A trusted community presence when a life is on the line

Life-or-death situations aren’t an everyday occurrence at OneWorld. But when a patient arrived with chest pain, rapid response from staff and providers proved he came to the right place.

It was a hot spring day when the patient walked into the Quick Sick Clinic at OneWorld. He had been working outside for hours and felt dehydrated. When he mentioned chest pressure to the front desk staffer, she recognized a potential problem.

Immediately, she took the man back to an exam room, where he was quickly seen by Associate Medical Director of Quick Sick Clinic Vickie Bangert, MPAS, PA-C. Bangert had just started an EKG when the man became unresponsive – prompting her to call a Code Blue. 

“The call went out, and a lot of us ran over because that’s what we do,” said Associate Medical Director of Family Medicine Alex Dworak, MD. “And it was a good thing because there was a person who was having chest pain and shortness of breath.”

While it’s not unusual for providers to be summoned for patients who have lost consciousness, acute life-or-death situations at OneWorld are rare. Quick Sick is for urgent care needs – not for emergencies. 

But on this day, for this patient, there was one clear choice for care.  

“That was the place where he felt safe and could go, and that was likely the closest place,” said Family Medicine Physician Melanie Menning, MD, MPH, who responded to the Code Blue.

OneWorld’s location offers crucial geographical access to care in the heart of South Omaha. It is also a trusted resource in the community. If someone doesn’t know where to go for help, OneWorld is known as a safe place to ask. 

Back at Quick Sick, responding providers felt for a pulse from the patient; not finding one, they began CPR. Meanwhile, an AED machine – already prepared by Quick Sick staff – recognized a shockable rhythm in the patient’s heart.

“So we were able to shock him and do another round of compressions,” said Dr. Menning. “Then he got a pulse back and began responding to questions. He was still pretty out of it but able to at least acknowledge that he knew where he was and what was going on.”

A rescue squad had arrived by this time, as someone called 911 from the start. With the patient’s heart rhythm back, OneWorld provided handoff to the EMTs, who then transported him to Nebraska Medical Center. 

Still not out of danger, the patient coded one more time at the hospital. Fortunately, the insertion of a stent in his blocked right coronary artery reopened blood flow to his heart. 

He survived.

One of the keys to success in the story is preparedness. Bangert’s Quick Sick team – beginning with front desk staff – practices scenarios and has protocols in place to recognize high-risk situations. For example, the Quick Sick team and other OneWorld departments immediately send patients back for EKGs if certain symptoms are present.

“The team dynamic within OneWorld of making sure that the front desk to health assistants to everyone involved in the process can recognize potentially dangerous situations and immediately act, I think, is a big key part of this,” said Dr. Menning.

Building on OneWorld’s wealth of experience, Dr. Menning also currently practices in a hospital setting where she responds to many Code Blues; Dr. Dworak has similar past experience.   

The OneWorld team’s responsiveness and care made an impression. Weeks after his life was saved, the patient and his family returned to Quick Sick to give out hugs and say thank you. 

To Dr. Menning, OneWorld was uniquely positioned to help.

“The story could have been very different, very easily,” she said. “Having that presence in the community where we’re trusted [means] he came, he had access. He could get in.”