How Denver’s Chain of Survival Saved a Young Runner

The moment Grecia Ruano Corona answered the 9-1-1 call earlier this summer, she could hear the urgency from the caller's shaking voice.

Somewhere along Denver's Platte River Trail, a young runner, named Molly, collapsed. She hit her head, started to bleed, and appeared to be having a seizure. The caller reported the runner as trying to breathe-gasping for air, but Ruano Corona, an emergency call taker with Denver 9-1-1, knew it was agonal breathing, a sign of how critical the runner's condition was.

The 9-1-1 caller struggled to explain exactly where she and the patient were. She could see the Platte River, a bridge but there wasn't a street sign or intersection to give Ruano Corona.

As the caller searched for her words, Ruano Corona worked to determine their location as eventually the caller started collecting her whereabouts, pointing out that they were near Commons Park, along the Platte River Trail.

The questions from Ruano Corona were fast and deliberate, shaped by years of emergency medical dispatch protocols, training, and experience. The caller's panic was unmistakable, but Ruano Corona needed information to get help started and to determine what Molly needed.

After a few minutes, the 9-1-1 caller followed instructions on assessing Molly and started lifesaving measures.

Another stranger, a man riding his bike, stopped to help. He took over the phone while the woman who initially called worked on Molly, following Ruano Corona's directions for CPR.

Within a few minutes after the collapse, firefighters from Denver Fire Engine 6, C Shift, arrived on scene. They had to be waved in from the trail and then climb down from the road. Denver Fire Engineer Philip Cagle ensured his approximately 20-ton apparatus got as close to the scene as possible. Sitting beside him, Lt. Jason Brewer coordinated the response and ensured fire dispatchers at Denver 9-1-1 gave Denver Health paramedics detailed instructions on how to access the scene.

Firefighters David Anthony and Nicholous Parks hiked down the trail and met with the 9-1-1 caller and bystander. Quickly, they scanned the patient and began working, including taking over CPR and providing manual breathing support for Molly. Because of their efforts, including the use of an automated external defibrillator (AED), Molly's pulse became stronger, indicating blood was once again circulating through her body.

The next link in the chain of survivability came when Denver Health paramedics Lt. Liz Ackerman, Railey Zantrop- Zimlinghaus, and Emilie Thurston arrived on scene. Working together, each step building on the last, they assessed Molly's condition and analyzed her heart rhythm with a 12-lead (ECG) electrocardiogram. They provided advanced life support, stabilized her, and prepared her for transport. With afternoon traffic ahead of them, they made the 4.5-mile trip to Denver Health-carrying a woman who, just minutes earlier, had been out for a summer run and was now fighting for her life.

At Denver Health, the emergency medical teams took over. The care that followed drew on years of training and the coordination of professionals who, in most circumstances, never know everyone involved in a patient's care because the emergency medical system is like a relay race with the baton of care being transferred at each stage.

Recently, this case was the subject of a presentation that brought together Denver Health, Denver Health Paramedics, Denver Fire, Denver 9-1-1, the University of Colorado Anschutz School of Medicine, and others.

The gathering offered those involved in the emergency - from start to finish - to get an opportunity to understand what happened after their part of the work was finished and how their work contributed to the chain of survival.

For emergency call takers like Ruano Corona, and the police, EMS and fire dispatchers, the last sound they may hear is the arrival of first responders. For paramedics, their involvement generally ends when they transfer a patient to the hospital.

During the presentation, those involved explained the response and the medical care that followed. They acknowledged what had worked and where improvement in the future could help the next patient.

It's not uncommon in emergency medicine to study even successful cases because doctors, nurses, and the entire first responder system know that even those cases offer lessons.

As the Office of Emergency Medical Response System, a partnership between Denver Health and Denver's Department of Public Safety, ended the presentation, the doors to the Rita Bass Trauma and EMS Education Institute auditorium opened.

Molly walked in.

After six days in the hospital, and months of rehabilitation, the young woman whose collapse had set into motion a series of critical lifesaving events now stood before the very people who helped save her life.

For the first responders in the room, it was a chance to see the human outcome of work that so often ends without knowing what came from their efforts.

Molly's survival began with a person who detected something was wrong-the first stage of critical care. From that moment, each person who became involved helped give the next person an opportunity to save her life.

It was the chain of survival working as intended and for Molly, it meant the chance to keep living.