It was a span of roughly 30 minutes, the time from her husband’s collapse to her climbing into a truck that escorted his ambulance to the hospital.
“I thought they were driving me to the hospital to tell me my husband was dead,” Cathy Colasanto recently said.
During that half hour on the afternoon of Saturday, Aug. 12, 2017 — at a bench near a Coligny Beach parking lot on Hilton Head Island — she had watched as strangers came to her and husband Tom Colasanto’s aid.
Tom was sitting on that bench when the color drained from his face and he fell over, backward, into the bushes.
A passing man saw it happen and helped lift Tom, laying him back on the seat. A woman — a nurse, walking with her family — hurried over to help. Another person called 911. And, Cathy recalls, there was someone helping with “crowd control” on the busy sidewalk winding from the lot toward the ocean.
More than 350,000 outside-of-hospital cardiac arrests occur each year, according to the American Heart Association — 90 percent are fatal. But when CPR is administered immediately after such an incident, it “can double or triple a person’s chance of survival.”
Tom’s case is both a poignant display of humanity and a glimpse of the high-stakes work of first responders.
He would survive, but a lot of things had to happen to save his life.
A year later, the 84-year-old Savannah resident would return to Hilton Head and do something he hadn’t done since his heart stopped.
‘Human I.V. pole’
Ashley Nickelson watched as Tom was loaded into the ambulance that August Saturday, moments after she’d served as a “human I.V. pole,” holding bags of fluid as paramedics administered them.
He was disoriented but talking — a good sign — and she’d been “pleasantly surprised to see him come back around” after first responders with Town of Hilton Head Island Fire & Rescue had shocked him three times with an automated external defibrillator (AED) to re-establish a normal heartbeat.
Still, Nickelson — a Charlotte, N.C.-based advanced-practice nurse anesthetist vacationing on the island with her family — knew Tom had a fight ahead of him.
According to the Cardiac Arrest Registry to Enhance Survival (CARES) — a Centers for Disease Control and Prevention and Emory University project that collects data to improve emergency response to out-of-hospital cardiac arrests — more than 200,000 patients will have resuscitation attempted each year. But only 10 percent will survive to hospital discharge.
And even after a patient leaves the hospital, their quality of life can be greatly diminished by heart damage incurred during the incident.
That Saturday wasn’t Nickelson’s first time administering CPR, or coming to the aid of someone in need.
“I don’t want this to sound strange or whatever, but I feel like, since I’ve gone into nursing, this has happened to me a couple of times,” Nickelson recently said. ”I went to (Las) Vegas with my husband, and I had to do the Heimlich (maneuver) on a man next to me who choked on a piece of steak.”
She was the first person to render medical aid to Tom that day, and did so in front of her husband and two children, just 4 and 6 years old.
“I was worried about my children being afraid, and I had to explain to them that Mommy was helping his heart beat, because his heart didn’t want to beat by itself,” Nickelson said.
Her kids, comforted by their father, understood.
She saw the paramedics arrive.
She watched as Tom’s ambulance sped toward the hospital.
She would think of him often over the next year, and wonder how he was doing.
‘Our miracle year’
Hilton Head Fire & Rescue responds to about 50 workable out-of-hospital cardiac arrests each year, according to its EMS Battalion Chief, Tom Bouthillet.
“Anytime someone survives, we’re quite happy, and I’m perfectly content with people calling it a miracle,” Bouthillet said. “But I also know that it’s the result of a lot of hard work.”
Since joining the CARES registry in 2010, Hilton Head Fire & Rescue has continued to assess and improve its — and the public’s — response to cardiac arrests. It offers bystander CPR courses to citizens and has a program that’s helped place “over 200 publicly available AEDs” on the island, Bouthillet said.
“We had a truly remarkable year (in 2017),” he said. “I call it our ‘miracle year’ from the standpoint ... of our on-scene performance.”
On average, about half of Hilton Head’s 50 workable cases will be “unwitnessed,” meaning no one sees the person collapse, making the odds of survival practically nil, he said.
Of the remaining half, 60 percent have a patient with an “initial shock-able rhythm,” meaning EMS crews can use an AED to re-establish a heartbeat.
In 2017, there were 16 such cases where AEDs were deployed, he said.
And of those, 11 resulted in patients’ survival and discharge from a hospital with “good functional capacity” — meaning they could walk, talk, take care of themselves and recognize loved ones.
Tom Colasanto’s case was one of them.
“That’s where I was reborn,” Tom Colasanto recently said, referring to the bench where, more than a year ago, his heart stopped.
His memories of the day consist of what others have told him, but he does remember the aftermath: 36 weeks of physical therapy, time in the gym, lifting weights — building up his strength and stamina so he could walk.
But Hilton Head Fire & Rescue’s data tells more of the story of that Saturday.
The 911 call came in at 2:11 p.m., Bouthillet said. The first Fire & Rescue unit arrived four minutes later. “Medic 2,” the ambulance carrying Tom, left for Hilton Head Hospital at 2:45 p.m. and arrived 14 minutes later.
Paramedics documented that they performed chest compressions on Tom 88 percent of the time he was in cardiac arrest. They averaged 113 compressions a minute, with an mean depth of 2.4 inches — “sweet spot” numbers within the optimal ranges, according to Bouthillet.
And Bouthillet referenced a first responder’s note, one that tells the rest of the story — how kindness kept Tom alive.
The note reads: “As code blue” — medical slang for a cardiac arrest — “was called ... , Mrs. (Ashley) Nickelson, without hesitation, started quality chest compressions. With the help of Mrs. Nickelson, the EMS crew was able to use limited manpower resources to establish an airway and apply the AED pads. Once other units arrived on scene, she continued to assist EMS crew where needed.”
The Colasantos returned to Hilton Head a year to the day after Tom’s cardiac arrest.
They stopped by one of Fire & Rescue’s stations and thanked the crew there.
They went back to the bench at Coligny; Tom sat on it and gave a thumbs-up. Cathy took a picture of him celebrating what he calls his “first birthday.”
He walked a mile and a half that day to mark the occasion — the first time he’d managed that long of a stroll since his heart stopped.
After the incident, they’d gotten Nickelson’s name so they could thank her. They’d been given a phone number for her, too, but two of its digits had been transposed, and calls were answered by a message saying the number was disconnected.
This month, though, they finally got the right number and were able to reach her.
They learned Nickelson and her family were coming to Hilton Head for a quick weekend trip before the kids started school.
So, last Sunday, they met her on the island.
“When things like that happen, it reinforces my belief in God and a greater good,” Nickelson said. “And I really do think that we’re here to help each other, and I think it’s important to be open to that when opportunities present themselves.
“And there were a lot of people there helping (Tom) that day, whether we remember their names or not.”
Like the gentleman who helped lay Tom back on the bench after he collapsed — he was an African-American man who, Nickelson recalls, dabbed Tom’s head with a cold washcloth and stayed at the scene to help in any way he could.
Like the paramedic Cathy knew only as “Sebastian,” who found her when she arrived at the hospital.
And told her Tom “made it through.”