Pictured: Lily, Nicole, Lara, Mitch, Nurse Emily and Dr Raj
Less than half an hour after collapsing in Nhulunbuy, 31-year-old mine worker Mitchell Pascoe had been revived from cardiac arrest twice.
At around 5pm on Wednesday 26 August, Mitch had started feeling unwell after eating and walked to a nearby pharmacy for antihistamines. On the way back, his condition deteriorated rapidly and he collapsed.
Mitch had never experienced an anaphylactic reaction before.
He managed to call Triple Zero himself, but as his condition declined, a woman passing by stopped to help and took over the call. There was no EpiPen immediately available.
St John NT Paramedics Lara Liechti and Lily Kay were nearby when the case came through. For them, Mitch’s survival came down to preparation, teamwork and an unusual number of people being in exactly the right place at the right time.
“In the 90 seconds we were in the ambulance together on the way there, we talked through the anaphylaxis protocol and what we were going to need,” Lara said.
“We knew he was in a very serious condition, so when we pulled up, we were ready to go.”
They arrived to find Mitch surrounded by colleagues in high-vis workwear, including two mining medics. Gove District Hospital senior doctor Dr Rajendra Pillay, known as Dr Raj, had also been driving past and stopped to assist.
Lara immediately went to assess Mitch.
“He was purple. There was no radial pulse. It was the worst-case scenario,” Lara said.
“We determined he was in cardiac arrest and everything moved very quickly from there.”
While Lily prepared medication, Mitch’s colleagues helped cut away his work uniform so defibrillator pads could be applied.
Lara immediately began chest compressions while Dr Raj helped Lily secure Mitch’s airway.
Then more help arrived.
Two nurses who happened to be walking past stopped to assist. St John NT Nhulunbuy Area Manager Nicole Patching also responded to the scene, and NT Police attended to help manage the scene and support the emergency response.
His heart started beating again.
“It felt like every time we needed another pair of hands, someone was there,” Lara said.
Together, the group moved Mitch into the ambulance.
A police officer drove, Dr Raj and Lily worked at Mitch’s head, Lara took the attending seat and one of the mining medics assisted from the foot of the stretcher.
While in the ambulance, he went into cardiac arrest once again.
After a shock from the defibrillator, the team were able to resuscitate him for a second time, restoring circulation before reaching Gove District Hospital.
At the hospital, another team was already waiting. The on-call anaesthetist had made it in, nurses had come from other wards, and staff were ready for Mitch’s arrival.
Around 20 minutes later, Mitch was awake and talking.
A few hours after that, he was preparing to be transferred by CareFlight to Royal Darwin Hospital.
“He walked himself from the resus bed across to the stretcher,” Lara said.
“And while he was waiting for the other CareFlight patients to be loaded, he asked, ‘Can I go outside for a smoke?’”
Anaphylactic cardiac arrest is an uncommon and extremely serious emergency, with survival dependent on rapid recognition, treatment and coordinated care.
It was only the second time Lara had attended a patient in cardiac arrest, and the first time achieving a return of spontaneous circulation (ROSC).
For her, Mitch’s outcome was the result of all of those things coming together at exactly the right time.
“He was in town. We were close. His colleagues and the mining medics were there. Dr Raj and two nurses happened to be passing by. Nicole came in. Police helped us. The hospital team was ready.
“So many people played a part.
“Whatever you believe in, the stars aligned for Mitch that day. Everything was in his favour.”
With around 15 years’ experience working in ambulance, Nicole said successful resuscitations like Mitch’s remain rare.
“You can work in ambulance for years and only see a handful of outcomes like this,” Nicole said.
“Fortunately, so many people were ready to step in and knew what needed to happen. Everyone had a role and everyone worked together.”
Mitch’s survival brought together paramedics, hospital staff, mining medics, colleagues and police in an extraordinary response across Nhulunbuy.
Nicole said the case was also a reminder of why preparation matters, particularly in remote communities where help may be further away and fewer hands may be available.
“What you can do is make sure people have the training and confidence to recognise it, act quickly and work together when it does,” she added.
St John NT’s Asthma and Anaphylaxis course teaches people how to recognise and respond to emergencies like Mitch’s. Learn more and book your spot, so you’re ready to help if it happens in front of you: www.stjohnnt.org.au/first-aid-training
Training includes 22578VIC Course in First Aid Management of Anaphylaxis and 22702VIC Course in the Management of Asthma Risks and Emergencies in the Workplace. St John NT RTO 88041.
