When Orange County EMT Camelia Carr and Paramedic Nicole Sheyko arrived at the home of Susan and Steve Halkiotis, they calmly and quickly exited their vehicle with the necessary equipment to treat an allergic reaction, up to the worst case scenario of anaphylaxis. In the eight minutes from the 9-1-1 call to arrival, Sheyko and Carr had discussed what to expect, talked through how they potentially would treat the patient, who would do what.
Carr was first out of the ambulance, and found Steve, who had left his wife’s side to flag emergency services. He was wide-eyed and scared, like something he couldn’t see had snatched his soulmate and replaced her with a loud stopwatch, each second thundering by.
He led the EMTs to his wife, Susan, who was laying on her side on the floor, pale and short of breath. She could still speak, but her voice was barely audible. Her blood pressure was 40 over 20.
Someone with the fire department, who was first on the scene, thought the reading might be a mistake. But Sheyko knew what was happening, and confidently came in with an epipen.
“I’m sure it’s right, because there’s a reason she’s mostly unresponsive lying on the floor,” Sheyko said. “And so I was already drawing up the epi. That was not really a long time at all.”
Had they arrived five minutes later, everything would have been different — the equipment, procedure, and quite possibly the outcome.
Once in the ambulance, Susan Halkiotis was already improving. Before she reached the hospital, Halkiotis would receive another dose of epinephrine and then the hospital doctors would take over.
Susan’s husband, Steve, found relief in knowing his wife would be OK, but he was still reeling from the events of the previous few minutes, beginning with Susan’s call to him for Benadryl. By the time he got the medicine for her, Susan was lying on the floor. She had been on the couple’s front porch of their home, talking on the phone with a friend. Susan said she felt a slight sting in her arm. It was enough for her to notice, but not to raise alarm. She didn’t recall ever before having this kind of reaction to a sting or bite.
But she was soon feeling nauseous and light-headed. She ended her call and started into her house to get medicine to counteract the sting. She got as far as the doorway before nearly passing out, and called to her husband.
“I have never seen her in that condition before,” he said. “I immediately called 9-1-1 and asked for assistance, gave them our address. I asked them to send help immediately.”
The operator instructed him to make sure Susan was on her side, and to continue talking to her until the ambulance arrived. The Eno Fire Department arrived, closely followed by EMS. Steve nervously watched as Sheyko and Carr took over the situation.
“We are a wonderful team,” said Carr, who has been working with Dr. Sheyko for nearly a year. “It’s fantastic. We have very complementary personalities. She gets very focused, very detail oriented, and I kind of spread out more and keep track of everything else that’s happening. We’ll take care of getting patient information and making sure we have our paperwork in order. Be sure we’ve gathered up all our equipment or brought in everything we need.”
“They immediately took command of the situation,” Steve Halkiotis said. “I saw that Susan’s blood pressure was 40 over 20. Dr. Sheyko quickly took action with an epinephrine injection, put in an IV line, got her on oxygen, they put her in the in the ambulance and proceeded to the Duke Medical Center. Susan clearly remembers one of the emergency room doctors (at Duke Medical Center) telling her that ‘those EMTs saved a life.’ It was that serious of a situation. It was truly a life-altering experience for me. The worst possible scenario would have been to lose the woman that I love.”
For the EMTs and paramedics, who are trained to make the most of every second and hone in on the quiet details in frantically noisy situations, Susan Halkiotis’ situation was an example of potential twists and turns aligning to create a path that was certain and safe.
“That’s like the perfect case,” said Sheyko, who started as an EMT before going through the paramedic academy. She has been with Orange County Emergency Services for three years. “We have somebody that we know if we had come five minutes later, she potentially would have been a cardiac arrest patient, and then it’s hard to get them back. This is the perfect case — you come, you identify something fairly quickly. We have the medicines to reverse (a condition), and some things we cannot reverse in our pre-hospital setting. It is, of course, very satisfying to know that you contributed, even though I have to say probably everybody in our system, who would have responded to that kind of call would have come to the same conclusion. It’s still nice to get this instant reward. I mean by the time we dropped her off we knew she was going to be fine.”
Carr concurred, and even told one of her kids about the experience. “I texted one of my children to tell him what happened because he likes to hear about what I do,” she said. “I told him how exciting it was that we were able to truly save someone. That’s a very satisfying and fulfilling experience. And because I’m a new EMT, I don’t have a lot of experiences like this under my belt. It will always be impactful but I still have some nervousness going into the into these kinds of encounters. There’s a great sense of satisfaction and fulfillment.”
Days later, Susan and Steve Halkiotis brought their grandsons with them to Orange County Emergency Services to recognize and thank Carr and Sheyko. The couple gave the team gift cards to local restaurants. They also spoke of how their perspectives have changed in their lives, and how much their appreciation for EMS has grown.
“It’s amplified and infinitely magnified my respect for those in our county and elsewhere that choose public service as their profession, and they’re dedicated to it,” Susan said. “Regardless of whether it’s first responders, paramedics, EMTs, law enforcement, but especially in this case I am so grateful for a well-funded emergency service in Orange County that would allow an ambulance to get to our house. Although we’re in eastern Orange County, we’re not exactly on the main grid that would allow them to get our house in eight minutes. That’s an amazing team. We appreciate the funding that goes to providing that infrastructure.”
Susan and Steve, who are both active in the Orange County community, also said the experience has shed a light on skills they can acquire or need to brush up on, like CPR training. “We hope that we’re never in that situation again, but I think it would be helpful that we get that refresher and feel confident with what we’re doing,” Susan said.
Susan has had some time to reflect on the events of that day, and was able to recall an incident that happened months ago that could have indicated she was at risk of anaphylaxis. She said she was in her front yard, playing with her grandsons. She went into some bushes to retrieve a ball when she felt something sting her on the chest. She recalled being flushed, feeling a little nauseous and needing to rest, but being able to move on with her day without any attention.
“I should have taken it more seriously, because the next time — it wasn’t like it progressed a little,” Susan said. “The next time was the slam to the ground and could have turned out much differently. So, the fact that there wasn’t a progression, it wasn’t like itching all over or sealing your airways. Those things didn’t happen with either episode. A lot of times those things are taken as a typical symptom of anaphylaxis, and I didn’t have them. And I’m so fortunate for those first responders.
“Steve and I both feel that the hand of God was with us in so many ways, and through so many people.”
Susan said she’s now a little nervous about being outside when insects are flying around. She is also now equipped with an epipen.