Montauk EMS Saves Heart Attack Victim

Stephen "Skip" Rankin is well aware just how lucky he is to be alive.

From his hospital bed at Stony Brook University Hospital on Tuesday, Rankin, a retired New York City firefighter, got choked up as he recalled how he nearly died just days earlier.

On Sunday morning, the 66-year-old, visiting friends in Montauk, was out on his friend Richie Nessel's boat when he felt a pain in his chest that he described as the worst pain he'd ever felt. Sweating and nauseous, he had all the classic signs of a heart attack, but he didn't quite want to say out loud what he said, "I knew in my heart."

Nessel, a longtime friend whom Rankin knew during his 13 years living in Montauk, said Rankin just didn't look well. "He said, 'I just don't feel right'."

Rankin said he wanted to wait a bit before an emergency return to shore, but Nessel had seen a heart attack before. "He absolutely refused instantly — thank God. He booked us back," Rankin said.

"The Nasty Ness" was out at the Frisbee's, eight or nine miles from the dock, but there was a lot of fog that morning and Nessel, a former charter boat captain, was concerned about the trip back. He called his wife, Janice, filled her in, and asked that she call 911. He wanted to focus completely on getting them back to shore as fast possible.

Just then the fog lifted.

"One minute I couldn't see 20 feet in front of me, the next I could see for a half-mile," he said. They were able to get back to shore in nine minutes.

Dispatchers requested an ambulance to meet the boat at the Diamond Cove Marina at 9:55 a.m.

Garrett Lake, one of Montauk Fire Department's paid personnel, arrived at the marina in a first responder vehicle at 10:04 a.m. The boat pulled into the dock about 15 minutes later. The ambulance, which arrived at 10:11 a.m., had its doors open waiting for Rankin.

Lake, a critical care emergency medical technician for four years who also works part-time as a Southampton Town Police Officer, is one of responders that the fire department hired as part of its pilot program that started June 15 to ensure one Advanced Life Support provider is on duty in Montauk 24 hours a day, seven days a week this summer.

When Rankin boarded the ambulance he was in pain, but breathing. Lake, along with EMT-B Brian O'Connor, a volunteer, began assessing him. He was placed on a heart monitor that is able to send the results to the county's medical control center at Stony Brook for review. Concerned about his condition, they sent a Stony Brook ambulance to Southampton Hospital so that Rankin could immediately be taken to the cardiac catheterization lab.

Just as the ambulance passed the Amagansett Fire Department, Rankin lost a pulse. His heart had stopped.

O'Connor immediately began CPR, while Lake began setting up the manual defibrillator, which analyzes the heart for any rhythm and shocks the heart, if enough of rhythm is found. After one cycle of CPR, a shock was delivered. They began CPR, again, and just as they were leaving Amagansett, Rankin came back.

Not only did he start breathing again, but he regained complete consciousness. "I don't even remember going out. The next thing I remember was them saying, 'We lost you.' I said, 'What?' I couldn't believe it," he said, trying to hold back his emotions.

The EMS providers continued to monitor him closely for the rest of the ride. "I knew I was in dire straits," he said.

With Joe Dryer — the chairman of the board of fire commissioners — behind the wheel of the ambulance, they arrived at Southampton Hospital at 11:02 a.m.

Rankin was quickly transferred to Stony Brook, where he underwent two procedures in the coming days. Two stents were placed in his heart. Doctors found a 100 percent blockage and a 90 percent blockage.

Asked how he was feeling after the whole experience. "I'm alive," he said, adding that he knows how lucky he is and how grateful he is to the people who had a hand in saving his life. "What could you say? It's the best gift that anybody could receive."

He left the hospital to return to Florida on Wednesday.

Since moving to Stuart, Fla., Rankin said he keeps abreast of the news in Montauk, and was well aware of the pilot program. "I think the idea of the paid EMT thing is phenomenal."

Kenneth Alversa, a lieutenant in Montauk's ambulance company and one of the program's organizers, said having advanced life support matters. "We've seen it make a difference in patient outcomes," he said.

The program cost about $80,000 and is slated through Sept. 15.

Basic EMTs receive about 150 hours of training, and are able to provide basic life support at a scene and during transportation to the hospital. Critical care technicians, like Lake, undergo nearly 800 hours of training and can provide a higher level of care, such as administering medications intravenously. They can also intubate a patient if necessary and monitor cardiac rhythms.

On cardiac emergencies, advanced life support is not only a necessity, but also imperative to have early, Alversa said. However, in departments manned solely by volunteers, it's simply not a guarantee that an ALS provider is available, particularly when 60 percent of the department's 700 calls occur in a four-month span.

There is only one volunteer in the Montauk fire department with ALS certification, and while he runs hundreds of calls a year, Alversa said it had become clear the department needed more help. With district funding, they hired eight paramedics — who receive over 1,000 hours of training — and two critical care techs. They share 12-hour shifts all summer long.

Alversa said the paid personnel respond to all calls, but don't make the long trip to Southampton Hospital — Sunday's call took three hours in total — unless it's a call that requires advance life support. Thanks to volunteer EMTs and drivers, they've never had to leave the district unnecessarily, he said.

They have also never had to go alone — a huge testament, Alversa said, to the volunteers' dedication. The program and its success has also meant Montauk has not had to ask for help from nearby districts since its inception, he said.

"We couldn't be happier with the way things are going," Alversa said.