The system saved Rob Madden’s life
June 29, 2016
On January 2, Rob Madden, 40, was skiing alone on a run at Ski Granby Ranch. His father skied a nearby trail. He was on a holiday vacation with his wife, two children and parents. Madden doesn't remember anything before the fall that sent him to St. Anthony's Hospital, a level 1 shock trauma center in Lakewood, just minutes from meeting his father where the trails merged.
We often hear stories about a broken health care system and how much money is spent on emergency services. We read stories about mistakes that cause harm and never feel good about the tragedies on the nightly news broadcasts.
Here is a success story straight out of Grand County about a man vacationing with his family during the holidays who falls while skiing and wakes up in the emergency room. What made him lucky is he received the best care from a series of emergency medical professionals at Granby Ranch, Grand County EMS, and Middle Park Medical Center.
Grand County EMS was paged to Ski Granby Ranch for a skier accident at 12:48 p.m. January 2, according to Ray Jennings, Grand County EMS/OEM Chief. The call was for an unconscious unresponsive male.
The first ambulance that was sent included one EMT, Jesse Gatewood and his partner, paramedic, Daniel Goncalves. A second ambulance including the shift captain, Erich Barber and Brian Gordon was sent shortly after, said Jennings.
"We measure what the criticality of the event is and send appropriately," said Jennings.
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The first ambulance arrived at Granby Ranch at 12:58 p.m.
Madden fell face first and rolled violently down the hill, according to the report. Granby Ranch ski patrol responded immediately. They immobilized him and got him onto a stretcher. When EMS arrived on scene at the base of Ski Granby Ranch Madden was still on the hill. Once ski patrol got him down he went straight into the ambulance.
He had a significant head injury and a high severity of trauma, said Jennings. The paramedics started rapid sequence induction, placing a breathing tube in him to help take care of breathing and reduce swelling in his brain, said Jennings.
"We do that to help protect the airway and the brain."
Then the paramedics and EMT intubated him, IVs were started and he was transported to Middle Park Medical Center (MPMC). Once the ER physician at MPMC saw the severity of the injury they called a helicopter and Dr. John Nichols, a Neurosurgeon at St. Anthony's in Lakewood. The helicopter flew Madden to St. Anthony's where Dr. Nichols was waiting for him.
At St. Anthony's
Dr. Nichols was prepared once Madden arrived and started additional care to save his brain. Madden was placed in a medical coma at the hospital to help his brain and help him heal. It is described as a deep sleep to help control neurons and mechanisms in his brain to allow his brain to calm down for the accident, Jennings said.
Madden spent a few weeks in ICU and then was moved to Craig Hospital, a center for specialty rehabilitation and research for people with spinal cord injuries and traumatic brain injuries in Englewood.
Dr. Nichols was at home when he got a call from the physician at MPMC who said they were transporting an unconscious patient.
"I made it into the hospital so that when he arrived I was there," said Nichols
At St. Anthony's the doctors gave an innovative treatment that made a difference which quite likely contributed to his outcome, said Nichols.
Madden was a patient for two weeks in Intensive Care with continuous monitoring.
"I was hopeful because he started doing things he should be doing at an earlier stage," said Nichols.
A head injury can kill you or impair you; it can change you whole life.
"We took him from death's door, to a good recovery – it's remarkable. It all came together. It was a good day for him, and an excellent outcome," said Nichols.
"This was a golden example of what we all work for day-in and day-out to get this outcome. We take the heat for resources we use – this was good use of resources that came together to save someone's life. From the ski patrol at Ski Granby Ranch who immobilized him and got him down, to EMS intubating him, the staff at MPMC, these resources all saved his life. The system saved his life."
No memory of the crash
"I remember going there to ski and my parents were in town from Washington State for the New Year holiday. I remember being with family," said Madden.
He remembered skiing to the lift for one more run before lunch and his dad decided to join him at the last minute.
This was his last memory until January 18.
"I don't remember the crash or chairlift ride," he said.
He has been told about the accident but trying to figure it out has been difficult.
"It is silly to fall while skiing. You get up and get the snow off and hope no one sees you. I think that is what I did."
He was alone during the actual crash and no one really knows for sure what happened since there were no witnesses to the crash. His father was on an adjacent run, which converged with his. Madden's father came upon the fall and gathered the skis and poles. When he saw a man in snow ahead of the skis, he realized it was his son lying in the snow face down.
"My father has that permanent image in his mind," said Madden.
When Madden learned about the sequence of events and how busy Grand County was that weekend, he is amazed that everything was done wonderfully.
"I owe my life to Mountain Patrol, Grand County EMS, the health care workers and Craig Hospital."
Madden met all the people that were with him that day, however he doesn't remember any of them.
"My wife and parents told me how everyone helped. It's amazing how things came together in my favor."
He is appreciative of the outpouring of support from the Colorado State Patrol, his employer.
"My bosses have visited me from day two and stuck with me. Kim [his wife] and the kids have done everything as I continue to work with my recovery and get back to where I can be."
Madden is back to work as a Sergeant with the Colorado State Patrol.
He is hoping to get approved to go back to full-time status and is waiting for doctors to give him clearance.
Brain injuries are the invisible injury, he said.
"You don't see it talking to someone but it has its parts that can limit what you can do. I have deficits I'm aware of and doing everything to get past them and working through them, it's a slow process."
Madden was paralyzed on his left side and at Craig Hospital he was able to move his left side, he said. He continues to have strength issues on the left side and balance is an issue.
"I have the balance of a 4-year-old," he said.
Most people in his neighborhood and the people he works with don't see the outward signs of his injury.
He is now able to run, hike and swim. He works out at the gym and lifts weights but has to think about every movement.
"I can't explain how you have to tell yourself how to walk," he said. At 40 years old there is no automatic anymore. Everything needs to be thought about. He is seeing improvements everyday but still sees deficits.
"It's getting better every day."
He continued "It's important to speak about traumatic brain injury and how many people are affected on an annual basis," he said.
"It's important to wear a helmet because there is so much that can happen out there."
"I want to repay the people who helped me. They were just doing their job but a darn important job," Madden said. "They are so important to me and my recovery. It was nothing short of a miracle."
"We are proud of our guys," said Chief Jennings. "It is a team effort. What ski patrol did, the flight crew and the trauma center – we work in tandem. We are working as a huge team to give life a chance."