VA Emergency Ambulance Service saves Veteran in crisis

When Army Veteran Curtis Ragan came to the emergency department (ED) at the Cincinnati VA Medical Center (CVAMC) feeling lightheaded, short of breath and generally unwell, he had no idea things would quickly take a scary turn. Thankfully, the newly established VA Emergency Ambulance Service (EAS) was there to save his life.

Emergency treatment and critical transfer

The ED staff suspected Ragan was suffering from coronary ischemia, or reduced blood flow to the heart. They were arranging a transfer to a community provider for further assessment and treatment when Ragan went into cardiac arrest—that is, his heart was no longer pumping blood effectively. Staff acted quickly and were able to get Ragan’s pulse back, but they knew another level of care was needed right away. Ragan now needed to be on extracorporeal membrane oxygenation, or ECMO, a life support technique that temporarily takes over the function of the heart and lungs. For that, he needed to be transported to a community hospital equipped for ECMO.

Critical response by ED staff and VA Emergency Ambulance Team

Normally, a community ambulance won’t transport a patient in cardiac arrest, and the receiving hospital must accept responsibility for the transfer of an unstable patient.

Fortunately, CVAMC had its own VA Emergency Ambulance Service to do the transport. Ragan coded again while being loaded into the ambulance, requiring chest compressions while enroute to the community hospital. Dr. Hannah Hughes, CVAMC chief of emergency medicine, was on duty and stayed in constant communication with the community hospital as the situation changed.

At the hospital, Ragan was diagnosed with giant cell myocarditis, a rare and severe form of heart muscle inflammation. Within a week, he no longer needed a tube to breathe. Unusually for someone who had been on ECMO for a significant period of time, Ragan was eventually discharged with no apparent neurological damage, which astonished medical staff.

“Without onsite VA paramedics and our own ambulance service to transport him to an ECMO-capable center, Mr. Ragan would have passed away in our emergency department,” said Dr. Hughes, who also serves as the EAS medical director.

Moving Forward

Ragan is getting fitter and exercises regularly. Now he wants to spread the word about VA’s support, encouraging other Veterans to reach out and experience the help that transformed his life. “I would say at all costs, try VA,” he said. “They saved my life.”

Currently, 34 VA facilities operate VA-owned emergency ambulance services like the one at VA Cincinnati, including VA North Texas and VA Ann Arbor. They are staffed by ambulance personnel trained to provide services from basic life support to advanced medical care. The VA EAS enhances emergency response capabilities when seconds count, and it exemplifies VA’s commitment to ensuring the health and safety of Veterans through reliable and effective emergency medical support.