A 21-year-old SCA patient beat the odds when resuscitated by his college peers

A 21-year-old SCA patient beat the odds when resuscitated by his college peers

Twenty-one-year-old Walter Watts was on his college campus when he suffered sudden cardiac arrest.

Twenty-one is the age that many graduate from college … are able to drink alcohol legally … and are considered adults in every way in the eyes of the law. The milestones you reach at 21 shouldn’t include sudden cardiac arrest (SCA). However, undergraduate Walter “Josh” Watts is one of the fortunate patients in his age group who experienced SCA and survived.

The last thing Watts remembers happening on Tuesday, February 7, 2012, was walking into his first class of the day at College of the Ozarks in Point Lookout, Missouri—about an hour and a half before his heart went into ventricular fibrillation. He learned from his professors later that he was acting perfectly lucid and normal in class that day and when he arrived for work at the Pfeiffer Science Building. But his memory is a blank. Watts had just started his work assignment, grading papers, when Associate Professor of Psychology Sheryl Haile, MEd, heard him hit the ground. Thinking he was having a seizure, she called the on-campus fire department, which is staffed entirely by students. Her call came into the firehouse at 11 a.m., and Chief Gavin Harnstrom and Dakota Williams—both seniors at the college—responded in their rescue vehicle within three minutes, meeting fellow responders Jessica Messer and Dalton Trussell on the scene. The responders knew instantly that the call was wrong—this was no seizure. Watts had turned blue, struggled to breathe and didn’t have a pulse. “For a few seconds, my thoughts were chaotic,” admits Williams. “We were expecting a seizure, and I’d only seen something like this in an ambulance when there were paramedics around. It took me five or 10 seconds to gather myself.” Harnstrom says that on arrival he, too, immediately grasped the unexpected situation, “I froze for a second, and I said ‘OK, it’s time to go to work.’” He asked his crew to start CPR and turned on the AED as soon as Williams had attached the electrode padsto Watts. “When it advised a shock, we all looked at each other,” says Williams. “We couldn’t believe it. Here was a kid younger than we are, and he needed to be shocked.” After a single shock, Watts began breathing again, albeit with a bag and mask still on. At this point, the college’s registered nurse had shown up with a second AED, and the local EMS service had arrived. They transported Watts to nearby Skaggs Regional Medical Center in Branson, Missouri. The total time from when the campus firehouse received the call to arrival at the emergency department was less than 15 minutes. “I was glad the paramedics came and took over, because to tell you the truth, I was kind of sweating,” says Harnstrom. “I was hoping I’d done the right thing. Here’s a healthy, 21-year-old kid, and the AED wanted us to shock.” The school nurse later took the AED to a local ambulance company to get the readout, and it verified that Watts had, in fact, been in ventricular tachycardia (v tach). “So it would have been much worse if we hadn’t shocked him,” says Harnstrom.

Student Responders at Work Of the student responders on the scene, some were trained volunteers, and others were working for college credit. All students at the College of the Ozarks participate in the unique Work Education Program, working 15 hours each week plus two 40-hour work weeks, rather than paying tuition. The campus Point Lookout Fire Department is “staffed” with four student officers who put in their time toward this program, and the remaining department members—all students—are volunteers. “We typically have about 13 or 14 students in the department, but that February we only had nine,” says Gavin Harnstrom, who was chief of the fire department the semester they received the call about Watts’ emergency. All students who join the department receive one semester of EMS training, after which the rest of the members vote on whether they’ll continue. And all members undergo training every semester, including refreshers in CPR and using an AED, for which Williams says he is grateful after being faced with an unexpected SCA. “We all knew how to use the AED, although it’s pretty foolproof,” he says. Student members of the department may decide to earn EMT certification as part of their training; Williams was one of the responders that day who had completed an EMT course through the Mercy medical system in nearby Springfield, Mo. The SCA call was definitely out of the ordinary for the young responders, who aren’t equipped to transport patients. “We mostly treat a lot of sprained ankles and wrists, and some cuts,” explains Harnstrom. The 9-1-1 calls to the department are actually 3-3-3 calls. Anyone can pick up a landline on campus and dial “3-3-3” in an emergency, which is what Dr. Haile did when she believed Watts was having a seizure.

The College of the Ozarks campus is small enough that the firehouse is just one block from the science building where Watts was—and small enough that most of the students know each other. Watts says he knew three of the four responders and is good friends with two of them. “I just can’t believe what they did for me,” he says. “They literally gave me the gift of life.” Diagnosis: TBD The cause of Watt’s SCA remains uncertain. He and his parents were unaware of any heart conditions, genetic defects or family history of sudden cardiac arrest, so the incident came as a complete surprise. However, Watts admits that for years, he had experienced heart palpitations and a fast heart beat (tachycardia) when exerting himself. He didn’t realize it was abnormal, so he never mentioned it. He says he felt heart palpitations the morning of his brush with death. It took two days for Watts to regain full consciousness in the hospital, after which he underwent an angiogram and other studies. The results were inconclusive, and after a week, he was

sent home with a wearable heart monitor and defibrillator as a temporary safety measure. Four months after the event, Watts reported that his doctors are “still batting around ideas” about what caused his arrest. They’re testing him, both parents and his 14-year-old brother Caleb for genetic diseases, such as Brugada syndrome, characterized by abnormal electrocardiogram findings. Another strong theory is that the arrest was a symptom of Wolff-Parkinson-White (WPW) syndrome, a heart condition in which an extra electrical pathway in the heart can cause a rapid heart rate. Watts did, in fact, have an extra pathway, and doctors performed a catheter ablation and used radio frequency to destroy the pathway’s opening and prevent it from re-growing. “I guess the extra accessory pathway was highly unusual,” says Watts. “It went from the bottom of the heart to the top, which is rare. That’s why my doctor, Dr. Arpana Chela, sent me to Barnes-Jewish Hospital in St. Louis for a second opinion.” Because of the high risk that an as-yet unidentified genetic disease would cause a recurrence, Watts underwent surgery to get an implantable cardioverter defibrillator (ICD), which will probably be permanent, depending on the ultimate diagnosis. He says six weeks after the surgery that he has recovered enough to raise his arms over his head. More importantly, he no longer has an irregular heartbeat and is able to be more active than he was before the event. He exercises every day, including frequent kayak runs on Binder Lake and hiking around the Jefferson City area. And without the heart palpitations that prevented him from running, he jogs regularly now. “My only restrictions [with the ICD] are that I’m not allowed to swim or drive for six months because of the risk of having a second cardiac arrest,” he says. “And I’ll never be able to be a commercial driver or pilot and can’t operate a jackhammer. I guess I’m also supposed to watch out for magnets.”

Looking toward the Future What does the future hold for this young SCA patient and his rescuers? Watts, currently home with his parents in California, Missouri, has one more year at the College of the Ozarks before he completes his bachelor’s degree. Then, he plans to enter a master’s program and ultimately work in the field of psychology. “I’m so eager to be driving, and to be back in school,” he says. “I just want to be more present in life. As soon as I can drive again, I’ll go [to Springfield] to see what Gavin and Dakota are up to. I’m looking forward to catching up with them.” Williams graduated the spring after the SCA call and soon after was hired as an EMT at Springfield’s Mercy medical system. As of June, Harnstrom was looking for a similar position. When asked about his interest in EMS, he said, “I’m trying to get a job in a fire/EMS service right now. I love this!” The medical emergency that struck on February 7, was a milestone in the lives of all the students present. It cemented the certainty that Williams and Harnstrom had for entering the field of EMS and continuing to save lives. As for Watts, he is aware of the tremendous second chance he has been given and is eager to learn CPR and the proper use of an AED. He will push for more AEDs in Missouri’s schools while continuing his college education.

Walter Watts and other young survivors of sudden cardiac arrest (SCA) face not only changes in their health and behavior, but also changes in their ways of thinking about themselves and about life. Lauren D. Vazquez, PhD, is a clinical psychologist at Ochsner Medical Center’s Department of Psychiatry (New Orleans) who specializes in cardiac psychiatry. “We think of cardiac events as being more in the experience of an old man than a young person. This incongruity really challenges a young patient’s idea of life and prompts different ways of thinking,” she says. “Like any other trauma, sudden cardiac arrest can have an impact.” It’s easy, if not natural, to feel victimized by the event. A young person may mourn the loss of his or her previously healthy, normal life. Vazquez outlines three typical reactions a young SCA survivor may experience: Emotional: Surviving the event results in a lot of anxiety. Survivors wonder, “Am I safe?” “Is it going to happen again?” “Do I need to start thinking about the end of life?” Behavioral: There may be avoidance of the place where the SCA occurred. If the person was at the gym, he or she may avoid returning to the gym; if it was in the mall, he or she may resist going to the mall. Avoidance is an attempt to control the uncontrollable. By not returning to the scene, the survivor believes, at some level, he or she is avoiding a second SCA. Social: There may be one of two extremes. Some SCA survivors isolate themselves and avoid contact with others, while others may not want to be alone, for fear it will happen again. Either way, this can limit their quality of life. It is also common to see sleep issues; many cardiac survivors have a fear of going to sleep. Vazquez also identifies three “resiliency factors,” or changes in outlook and attitude that can help survivors live happier lives: 

1. Make the shift from victim to survivor. “They have to challenge their perspective of what happened and what they’re still going through,” says Vazquez. “All the medical investigations that occur afterward can be frightening and add to the trauma. You have to be able to view this as positive.” This is not always easy, she warns. 

2. Develop “quality of life prescriptions” and take them as regularly as you take medical prescriptions. Take time for the things that make life better. “People who have experienced sudden cardiac arrest have a second chance at life,” says Vazquez. “Their focus is on making that life count and enjoying every moment.” 

3. Seek an active, positive approach. “People who manage this will do well. It’s a process, to change your mindset,” says Vazquez. For more information, visit www.sca-aware.org/campus.