The chain of survival: How a fire chief who suffered 2 sudden cardiac arrests beat the odds

A month after his son initiated CPR for his first SCA, Wayne Kewitsch suffered a second medical emergency while driving

Sudden cardiac arrest (SCA) is the third leading cause of death in the United States. In fact, every 90 seconds, someone dies from SCA.

These incidents usually happen outside of a hospital and survival is largely dependent on bystander intervention. If a bystander does intervene by performing CPR, then survival rates often double or even triple. The key is to initiate treatment within the first minute.

However, nearly half of all SCA victims will not have someone nearby to help them in their time of need, and nine out of 10 SCA victims die.

These are not favorable statistics, but survival is possible – just ask Wayne Kewitsch.

He beat the odds – twice.

WAKING UP IN THE AMBULANCE

Kewitsch started as a paid on-call firefighter in St. Louis Park, Minn. in 1995. Previously, he had been an EMT and worked for a private ambulance company in Chicago while he was attending college. In 2000, he was hired by the Richfield (Minn.) Fire Department. He worked his way up as a lieutenant, assistant chief and became chief in 2011.

Kewitsch’s 20-year career with the department had been uneventful in terms of his health – up until July 1, 2020. On that Wednesday, he was off duty, but had worked the day before. He was planning to take the rest of the week off to enjoy an extended Fourth of July weekend.

While he was walking back from taking the garbage to the curb, he felt something strange. It only lasted for about 15 seconds and then it was gone.

"It felt like there was a steel bar right on my sternum and somebody was standing on it," Kewitsch said.

But since the feeling went away as quickly as it appeared, Kewitsch shrugged it off and attributed it to a bout of reflux he had previously dealt with.

"I went back into the house to eat some yogurt, sat down in my chair and started to send some emails," he recalled. "The next thing I remember is waking up in the ambulance as we're going Code 3 to the University of Minnesota."

Kewitsch was later filled in on everything that happened before he woke up in the ambulance.

"My wife, who was working from home due to COVID-19, came out to get her coffee," he said. "She heard my agonal breathing and screamed for our son, who was also home from college due to COVID-19."

They laid Kewitsch down on the floor and his son started doing hands-only CPR – a skill he was taught by Kewitsch as a Boy Scout.

THE WIDOWMAKER

As his son, Jack, was doing compressions, his wife, Ruth, called 911.

"And, of course, my address is tagged in the CAD system," he said. "The lieutenant on duty recognized the address and he's like, 'That's the chief's house.'"

Crews from Edina responded to Kewitsch's house, including two police officers, two medic rigs and an engine company.

"There were five or six medics working on me in the back of the ambulance. They shocked me once at home. I went back into VF and they decided that they were going to take me to the University of Minnesota, where they're doing ECMO for people that are in refractory VF."

The Edina medics also used a device called the EleGARD, which is used for device-assisted head-up CPR. "It raises the torso so you can get head-up CPR. It reduces the intracranial pressure and you get much better perfusion," Kewitsch explained.

Kewitsch regained consciousness and started talking to one of the medics. "His dad and I worked together and he had just retired recently," he said. "He's like, 'Chief, Chief,' and I look up at him – and I'm in VF – and I say, 'Say hi to your dad for me.' And then I hear them go, 'OK, Chief, this is going to hurt.'"

They shocked Kewitsch once more and he became conscious again. "That time, I converted and stayed in sinus rhythm. So, I was talking when I got to the cath lab; I was sitting up and able to get myself over onto the table."

It turns out Kewitsch had an 80% blockage of his left anterior descending coronary artery, which is also known as the widowmaker. He spent a total of 51 hours in the hospital and was discharged for the Fourth of July weekend.

"I came home and started cardiac rehab," he said. "I was doing everything I needed to do because I was planning on going back to work."

But a month later, on August 21, he suffered a second sudden cardiac arrest.

“EVERYTHING WENT GRAY”

By this point, Kewitsch was doing cardiac rehab three times a week. He was walking two miles on the days off and was feeling good. On the morning of Aug. 21, Kewitsch was driving with his wife to a friend's cabin when "all of a sudden, everything went gray."

"My wife looked over because the car started to veer a little to the right. She looks over and she's like, 'Oh, not again.' And she grabs the wheel and steers us off the highway."

At the time, they were driving 60 mph on a two-lane highway. His wife was able to steer them off the highway, but they ended up about 40 yards into a cattail marsh.

The occupants of a car behind them noticed what had happened.

"The car behind us was a younger couple and the wife, Emily, is a nurse," Kewitsch said. "She tells her husband, Matt, 'Pull over, something is wrong,' and she hightails it into the marsh. Matt calls 911 and is trying to figure out where we are because we had taken out the street sign."

Emily started doing compressions on Kewitsch in the front seat of his Nissan Rogue.

Monte Fronk, Mille Lacs Band’s emergency response coordinator, arrived on scene moments later.

"The first one on scene with an AED was the emergency management director – he's also an EMT – and they throw the AED on me and they're taking turns, alternating doing CPR on me and the bag valve mask. They ended up shocking me seven times."

After the seventh and final shock, Kewitsch regained consciousness. "They popped the IO in and I yelled so loud. I can remember Ruth saying, 'Pain is good. Stay with me,' and they threw me on a backboard."

Medics had to carry Kewitsch through the marsh and back out to the ambulance. Crews drove to a nearby city, Onamia, where a medevac helicopter was waiting for him.

"I remember getting out of the ambulance, being wheeled over to the chopper and getting into the chopper," Kewitsch recalled. "They told me it was a 30-minute ride to the University, so they were going to take me back to the University of Minnesota."

They did another angiogram and, this time, everything was clean.

"They ended up doing an electrophysiology study and they found an errant pathway, which they took care of. They ablated and implanted a defibrillator. They also did an MRI and discovered that I have no scar tissue in my heart. There's no ischemia, so they don't really know what caused that second one."

Once the defibrillator was implanted, Kewitsch's firefighting career had ended.

LEAVING THE FIRE DEPARTMENT

In January 2021, Kewitsch became the executive director of the Minnesota Firefighter Initiative, an organization dedicated to providing firefighters with the necessary tools to prioritize and protect their health and wellbeing.

Wayne Kewitschabout 10 months ago

Ruth and I met two heroes today.

As many of you are aware I suffered a second out of hospital sudden cardiac arrest four weeks ago today.

We were going to spend the weekend with friends at their cabin in Crosslake and left shortly after I returned home from cardiac rehab. We were driving north on 169 and were just a few miles north of Grand Casino when everything went gray. The best way I can describe it is all I could see was similar to the scratchy gray and white blur that is at the beginning of every HBO show. I started to turn the wheel slightly to the right and that is the last thing I remember until I obtained return of circulation.

Ruth looked over and saw that I was unconscious, she grabbed the wheel and steered us into a swampy area adjacent to the highway. We ended up approximately 40’ inside the swamp in 2’ of muck surrounded by cattails.

Two incredible people that were driving behind us pulled over, called 911 and waded in to help. Emily is a nurse at Mercy Hospital and she was the first one to reach me and started doing compressions on me in the front seat of the car while her husband, Matt, called 911 and worked on getting better access to the car.

Several law enforcement officers arrived but none carried an AED. Fortunately Monte Frank, Emergency Management Director for the Mille Lacs Band of Ojibwe, arrived with his AED. I’ve known Monte for 15 years. A BLS rig arrived followed by an ALS rig. The medics tromped through the muck bringing their monitor and other equipment to the car. I received a total of seven shocks. I obtained ROSC after the 7th shock and that’s when they were able to get an IO into my left leg (I now have matching IO scars). The IO insertion was painful enough that I screamed out; I can remember Ruth telling me to be that it’s good to hurt and to stay with them.

They placed me on a backboard and hauled me out to the ALS rig. I found out today from Emily and Matt that a retired St. Paul firefighter was on scene and assisted with them carrying me out. In the rig I can remember yelling for Ruth. I hear her in the front seat to telling me to calm down and let them help me. I don’t remember the Code 3 drive to Onamia but I wake up as they’re rolling me to the helicopter, it’s running hot, ready to go. Ruth tells them to take me to the University of Minnesota, they get me loaded, place a headset on me and tell me it’s a 30 minute flight.

We arrive at the U and I’m brought straight to the Cath Lab where I once again meet Dr. Yannopoulos, I thought about making a joke about “warranty work” but considering what he was about to do I thought better of it. They determined that my arteries and stents are in great shape so they believe it is some type of arrhythmia.

While this was happening, Ruth was being driven to Elk River by Mille Lacs County Sheriff’s Investigator Jason Gallion where she was met by RFD Asst. Chief Mike Dobesh who drove her the rest of the way to the U.

The following Monday I had an MRI done along with an electrophysiology study which located an errant pathway which they ablated. The MRI determined that I have no heart muscle damage which means my first event wasn’t an MI. They also implanted and internal cardiac defibrillator (ICD) so this should hopefully never happen again.

My ICD communicates with an app on my phone via Bluetooth so now I’m “discoverable” and part of the Internet of Things…..not so sure about that yet. I truly believe part of my outcome was due to the fact that I was “heads up” while they worked on me; kind of a DIY EleGARD (see attached pic).

This afternoon Emily and Matt Roeder stopped by our house. Ruth was able to “re-meet” them and I was able to meet them for the first time. I can’t begin to put into words the how much I appreciate what they did for me that day. I probably wouldn’t be here if they hadn’t stopped and knew what to do. They along with the ENTIRE chain of responders and medical personnel were there for me as they would be for anyone.

I owe all of them my life.

#kewitschstrong #HeadUpCPR #umn_resuscitation #learnCPR #RFD

not ignoring warning signs – no matter how big or small.

"I think one of the reasons firefighters deny warning signs is that they're afraid it's going to be the end of their career. And it could be. But would you rather be alive and able to spend time with friends and family or be dead?"

For Kewitsch, the answer to that question has always been a no-brainer.

"One of the doctors came in after my first surgery and said, 'You should go buy a lottery ticket.' I said, 'Doc, I already won the lottery.'"

About the author

Sarah Calams, who previously served as associate editor of FireRescue1.com and EMS1.com, is the senior associate editor of Police1.com and Corrections1.com. In addition to her regular editing duties, Sarah delves deep into the people and issues that make up the public safety industry to bring insights and lessons learned to first responders everywhere.

Sarah graduated with a bachelor's degree in news/editorial journalism at the University of North Texas in Denton, Texas. Have a story idea you'd like to discuss? Send Sarah an email or reach out on LinkedIn.

Posted by mike.ittnerMay 4, 2021 at 6:04 AM

This may sound petty, Monty Fronk did an exceptional job however, the Mille Lacs EMS Crew seems to be suspiciously absent in this event. I was not on scene, But I did speak to the crew present. They were very much invested in this call and I believe they need to be credited as well. This was a great example of TEAM WORK in action! Not just the actions of 1 individual.