonio, Texas. She is owner of Ophthalmic Seminars of San Antonio and conducts instructional seminars to ophthalmic assistants and technicians in Texas and nationally. She is currently the JCAHPO representative on the board of Directors of the Association of Technical Personnel in Ophthalmology (ATPO). You contact Sergina by visiting her website www.ophthalmicseminars.com