Fast-acting 'chain of survival' saves man from sudden cardiac death at Worthington Community Center

Columbus resident Lee Caryer recalls walking the indoor track at the Worthington Community Center on East Wilson Bridge Road the morning of June 25, much like he had done on many previous days.

Caryer, 75, set out to walk 4 ½ miles on the track, covering a mile with every 12 laps. Caryer got about 3 ½ miles in and said the last thing he remembered was sitting down to do some floor exercises.

“What I remembered was false,” he said. “My mind played a trick on me, because I didn’t. I fell down on my face.”

Without warning or prior symptoms, Caryer had collapsed from sudden cardiac arrest.

A center member walking behind him immediately called for help, according to the narrative of the incident Caryer acquired from talking to first responders and others who were there. Recreation center staff and other members rushed to his aid and called 911.

Recreation supervisor Kevin Timmons was down in the lobby when Caryer collapsed.

“I walked upstairs and found Lee laying down with a few staff around him,” he said. “They told me they couldn’t find a pulse and that he wasn’t breathing.”

Timmons, who is CPR- and AED-certified and helps train lifeguard staff at the community center pool, said this wasn’t the first time he has been in a situation like this. Timmons said he promptly began administering compressions and utilized the on-site defibrillator.

Timmons was able to reacquire a faint pulse after administering three-to-four rounds of compressions and two shocks from the automated external defibrillator, he said, just as personnel from the Worthington Division of Fire & EMS arrived, led by captain Peggy Dyas, the on-duty battalion chief that day.

“We swapped out equipment, they began putting medicine in him and they took him to the hospital,” Timmons said.

The 911 call came in at 8:36 a.m., Worthington medic Tyrone Stewart said, and first responders were on their way almost immediately. They got Caryer to the hospital at 9:07 a.m. – just 31 minutes later.

Lost time

Caryer recalled waking up in the Intensive Care Unit at OhioHealth Riverside Methodist Hospital on Olentangy River Road the morning of June 26, confused and wondering why he was there.

Approximately 26 hours had passed, Caryer said, and he had been on a ventilator.

“That was a pretty startling development,” he said. “It was disorienting.”

On June 28, one of his attending doctors came into his room, telling him, “a few days ago you died.” Caryer said he had spoken to other doctors in the days before but did not remember much before then.

“You talk about opening your eyes; that was a real attention getter,” he said.

Caryer said he was told he did not suffer a heart attack but rather sudden cardiac arrest – a condition that leads to sudden cardiac death unless emergency treatment begins immediately, according to the Cleveland Clinic. Sudden cardiac arrest is caused by a malfunction in the heart's electrical system, usually from an arrhythmia, or abnormal heart rhythm, and sudden cardiac death is the largest cause of natural death in the U.S. and responsible for half of all heart-disease deaths. according to the clinic website.

Caryer said he was told victims of sudden cardiac arrest have a 5% chance of survival.

“Once this happens, you have about four or five minutes to have your heart restarted, or you’re going to suffer serious problems or you’re going to die,” he said. “Fortunately I was at the (community) center where (an AED) was available, and it was my only chance.

“If this had happened to me at a theater, at a restaurant, driving my car ... I would have just died and that would have been it.”

Caryer had a small stent inserted and a defibrillator installed in his chest and was released from the hospital July 2, eight days later.

Chain of survival

Worthington fire Chief Mark Zambito said department protocol calls for dispatching an engine crew and a medic crew for emergency calls such as Caryer’s.

For Caryer’s emergency, this included an engine crew of Pat Toole, Bob Zvansky and Billy Rings, supervised by Dyas, as well as a medic crew of Stewart, Chelsea Carothers and Eric Erhardt.

Caryer’s survival was no accident, Zambito said. It was a result of the precision and effectiveness of the "chain of survival" employed in Caryer’s situation.

The chain of survival consists of a multitude of steps that must be done quickly and efficiently to increase the likelihood that a cardiac patient survives, according to the American Heart Association. This includes activation of emergency response, high-quality CPR, defibrillation, advanced resuscitation, post-cardiac arrest care and recovery.

In Caryer’s situation, recreation center staff and good samaritans were able to attend to him quickly and stabilize him before first responders arrived, and Zambito said that made all the difference.

“They pretty much met every checkbox in that chain,” Zambito said. “By the time our guys got there, he was already breathing.”

Once there, the Worthington Division of Fire & EMS – a department in which all members are certified EMTs, and many are paramedics – took over, Zambito said. When emergency personnel arrived, they quickly and efficiently provided Caryer advanced life support and transported him to the hospital, he said.

“The (recreation) center staff, they did the heavy lifting,” Zambito said.

He said HIPAA guidelines prevent him from elaborating more on the situation.

The biggest factor in determining life or death in these emergencies is time, Zambito said, and everyone who responded to Caryer that day made the most efficient use of it.

“Time is against you the second the person goes down,” Zambito said. “(It is) four to six minutes before you start having brain damage, so we want to get CPR going before that four-minute mark, whether it’s us or bystanders. It’s vital.”

First responders left the station at 8:37 a.m. after they were dispatched just a minute earlier, Stewart said. They arrived at the community center three minutes later at 8:40 a.m., and were on their way to Riverside Methodist with Caryer at 8:57 a.m.

Every second following "time zero" – the moment a patient goes into a cardiac arrest – is crucial, Stewart said.

"That's really when your clock is going to start ticking," he said.

Caryer said he is grateful for all the people who played a role saving his life that day.

“I had some people overachieving on my behalf,” he said. “Not only doing their job, but overachieving while they were doing it.”

A new perspective

Caryer said he was cleared of any restrictions by his doctor about a month after being discharged from the hospital and is back to himself, to the surprise of his friends.

“I’m virtually better than I ever was, except I’m a few months older,” he said. “ And that’s hard for my friends to believe because they know how serious it was.

“There’s been nothing that I’ve had that seems to be a consequence of what I went through.”

With this incident behind him, Caryer said, he has been a little calmer and taking things a little slower.

“I find myself being more patient with problems, more accepting of issues,” he said. “It’s not that I’ve changed totally, but there’s a significant shift.”

Caryer said he is back at the community center three to four times a week for exercise. His routine includes walking the track, doing floor exercises and riding a stationary bike.