“I remember being drenched in sweat, absolutely exhausted and just screaming in my head ‘come on man, you can’t die here!’”
This vivid account is how Flight Nurse Jessica Dalziel recalls the moments prior to one of the most unforgettable saves of her nursing career.
It all started one afternoon in June 2015. The National Association for Stock Car Auto Racing (NASCAR) was in town, and people had turned out in droves to Sonoma Raceway – a 12-turn, 2.5-mile road course located in the hills of Sonoma, California.
Every year, REACH designates a medical flight crew and helicopter to be on-hand at the raceway during NASCAR weekend. On this particular day, Jessica, along with Flight Paramedic Patt Wyckoff and Pilot Chris Coulter, were the appointed flight team.
The race had started without a hitch until one non-injury crash set things back slightly. The track crews had cleared the wrecked cars quickly, but just as the race was getting back underway, an emergency transmission came over the radio to the communications tower. The crew at the ninth turn were requesting emergency medical assistance – they had a man down. The man in distress was Keith Joseph, a tow truck driver for the raceway.
Keith had just returned to his post after helping clear the accident, when he suddenly passed out.
“I don’t remember much from that day,” said Keith. “From what I was told, I had just got back to the station, and when I stepped out of my truck, I collapsed.”
As the tower requested more information from turn nine, REACH’s Chief Medical Officer, and the official race physician for the day, Dr. Gary McCalla, was listening intently for a dispatch request. Shortly thereafter, the tower gave him the green light to head to the scene.
“When I got to the ninth turn, paramedics were already placing Keith on a backboard and loading him into the back of an ambulance,” said Dr. McCalla. “So I jumped in with them, and as we drove, we just started assessing him. We quickly figured out that he didn’t have a pulse.”
Keith was in cardiac arrest, and if he were going to survive, Dr. McCalla and the paramedics would have to work quickly.
The ambulance sped off toward the helipad as Dr. McCalla and the paramedics began CPR. Performing around 120 compressions per minute, they were working hard to keep oxygen flowing to Keith’s brain while they geared up the defibrillator.
Seconds later, the team cleared themselves from contact with Keith and delivered the first shock to his heart – it was unsuccessful. While Dr. McCalla and the paramedics were working tirelessly on Keith, the ambulance was requesting permission to cross the track while the race continued. When they received an “all clear” from the tower, they sped across the raceway toward the helipad.
When they pulled up next to the helipad, Patt and Jessica were waiting and ready to jump in and help.
“The ambulance came flying up to the helipad, the doors sprang open, Dr. McCalla was there doing chest compressions, and from there it just became a blur,” said Jessica.
As they switched off performing compressions, the team worked to get IV lines placed, medications started, and a breathing tube inserted into Keith’s windpipe. They were not going to give up on Keith easily. However, after several minutes of performing CPR, doubt started to creep into everyone’s minds.
“I didn’t want to stop CPR because I kept thinking about how young Keith was,” said Dr. McCalla. “If you stop, there is no going back, so I just kept on going.”
The team worked diligently, trading off performing compressions and watching the monitors, administering breaths using a bag, and administering medications. The scene in the back of the ambulance was organized chaos.
“We did another pulse check and he finally had a pulse, but his heart rate was really slow,” said Jessica. “Dr. McCalla and I gave him some medicine and performed CPR for another two minutes. I remember being drenched in sweat, absolutely exhausted and just screaming in my head ‘come on man, you can’t die here!’”
The team’s persistence and Jessica’s silent pleading paid off. After 30 minutes of CPR and several shocks from the defibrillator, the color slowly started to come back into Keith’s skin and his heart rate grew stronger.
As another rush of adrenaline kicked in, Jessica, Patt, and Dr. McCalla hurriedly prepared Keith for transport. Meanwhile, Chris was getting the helicopter ready for departure.
“It really came right down to the end,” said Chris. “They rushed him over to the helicopter, we got in and took off, and flew him over to Santa Rosa.”
Minutes later, Chris had the aircraft safely on the helipad at Santa Rosa Memorial Hospital. Thanks to a phone call placed by Dr. McCalla, the hospital was aware that the REACH team was on their way and they had a team of clinicians standing by waiting to escort Keith directly to the CATH lab upon his arrival.
After Jessica and Patt handed off care to the team at Santa Rosa Memorial, doctors placed Keith into an induced coma for three days in order to give his body time to rest. When he awoke, it was as if the heart attack had never happened. On July 4, Keith was healthy enough to go home.
“Keith is one of the rare ones,” said Patt. “This kind of outcome doesn’t happen very often, and I’ve been flying and working on a ground ambulance for a long time. He was definitely in the right place at the right time.”
Nearly two years later, Keith is happy to be back out at the track doing what he loves.
“Everything worked out for the best,” said Keith. “If it wasn’t for the response of the medical team at the race track, the outcome would have been totally different.”