A Life Saved, and Saved, and Saved Again

Patient grateful for extraordinary coordination, life-saving care.

Valerian D’Souza was no stranger to pain. He had been experiencing stomach problems for several years. He chalked it up to eating certain foods, took his medication and hoped for the best. On a Sunday in April, Valerian’s day took an unexpected, life-threatening turn. He was having stomach discomfort, but medication brought no relief. His son took him to a nearby freestanding emergency department, ER at Spanish Springs, an extension of Northern Nevada Medical Center^®.

When he arrived, medical staff brought him to a treatment room  and started to assess his condition. Before they could start an EKG and draw blood, Valerian went into cardiac arrest. Emergency medicine physician Karyn Liebsch, DO, started CPR. “It was a complicated resuscitation. We were doing CPR and also using a defibrillator, which sends electrical shocks to the heart,” she says. “We were not getting any response from the patient for several minutes, but then we started to pick up some faint vital signs, so we began trying to stabilize him.”

All hands on deck

A nurse called for emergency transfer to take Valerian to Northern Nevada Medical Center, but, again, he went into cardiac arrest. Dr. Liebsch was then joined by Firefighter/Paramedics from the Truckee Meadows Fire Protection District. Valerian was intubated and the team administered medications to help restart his heart and continued with CPR.

The paramedics brought in a LUCAS device, which does mechanical chest compressions on patients suffering from cardiac arrest, according to TMFPD Division Chief Joe Kammann. “Manual CPR is physically demanding, which can result in inconsistent chest compressions the longer it needs to be done,” he says. “But the LUCAS device allows medical staff to focus on other interventions to help try and save the patient.”

What is a LUCAS device? 

The Lund University Cardiopulmonary Assist System (LUCAS) is an easy-to-use machine that helps medical professionals deliver mechanical chest compressions to patients in cardiac arrest. It frees up nurses and doctors to focus on additional interventions to help save lives.

For close to an hour, Dr. Liebsch, two paramedics and two nurses worked frantically to save Valerian’s life. “Just when we thought we had a pulse, he would go into cardiac arrest again. We were very motivated to get him stabilized so he could be transported to Northern Nevada Medical Center,” she says.

Dr. Liebsch called ahead to the hospital to alert doctors of Valerian’s condition while the paramedics prepared to transport him. Kammann says one paramedic maintained life support during the transit. “He was ventilating the patient by hand, administering sedatives, had the LUCAS device on standby, was calibrating heart medications and monitoring an external pacemaker,” he says. “They arrived safely at the Northern Nevada Medical Center ER, where specialists were waiting for him.”

Cardiologist Thomas Truong, DO, was one of those specialists. When Valerian was brought in to the ER, he had another cardiac arrest, and was promptly revived. “The patient’s heart rate was low and he had no pulse, so we administered more medication and put in a temporary external pacemaker to keep his heart rate stable,” says Dr. Truong.

View ER Wait Times at Northern Nevada Health System →

A trip to the cath lab

Valerian was immediately taken to the catheterization lab, where Dr. Truong found that the artery that feeds the part that controls heart rhythm was 100% blocked. “That explains why the patient had become so unstable. When you have no blood supply, it can affect the heart rhythm and rate,” he says. “But we were able to restore blood flow and place a stent in that area.”

Dr. Truong says Valerian’s care and the extraordinary measures taken by Dr. Liebsch, the nurses and EMS were straight from a medical textbook. “Dr. Liebsch wasted no time in intubating Mr. D’Souza and calling for assistance,” he says. “Between them and our team here in the hospital, it was great communication the whole time. And we were able to save Mr. D’Souza’s life.”

Such expert coordination isn’t left to chance. Medical staff, including an EMS representative, participate in monthly meetings to review patient cases. “We look at every case thoroughly to see if anything can be improved and continue to create best practices,” Dr. Troung says. “I grew up in Reno, and this community means a lot to me. If there is anything we can do in a collaborative fashion that improves the quality of life and saves lives, that is what we strive for.”

A team effort

Dr. Liebsch emphasizes that Valerian would not have made it to the hospital alive without the assistance from the paramedics. “It was a true team effort!” she says. And one with a unique twist. “People normally call 911,” says Kammann, the Division Chief, “but in this case, it was an ER calling for assistance. It is a great example of community collaboration, because our resources are here to help everyone.”

Today, Valerian has no stomach pain, and he is back to work and exercise. He is humbled by the heroic efforts of those who helped save his life. “I am so grateful for all of the doctors, nurses and paramedics who took such great care of me. They really went the extra mile,” he says. “I also had a wonderful patient experience here, and recommend it to anyone, especially if you are having a heart issue.”

Northern Nevada Health System offers 24/7 ER care in four close-to-home locations in Reno and Sparks, featuring shorter wait times, easy access and convenient parking.

If you are experiencing a medical emergency, dial 911 or get to the nearest ER.

Heart attacks in men and women

Recognize the signs and symptoms

According to the American Heart Association, men and women often experience different heart attack symptoms. Timing is critical for anyone experiencing a possible heart attack, since 85% of heart damage occurs within the first two hours of a heart attack.*

Learning how to recognize the symptoms of heart attacks can greatly increase your chances of survival.

Heart attack symptoms in men

Men often (but not always) experience what are known as “classic” signs of a heart attack:

• Discomfort in the center of the chest that may feel like pressure, squeezing or fullness that goes away and comes back
• Chest discomfort accompanied by fainting, lightheadedness, shortness of breath or nausea
• Pain that spreads to the neck, shoulders or arms

Other symptoms of a possible heart attack can include (and are similar to women’s symptoms):

• Cold sweats
• Feeling of indigestion
• Sudden dizziness
• If you previously had symptoms, are they recurring more frequently or stronger?

Emergency Services at Northern Nevada Health System →

Heart attack symptoms in women

Only 50% of women who have heart attacks get chest pain.** Women are more likely to experience:

• Pain in the arm (especially left arm), back, neck, abdomen or shoulder blades
• Upper back pain that travels into the jaw
• Nausea, vomiting or dizziness
• Unusual fatigue, sometimes with shortness of breath
• Shortness of breath or breathing difficulty
• Palpitations, paleness or cold sweats
• Mild, flu-like symptoms

If you or someone you know experiences these symptoms, or if something doesn’t feel right, DO NOT WAIT. Call 911 immediately.

*Society of Cardiovascular Patient Care

**American Heart Association