Vail Daily letter: Unsung heroes of the Vail Valley
It was with great interest that I read the article of the “miracle man” that appeared in your April 7 edition of the Vail Daily. The readers of the Vail Daily should know that this was a report written in the Salisbury Independent newspaper out of Maryland. I would have entitled the article “Miracle men and women of the Vail Valley.” There were several inconsistencies that did appear in the article that I would like to clarify for the Vail community to provide insight into the “unsung” heroes of this story.
Mr. Peter Roskovich, while skiing with his friend, local Mark Tamberino, sustained a heart attack, which was complicated by ventricular fibrillation, or sudden cardiac death. Mr. Tamberino quickly recognized the situation and began administering CPR. Another skier, who was nearby, witnessed this event, and happened to be an emergency room physician, also began assisting in the CPR process.
The Vail Mountain Ski Patrol was immediately notified of the event and sprang into action. Ian King was the first patroller on the scene, and soon after, other patrollers joined, bringing with them medication and the most important device, an automated external defibrillator (AED). Mr. Will Dunn, a paramedic who was also skiing on the mountain, was notified and immediately responded to the situation. Upon arrival of the AED, Mr. Roskovich was successfully defibrillated to a more normal heart rhythm by the members of the Vail Ski Patrol and Will Dunn. This was the first miraculous step in Mr. Roskovich’s ultimate recovery. Without an effective cardiac rhythm, there is essentially no chance of survival if one sustains a sudden cardiac arrest without prompt defibrillation.
Dr. Reginald Franciose (medical director of the Vail Ski Patrol and a trauma surgeon at Vail Valley Medical Center) and I happened to be skiing that day and were notified of the cardiac arrest. We both met Mr. Roskovich and the entire team that was involved in his transport at the top of Patrol Headquarters. Dr. Franciose organized the medical evacuation of Mr. Roskovich off of Vail Mountain, and I quickly skied off and hailed a town of Vail bus for a ride to the hospital where my cardiology team and I awaited the delivery of Mr. Roskovich.
The Ski Patrol executed an exemplary job in the evacuation of Mr. Roskovich from the Back Bowls of Vail to an awaiting ambulance at the bottom of the mountain, where paramedics administered multiple medications and placed a tube into Mr. Roskovich’s airway to ensure adequate oxygenation.
Mr. Roskovich was then transported emergently to Vail Valley Medical Center, where he was immediately attended by the staff of the Vail Valley Medical Center’s emergency department. In the emergency room, Mr. Roskovich was stabilized and immediately transported to the cardiac catheterization suite for emergent diagnostic catheterization, as his EKG revealed he was having a myocardial infarction, or heart attack. This is an event when one of the arteries of the heart becomes completely occluded and can result in substantial damage to the patient’s heart. The treatment of choice is prompt opening of that artery via catheter techniques. Thankfully, these techniques are now available at Vail Valley Medical Center with its recent opening of the cardiac catheterization lab.
Mr. Roskovich was found to have an occlusion of his left anterior descending coronary artery (somehow this has gotten a nickname of the “widow maker”) and underwent successful opening of this vessel with two stents. This situation can be very complicated and Mr. Roskovich did require multiple other therapeutic maneuvers to stabilize his medical condition. These included the placement of an intra-aortic balloon pump, which helps assist the heart’s function and multiple defibrillations (or shocks) to restore his normal heart rhythm.
After an individual sustains a cardiac arrest, the patient’s chances of neurological recovery are increased by reducing the patient’s body temperature (controlled hypothermia). The cooling process was initiated in the cardiac catheterization lab at Vail Valley Medical Center. Preparation was then made for transport to Presbyterian/Saint Luke’s Medical Center in Denver for further care. This was an extremely complicated transport and was effectively and efficiently carried out by the Eagle County paramedics and staff.
I felt compelled to write this letter to clarify the situation and bring attention to the “unsung” heroes of the Vail Valley. This “miracle” was the end result of the incredible training and skills of the Vail Ski Patrol, the incredible response and knowledge of the paramedics of Eagle County, the staff and physicians of VVMC and the leaders of VVMC who had the foresight to build a cardiac catheterization to take care of such patients, and the ambulance district for the careful transport of Mr. Roskovich, who was in critical condition. These folks have the “hard job.” To be frank, mine is easy!
Dr. Jerry Greenberg
Cardiologist, Vail Valley Medical Center