The chain of survival: How a fire chief who suffered 2 sudden cardiac arrests beat the odds
A month after his son initiated CPR for his first SCA, Wayne Kewitsch suffered a second medical emergency while driving
Sudden cardiac arrest (SCA) is the third leading cause of death in the United States. In fact, every 90 seconds, someone dies from SCA.
These incidents usually happen outside of a hospital and survival is largely dependent on bystander intervention. If a bystander does intervene by performing CPR, then survival rates often double or even triple. The key is to initiate treatment within the first minute.
However, nearly half of all SCA victims will not have someone nearby to help them in their time of need, and nine out of 10 SCA victims die.
These are not favorable statistics, but survival is possible – just ask Wayne Kewitsch.
He beat the odds – twice.
Waking up in the ambulance
Kewitsch started as a paid on-call firefighter in St. Louis Park, Minn. in 1995. Previously, he had been an EMT and worked for a private ambulance company in Chicago while he was attending college. In 2000, he was hired by the Richfield (Minn.) Fire Department. He worked his way up as a lieutenant, assistant chief and became chief in 2011.
Beating the odds
Read more about this rescue from Monte Fronk, MLB emergency response coordinator's perspective
Kewitsch’s 20-year career with the department had been uneventful in terms of his health – up until July 1, 2020. On that Wednesday, he was off duty, but had worked the day before. He was planning to take the rest of the week off to enjoy an extended Fourth of July weekend.
While he was walking back from taking the garbage to the curb, he felt something strange. It only lasted for about 15 seconds and then it was gone.
"It felt like there was a steel bar right on my sternum and somebody was standing on it," Kewitsch said.
But since the feeling went away as quickly as it appeared, Kewitsch shrugged it off and attributed it to a bout of reflux he had previously dealt with.
"I went back into the house to eat some yogurt, sat down in my chair and started to send some emails," he recalled. "The next thing I remember is waking up in the ambulance as we're going Code 3 to the University of Minnesota."
Kewitsch was later filled in on everything that happened before he woke up in the ambulance.
"My wife, who was working from home due to COVID-19, came out to get her coffee," he said. "She heard my agonal breathing and screamed for our son, who was also home from college due to COVID-19."
They laid Kewitsch down on the floor and his son started doing hands-only CPR – a skill he was taught by Kewitsch as a Boy Scout.
As his son, Jack, was doing compressions, his wife, Ruth, called 911.
"And, of course, my address is tagged in the CAD system," he said. "The lieutenant on duty recognized the address and he's like, 'That's the chief's house.'"
Crews from Edina responded to Kewitsch's house, including two police officers, two medic rigs and an engine company.
"There were five or six medics working on me in the back of the ambulance. They shocked me once at home. I went back into VF and they decided that they were going to take me to the University of Minnesota, where they're doing ECMO for people that are in refractory VF."
The Edina medics also used a device called the EleGARD, which is used for device-assisted head-up CPR. "It raises the torso so you can get head-up CPR. It reduces the intracranial pressure and you get much better perfusion," Kewitsch explained.
Kewitsch regained consciousness and started talking to one of the medics. "His dad and I worked together and he had just retired recently," he said. "He's like, 'Chief, Chief,' and I look up at him – and I'm in VF – and I say, 'Say hi to your dad for me.' And then I hear them go, 'OK, Chief, this is going to hurt.'"
They shocked Kewitsch once more and he became conscious again. "That time, I converted and stayed in sinus rhythm. So, I was talking when I got to the cath lab; I was sitting up and able to get myself over onto the table."
It turns out Kewitsch had an 80% blockage of his left anterior descending coronary artery, which is also known as the widowmaker. He spent a total of 51 hours in the hospital and was discharged for the Fourth of July weekend.
"I came home and started cardiac rehab," he said. "I was doing everything I needed to do because I was planning on going back to work."
But a month later, on August 21, he suffered a second sudden cardiac arrest.
“Everything went gray”
By this point, Kewitsch was doing cardiac rehab three times a week. He was walking two miles on the days off and was feeling good. On the morning of Aug. 21, Kewitsch was driving with his wife to a friend's cabin when "all of a sudden, everything went gray."
"My wife looked over because the car started to veer a little to the right. She looks over and she's like, 'Oh, not again.' And she grabs the wheel and steers us off the highway."
At the time, they were driving 60 mph on a two-lane highway. His wife was able to steer them off the highway, but they ended up about 40 yards into a cattail marsh.
The occupants of a car behind them noticed what had happened.
"The car behind us was a younger couple and the wife, Emily, is a nurse," Kewitsch said. "She tells her husband, Matt, 'Pull over, something is wrong,' and she hightails it into the marsh. Matt calls 911 and is trying to figure out where we are because we had taken out the street sign."
Emily started doing compressions on Kewitsch in the front seat of his Nissan Rogue.
Monte Fronk, Mille Lacs Band’s emergency response coordinator, arrived on scene moments later.
"The first one on scene with an AED was the emergency management director – he's also an EMT – and they throw the AED on me and they're taking turns, alternating doing CPR on me and the bag valve mask. They ended up shocking me seven times."
After the seventh and final shock, Kewitsch regained consciousness. "They popped the IO in and I yelled so loud. I can remember Ruth saying, 'Pain is good. Stay with me,' and they threw me on a backboard."
Medics had to carry Kewitsch through the marsh and back out to the ambulance. Crews drove to a nearby city, Onamia, where a medevac helicopter was waiting for him.
"I remember getting out of the ambulance, being wheeled over to the chopper and getting into the chopper," Kewitsch recalled. "They told me it was a 30-minute ride to the University, so they were going to take me back to the University of Minnesota."
They did another angiogram and, this time, everything was clean.
"They ended up doing an electrophysiology study and they found an errant pathway, which they took care of. They ablated and implanted a defibrillator. They also did an MRI and discovered that I have no scar tissue in my heart. There's no ischemia, so they don't really know what caused that second one."
Once the defibrillator was implanted, Kewitsch's firefighting career had ended.
Leaving the fire department
In January 2021, Kewitsch became the executive director of the Minnesota Firefighter Initiative, an organization dedicated to providing firefighters with the necessary tools to prioritize and protect their health and wellbeing.
Ruth and I met two heroes today. As many of you are aware I suffered a second out of hospital sudden cardiac arrest...Posted by Wayne Kewitsch on Friday, September 18, 2020
"MnFIRE has been around since 2016 and we do advocacy for firefighters' health," Kewitsch said. "We do training and education on the three big things that affect firefighters: cardiac incidents, emotional trauma and cancer."
However, leaving the fire service, Kewitsch said, was difficult.
"I went through a whole grieving process. I was the chief one day and then I wasn't. I was never going to put my gear on again. I was never going to go to a fire again. I was never going to go to a call. I had a really successful career and then, all of a sudden, boom, done."
But it's never lost on Kewitsch on how lucky he really is to still be alive.
"To have all those chain of survival pieces come into play not once, but twice, and to survive and be neurologically intact ... I'm one very, very fortunate individual," he said. "Because the people that we do save from cardiac arrest, their outcomes usually aren't that good."
Any time he talks to firefighters, Kewitsch shares his personal experiences to drive home the importance of not ignoring warning signs – no matter how big or small.
"I think one of the reasons firefighters deny warning signs is that they're afraid it's going to be the end of their career. And it could be. But would you rather be alive and able to spend time with friends and family or be dead?"
For Kewitsch, the answer to that question has always been a no-brainer.
"One of the doctors came in after my first surgery and said, 'You should go buy a lottery ticket.' I said, 'Doc, I already won the lottery.'"
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