13 Minutes: Casper woman saves husband as dispatcher coaches her through CPR
By Kristy Bleizeffer Jun 28, 2016
Enrico Jay Foss, 53, followed his typical routine: He came home, did his regular P90X workout, and ate dinner with his wife, Francine. That night, April 13, it was grilled steak with a side salad.
The couple talked about the work they needed to do as the weather finally turned to spring. Jay was in a great mood, Francine said. He walked toward the bathroom, but came right back and sat on the bench at their dining room table.
“I don’t feel so good.”
“Do you want me to call somebody? What is going on?” Francine asked, but that was all she had time for. She caught Jay as he slumped to the side — eyes fixed and limp. The telephone crashed to the floor, causing its battery to fall out. She laid Jay on his back next to the table. Then she ran to the bedroom to retrieve another receiver. She dialed 911.
“He’s not breathing effectively,” the voice on the other end said after a quick triage. “We have to start CPR. Are you ready?”
Francine didn’t know if she was. Like 70 percent of Americans, Francine didn’t know CPR.
Few Americans would know what to do if someone collapsed in front of them, despite the fact that nearly 80 percent of out-of-hospital cardiac arrests happen inside the home. It’s an odds-on favorite that if someone does collapse in front of you, it’s someone you love and live with. According to the American Heart Association, immediate CPR can double or triple their chance of survival.
Francine had no time to be unsure.
“Listen carefully,” the voice on the phone instructed. “We’re going to start mouth-to-mouth.”
First time for everything
Jacci Warne, shift supervisor and lead dispatcher of the Casper Public Safety Communications Center, had three trainees on the night of April 13. So, it was the fire dispatcher who answered the 8:07 p.m. call: A woman reporting an unconscious male, about 15 miles west of downtown Casper.
The dispatcher called on ambulance, fire, sheriff and Wyoming Life Flight to respond. Then, she transferred the call to Warne.
Warne has been a dispatcher for 18 years, 16 years of those in Casper. As a certified Emergency Medical Dispatcher, she knows coaching someone all the way through CPR is a long shot.
“Generally, when you’re calling 911, it’s one time in your life and it’s the worst time of your life. Your emotions are all over the place,” Warne said.
Most people never calm down enough to start CPR or they are reluctant to follow instructions. They may interrupt and ask whether help is on the way, Warne said. While first responders typically arrive on scene within two to three minutes within Casper city limits, it can take longer for out-of-town callers who tend to tire or give up too soon.
Warne had never coached someone all the way through CPR before she encountered Francine Foss from the other end of her telephone line.
With Warne counting to keep the pace, Francine straddled her husband’s torso and administered 30 chest compressions —two per second, at least two inches deep. Then, she moved to his shoulder, tilted his chin back and gave two full breaths, each about a second long.
Then she did 30 more compressions.
And gave two more breaths.
Together, Warne and Francine kept it up for 13 minutes.
“It is a very long time,” said Andrew Sundell, a firefighter and paramedic with Casper Fire-EMS. “As first responders, we switch out every 2 minutes.”
Help on the way
Toward the end, Francine did begin to tire.
“Get someone here with oxygen or something because I think I’m wearing out,” Francine told Warne over the phone, 13 minutes in.
“He is coming. He’s on your road,” Warne answered.
Francine looked out her front patio to see a Natrona County sheriff’s deputy running in. It was Deputy Sheets, according to the incident report, the first responder on the scene.
“Stand clear,” he said.
Sheets jolted Jay with an AED and resumed CPR, followed soon after by Wyoming Medical Center paramedics and Natrona County Fire District Squad Seven. Life Flight One arrived about 10 minutes later and departed with Jay within about 20 minutes. They arrived at Wyoming Medical Center at 9:02 p.m.
The American College of Cardiology recommends less than 90 minutes in door-to-balloon time – the time from when a patient arrives at the Emergency Room to the time a device is inflated in the blocked heart vessel, allowing blood to pass through. WMC averages about 45 minutes, within the top 10 percent of hospitals in the country. Time means muscle, the saying goes, because the quicker the blocked heart vessel is opened, the less heart muscle is lost.
Jay Foss suffered ventricular fibrillation —a quiver in his heart’s lower chambers — causing acute myocardial infarction. It is the most serious cardiac rhythm disturbance because the heart can’t pump blood and goes into cardiac arrest. He required more AED shocks on his way to Wyoming Medical Center to keep his heart going, and his first electrocardiogram (EKG) was delayed because his heart stopped altogether. But when he was rushed to the Cardiac Catheterization Lab, his blocked artery was opened within 49 minutes.
As WMC’s cardiovascular service line coordinator, Mica Elmore, R.N., has seen her share of heartbreaking stories. This one was different, and one the team will all remember, she said. In all, nearly 30 people from five different agencies worked to save Jay’s life.
“On April 13, the emergency services in Natrona County all came together. Francine Foss called 911 and dispatch instructed her through CPR until emergency responders arrived. Jay Foss was transferred to Wyoming Medical Center still clinging to life. It took the team from the ER to the heart cath lab to save him,” she said. “It all happened in less than two hours. I can’t think of a better example of how the emergency services in Natrona County work together.”
And it started with a call from Francine Foss, a wife who refused to give up.
“I am not shocked, just because that is the way she is,” said Jay Foss of his wife. “She does not panic.”
Everyone should learn CPR
Jay Foss recovered quickly, surprising many of his caregivers. But one thing is certain: Without the immediate commencement of CPR, he would not be alive.
“The piece we are usually missing in the system is somebody like Francine starting CPR,” Sundell said. “If it takes us five minutes to get to someone, and if there is nothing going on during those five minutes, it makes a huge difference in their care.”
If more people were trained and willing to start CPR, more lives could be saved. That’s why Wyoming Medical Center is offering free CPR classes on the fourth Saturday of every month, beginning July 23. The class will focus on chest compressions only since many people are reluctant to give mouth-to-mouth ventilations to strangers. The latest research shows that the compressions are the most important aspect to CPR anyway, especially within the first several minutes.
“Any healthy person who falls over from a heart attack, they probably already have enough oxygen in their system for about 6 to 10 minutes,” Sundell said. “You do not even need to breathe for them for that time frame. All you need to do is compressions to circulate the blood and the oxygen.”
The abridged class will be free and open to anyone who wants to learn.
As for Francine Foss, she can’t get over how the system worked together to save one life.
“We just cannot thank everyone enough. From the 911 dispatcher, to Deputy Sheets and the fire department, to the paramedics and flight crew, and to the doctors and nurses at Wyoming Medical Center. It would not have been possible without them,” Francine said. “My 911 operator, I just love her. It was her. Her voice, her pacing and keeping me on track that kept me going. I had never done CPR before.”