(Part 1) Flight Nurse Helicopter Crash Survivor Speaks: 90% Burns & a Miracle Recovery — Dave & Amanda Repsher

This is episode one of a two-part series. 

Flight nurse Dave Repsher and his wife Amanda — also a nurse — join host Jana Price on Nurse Converse to share one of the most powerful survival stories in nursing.

On July 3rd, 2015, Dave was working a shift on a Flight for Life helicopter when it crashed 32 seconds after takeoff. Covered in jet fuel and on fire, he suffered burns over 90% of his body. The pilot did not survive. Doctors did not expect Dave to make it through the night.

Almost a year later, he walked out of the hospital alive.

Jump Ahead: 

02:09 — Introducing Dave and Amanda Repsher

02:53 — Dave's path into nursing: from ski bum to flight nurse

04:29 — Amanda's path: raft guide, EMT, paramedic, ICU nurse

05:58 — How Dave and Amanda met at an ACLS class

06:43 — Setting the scene: July 3rd, 2015, the helicopter crash

27:55 — The lifetime impact of small acts by nurses

30:26 — Arriving at the burn unit in Denver and being let into the "tub room"

34:18 — Severe inhalation injuries and renal failure

35:42 — The everyday battle for survival

37:28 — "The perfect storm of good"

39:08 — Dave wakes up after five and a half months

42:53 — Amanda fills in what really happened: emergent thoracotomy and SVC syndrome

49:58 — Wrap-up and tease for part two

In part one of this incredible two-part conversation, Dave and Amanda walk through the day of the crash, what those first hours in the burn unit looked like, and how Amanda fought to be part of his care team. They share the small moments from nurses — a phone call, a hand on a shoulder, a tech explaining each burn degree — that changed everything. Dave also opens up about what it was like to wake up after five and a half months and beg his wife to let him die, not knowing the medical crisis that had just nearly killed him.

This episode is for every nurse who has ever wondered if the small things they do for patients and families actually matter. They do. Sometimes for a lifetime.

Listen to part one now. Part two coming soon. Learn more at nurse.org/nurseconverse.

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Transcript

SPEAKER_01 0:00

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SPEAKER_02 0:37

Hey guys, thanks for joining me again, Jana Price, on another episode of Nurse Converse. Today I have the pleasure of having Amanda and Dave Rupcher on. I met both of these guys at a BCM conference in Dustin, Florida. And I came to this conference as an attendee. I, you know, came up to speak. I didn't know what we were getting into. And by the end of hearing Dave and Amanda speak, I felt like I had watched an episode or an entire Rudy movie all over. This is hands down one of the most um encouraging. And I just, it's just such a privilege to have them on today based on what you guys are going to hear. So uh but guys, thanks for coming on and thanks for taking time to speak with us. I want to introduce them. Dave was in an accident uh many years ago. He was in a helicopter crash that burned over 90% of his body, and Amanda is became his wife through it all, and she stood by his side through the whole time. Now that's an amazing story in itself, but let me tell you what really makes this amazing is Dave and Amanda are both nurses, and they're one of us guys. So here we are. We've got this amazing story that I hope today, go ahead, sit down, get a cup of coffee. If you're driving, go ahead and prepare yourself because the story you're about to hear is going to be life-changing. And it's such an honor to have you guys on. So thanks for joining us, Amanda and Dave.

SPEAKER_03 2:09

Thank you for having us. Yeah, thank you so much.

SPEAKER_02 2:11

Absolutely. All right, so let's go ahead and start this out. I want to give you guys, like we said, we're talking to two nurses here. These are these are our people. And I want to hear a little bit about before we get into just the intensity of what happened, which I want to warn you guys, it is very intense. So go ahead and prepare yourself, but don't shy away. Don't don't turn away. This this story is something that we all have faced in our nursing career as far as taking care of patients. And they're gonna come, you're gonna come away with some great insight and some information. But let's talk about um, Dave and Amanda, how how did you guys start out as nurses? Let's start with you, Dave. Where did you start out?

SPEAKER_03 2:53

So I was uh I was a ski bone, for lack of better terms. I uh, you know, I got out of college and um my first go-around of college and really didn't know what I was gonna do and ended up uh taking a year off, going to Utah and being a full ski bone there. And in between the summer, I ended up taking a job at uh a ski patrol at Copper Mountain, Colorado. And uh that was sort of my introduction to emergency medicine, and and I just kind of I fell in love with it and uh kind of worked my way up and became a paramedic and uh worked on the ambulance for quite a few years, and then eventually I decided I wanted to continue my education and sort of you know expand out, uh, you know, and hopefully end up on a helicopter at some point. And so uh went back to Harrison School and uh worked in uh intensive care unit in Denver, Colorado for uh four years until I was a you know, had enough experience to get on to uh you know helicopter with flight for life. And uh that was that was it, that was huge for me. That was sort of the culmination of my life experience and it's really where I I wanted to be. And I was, you know, just I was thrilled to go to work. I I really enjoyed that that responsibility and uh you know, sort of that, you know, serving of the community or you know, however you want to frame it in the region. And so I I really loved it. I I thrived on it and uh it was just a great challenge and uh you know I still miss it to this day.

SPEAKER_02 4:24

But absolutely and that's amazing. Amanda, what's your background?

SPEAKER_00 4:28

Well, it's kind of funny. I actually tell people that I literally fell into nursing because I was a uh a raft guide and a snowboard instructor, and then I had an injury from a fall that I couldn't uh do those physical jobs anymore, and I had taken my EMT basic uh to help me with those jobs. And so then I took a job in the ER working as a uh front desk admissions person, and uh just one thing led to another, and I ended up going uh working on the ambulance, and then I went to paramedic school and I worked on the uh ambulance in the Vale Valley for seven years. While I was doing that, I decided that um I really wanted some uh longer contact with my patients, and uh so I went to nursing school and uh and then just kind of did all sorts of different nursing, really fell into the uh ICU aspect. I I really loved that. And uh I did oncology ICU, which is um still one of my uh my most rewarding jobs that I've done, and then um cardiac ICU. I did transition into administrative nursing. So I was a trauma outreach manager for the largest health system in Colorado at the time of Dave's crash. Um we actually did work for the same company. He was with the flight aspect, and I was in the administrative trauma department.

SPEAKER_02 5:52

Wow, that's amazing. Now, correct me if I'm wrong. Did you two meet at an ACLS class?

SPEAKER_03 5:58

Very romantically, yes. So looking like two true nurses right there. Yeah, I it's you know, everyone dreads going to ACLS, but hey, yeah, sometimes good things come of it. So there you go.

SPEAKER_02 6:11

Hey, you guys listen out there who might be single, you may end up getting your your your new partner out of it. So, okay, spokesperson for there. That's amazing. Well, that's awesome, guys. You both aren't very background.

SPEAKER_00 6:23

Yeah, and uh to Dave's credit, like uh um asking me out, our first official date was kayaking together. So wow, and he was about 45 minutes to an hour late, and I was with my roommate, and I said, nope, we're waiting, we're definitely waiting. And he showed up with his brother, and wow.

SPEAKER_02 6:43

Wow, look at what a good woman. What a good woman waiting for you. That is amazing, awesome. All right, well, that that's an amazing background, and that leads us into um I want to go ahead and fill you guys in a little background, and then I'm I'm gonna let them tell the story. But on July 3rd, 2015, um, Dave was flying. I believe you were going to a PR event. He was a flight nurse on a helicopter, and they were at a hospital when they were leaving. And shortly after takeoff, I believe it was 32 seconds. If I'm correct, it was 32 seconds after takeoff. Um, he the helicopter crashed right in front of the hospital. And there was a pilot, it was Dave and nurse, and there was another nurse. And Dave, when it crashed, was covered in fuel, and he was on fire, and he had 90% of his body burn. And for you burn nurses out there and ICU nurses, a 90% TBSA is is we all know the um statistics of surviving that are almost none, and very few people do, and very the ones that do rarely go on to live a life like Dave is living. So it's it's an amazing, amazing thing that you survive, but it does not come without a story and a lot of tragedy. Um, the pilot of the the plane did not survive, and it's it's an emotional thing to see. Uh, there's a documentary out called D-Rep, and there's also something that Denver news station did, General 9 News, where it actually shows the plane crashing, and you can see Dave pushing the door open, covered in flames, because he was covered in the jet fuel, getting out and people rushing to save him. And in the same sense, you can see one of the believe it was an extrac, uh, went and used a fire extinguisher to help get the pilot out. And he did not survive, but he survived long enough to say goodbye to his widow, Karen. And it is um the documentary, I highly encourage you to watch it. It's incredible. It tells the struggle. But here we have um Dave and Amanda today who are going to kind of walk us through the day of the crash and what came after it, because I've had a chance to listen to them. And as nurses, this is what I want everyone to get out of this. They went into this as two people who had experienced a tragedy with a nursing background, right? We have a tragedy with a nursing background. And they went in as nurses, but also as patients. They're gonna come away with a lot of lessons that I hope you out there as nurses will take away for when you're taking care of your patients. And for those of you who inevitably will experience tragedy, I want you to take the lessons that Dave and Amanda have to teach because this is truly a story that is life-changing for all these nurses out here. So um I'm gonna go ahead and step back, guys, and let's start out, if you don't mind. Dave, if you'll just kind of walk us through that day and then um Amanda, chime in whenever either you guys want.

SPEAKER_03 9:56

Yeah, it's uh, you know, it's it's hard to believe. It's been a little over 10 years now, but uh, you know, we're you know, looking looking back on that day, it was you know, just uh going to a day of work, right? We we had just gotten back from vacation and it was a really busy holiday weekend. We live in a resort community. Uh, you know, it's uh we're surrounded by five major ski resorts, and it's a big summer community from the uh, you know, just the region. And and so it was packed, you know, that we, you know, our public, you know, it was you know, the hospital was busy, but we were just, you know, that day we had a public relations event scheduled, which is very common on a helicopter. It's uh, you know, we call them touch a truck days or whatever you want to call it, you know. But like you fly in and you know, we're we're going to a Boy Scout camp, just you know, 60 miles away, uh, which we you know, fire trucks and police cars and whatever else, and you're you're part of the whole thing. And uh, you know, that's so you know, thankfully we didn't have a patient on board, or you know, we were going to help someone out, and uh you know, something went catastrophically wrong on takeoff. And you know, the just at that point it was, you know, my memory's a bit spotty still, but you know, I just remember kind of being along for the ride. There's really not much you can do, and uh just grabbing onto my you know harness and holding on. And you know, I remember the impact and you know, I was confused, but I don't think I lost consciousness, but you know, can't really tell for sure. I don't have that memory, but really my first big you know recollection after the impact was just the sensation of you know cold liquid pouring over my back and shoulders. Uh and I I reference it as you know, people see uh, you know, the coach getting the bucket of Gatorade dumped on them at the you know at the end of the Super Bowl or whatever it is, you know, the or the ice bucket challenge from the those days in the back. And and that's just kind of that's what I remember. And then it was flame. And that the cold liquid was jet fuel, you know, sitting in the back left seat and right up against the bulkhead, and the fuel tank is sits right behind me. And so on impact, you know, the bulkhead collapsed and uh the fuel tank collapsed and poured right away. And so and then um with all those vapors and hot engines and hot parts, it uh you know, and it ignited and uh so I was engulfed in flames. And uh I didn't, you know, I knew I just had to get out. I had to get away. Like I really didn't know where my you know I had my location was. I didn't have you know a real sense of what was going on. I just had to get out. Turns out I you know I pushed the door off and you know, just tried to get away from the helicopter, trying to get away from the flames, and every direction I turned there was flame. Yeah, because it it turns out that I was the flame. So I was just uh you know fully saturated, fully engulfed. And you know, like I said, it was a busy holiday weekend, and there's a bike path that runs right behind the hospital. And you know, that this gentleman was just out on his you know, day off riding his bike and you know, witnessed this whole terrible thing, saw me running around on fire and yells out, like, get on the ground and you know, roll towards me. And that's all I could, you know, could focus on at that point, and and hearing that voice. And you know, so I just ended up kind of rolling down to him, and you know, this poor guy's scooping dirt on me, you know, for like two minutes until a fire extinguisher finally made it from the hospital uh out to me. And that same fire, the same fire extinguisher that you referenced in the introduction uh was Jimmy, uh a CT tech who was you know had the wherewithal amazingly that you know to grab that, come out to the helicopter and and got Patrick out. And that was the same fire extinguisher that I mean got to me and put me out.

SPEAKER_00 13:58

And you know, at that point Thank you, Jimmy, if you listen.

SPEAKER_03 14:01

Yeah, thank you. Oh, amazing, amazing story. If he got burned in the process as well, that doesn't get that doesn't get uh really recognized much, but he suffered uh burns on his face and forehead from uh just the intense heat that he was in trying to get Patrick out. So uh just an amazing story in itself. You know, and then obviously the world to you know to Karen has laid out uh you know that Patrick was able to get out of a helicopter. Otherwise, it's you know you can imagine the just imagine that. There are so many stories within the story. It's you know, you can it just uh of of people stepping up. Uh it's just amazing.

SPEAKER_00 14:42

And well, and Patrick actually was able to speak to the other nurse on board. They were laying next to each other on the ground before they got into the ER. And wow he told him he loved him.

SPEAKER_02 14:57

So wow, that's really and and that was Matt that was also the other nurse as well. And um yeah.

SPEAKER_03 15:04

So wow Matt was you know, he was in the sitting next to me on the right side, right behind Patrick, and he was saturated in fuel as well. But you know, thankfully he was able to uh kind of scramble out of the helicopter before he was, you know, so he never got ignited. And so uh, although he's saturated, he was able to kind of scramble out and get away. And uh so he did, you know, he had some hidden injuries and uh that he continues to deal with these days, but he's uh he's doing well, technically doing really well.

SPEAKER_02 15:35

Okay, so yeah, I'm glad to hear that. So you you were in this, you're out there, they've extinguished the fire. You guys are at a hospital, right? You're at a, I believe you were at a level three, am I correct, uh hospital. And obviously they bring you in and and it they get you into the ER. They're they've got all three of you coming into the ER, and as well, Jimmy. We've got injured people. Uh is it four, maybe more people who helped, I'm not quite sure, that are injured that come into this hospital. And without a doubt, you and Patrick are by far the worst burn. And you come in, and and what happened at that time once you were in this ER? What's going through your mind that you can remember?

SPEAKER_03 16:20

Like, I guess once a nurse, always a nurse, right? So they're the uh, you know, the ambulance crew, you know, again, they're all friends of mine. I know them all. Yeah, you know, there's an ambulance base right below the hospital. And so they were there like immediately. And they scooped me up on a bat board and we're running, you know, they're running me into the hospital. And at this point, you know, I'm like a couple hundred yards away from the entrance and they're dragging me in. And so you're embarking orders the whole time. Like this is the uh, you know, this is the dose you need to get me to, you know, to you know, sedate and you know, sedate me and you know, innovate me. And you know, it's like they're all this stuff. So I'm you know, I'm telling them what to do on the way in. It's like, you know, I guess that's just the mode I was in, right? And uh and I just you know, we get into the ER and yeah again, it it's family, right? It's friends. We're based out of the hospital. You know, I I've been working with these these folks for years, and they're faced with you know, not only me, but with Matt and Patrick and you know, resuscitating Patrick and you know, just yeah, like what those folks went through too is just uh you know, it was you know life altering for a lot of those guys too.

unknown 17:39

Right.

SPEAKER_02 17:39

Right. Seeing your your coworker and your friend and family on there. That's as a nurse, I sit here and I hear you talk about that, and I I don't want to put myself in that position, but subconsciously I do, and I think, wow, had that been, I have many, many friends who are flight nurses, and for that to be a reality, just absolutely it it goes right here. So yeah, if your nurses out there listening, this is you just kind of think about that and the and the care that came into fact that I I have to say you're you're telling them what to how to, you know, what mets to use to intubate you. And you said once the nurse, always the nurse. And I can't say I wouldn't do any differently. Were you aware at the time though, how severe your injuries were?

SPEAKER_03 18:27

Yeah, you know, like I didn't really start to feel anything until, you know, like pain or what or anything like that, until I I kind of got into the trauma bay. And then, you know, then I, you know, then I really started to that's when I really started, I think, the at the first point, kind of relax a little bit from the initial, you know, the initial event or whatever. And then, you know, I just and I still remember this day, I don't know why, but I just I was holding my hands up like this, up, you know, up in the air and just seeing the, you know, seeing my skin just like slough off, you know. And they were trying to find an IV spot on me, uh, because you know I was so burned and you know, some yelling out, you know, grab dick, you know, grab dip, do whatever, you know. And uh, you know, but you know, they finally got a line on me and then and I knew I was hurt, and you know, I didn't know how bad or anything like that. I just knew I was hurt and I didn't know you know what was gonna come up. Like, and and I just remember looking up at one of the nurses who was a travel nurse at that point, and uh so I didn't know him very well, but I just looked up and said that tell Amanda I love her because I you know, right, I was there sedating me because I didn't know if that was it or you know what was coming what was coming next. And so and that was the last thing I remember until you know five and a half months later when I finally woke up in the intensive care unit down in Denver. So it was a giant, it's it's still to this day, it's just a giant black hole, like of memory there, yeah.

SPEAKER_02 20:08

And Amanda, when did you get the call that this had happened? Like what what was you where were you and what were your thoughts?

SPEAKER_00 20:21

So we had just gotten back from a river trip up in Idaho, and uh in retrospect, that was an incredible gift. It was one of our best river trips we've ever done. And so I was still off because I believe it was a Thursday and um being on salaried work, I wasn't going back to work till Monday. And um I had gone to the gym, gone to the grocery store, I just made myself a sandwich and I was sitting down to eat it. Um, and a really uh good friend of ours called. And what I didn't know when he was calling me was that he already did know that it was the Flight for Life helicopter, but he had heard it through the county alert system, and um he knew that I was alone. So his words to me were Amanda, there was a helicopter crash in Frisco, but I heard that everybody walked away. And of course the panic set in instantly, but my panic and my brain were fighting each other because I was like, it can't be Dave. There's other helicopters that fly around in this county, there's other medical uh helicopters that come up to get kids. And um, I was like, there's utility helicopters, forest service helicopters. And so I called Dave's phone and there was no answer, which was not um a surprise because he left it in the car or his bag when he was at work. And I called the flight nurse line, and again, no answer. So panic was starting to get a little bit higher. But um, I was sitting down at the computer to look up the central dispatch number because I didn't know that one off the top of my head. A friend of ours who runs the ambulance service at the hospital called. And as soon as I saw his caller ID, I just I knew. And so I picked up the phone and I said, You tell me now what? And he said, He's alive. It's bad. You need to get to the hospital now. And I couldn't breathe. I felt like somebody had just punched me in the gut. I just completely panicked and I just started crying. And I said, You got to get me to the hospital. I can't drive. And so uh he arranged to have the ambulance supervisor come to our house, which is about 10 minutes from the hospital. And then I asked him if anybody had called uh Dave's mom. She's very well known in the county. She used to run the public health department. And uh he said, No, uh, you're the first phone call. And so I hung up with him, and they had just gotten, she and her husband, Dave, had just gotten back in from a hike where they were out of cell service. And uh she picked up the phone amazingly, and I said, The helicopter crashed, he's alive, get to the house now. And so they flew out the door and got to our house, which was about five minutes away. And just as they were showing up, the ambulance supervisor was pulling in um lights and sirens. And so Marilyn and I jumped in the supervisor vehicle, and Dave followed in the car. And we were going to the hospital, driving up the uh the hill that is it was just packed with cars, and it was a holiday weekend. It was just the counting was just we blow up from 25,000 um residents to like 125, 150,000 people in town. As soon as we pulled up to we were going lights and sirens, as soon as we pulled up to the door, I jumped out and I ran into the ER. And I got to Dave, and at that point he was already intubated, and there were a lot of people uh around the bed, and I just looked up at them and like Dave, I went into nurse mode, and I just said, What's his core temperature? You know, and I just started rowing through the burn list, and uh, and they looked at me and they're like, Amanda, we got this. And so I looked around and I looked at the anesthesia, the people at the head of the bed. It turned out it was the anesthesiologist, and I just said, Who intubated him? And uh he said I did. And I said, What did his airway look like? And you know, he said it didn't look that bad, and uh, and then it was just you know looking around at friends, good friends of ours taking care of him, and I just you know, I was like, like always in the best hands possible right now. So when the helicopter arrived to take uh Dave, and I was aware that other stuff was going on in the department, I didn't know what was going on with Patrick and Matt. So he ended up getting the helicopter that was able to land at the hospital because at that time Patrick had already died. So I just remember asking them, he's going to university, right? And they said, Yeah, yeah, yeah, he's going to university because I wanted to make sure he was going there. I used to work there actually. So as we're putting him into the helicopter, it was starting to rain and the winds were starting to kick up. And the chief life nurses, just Peter, he was just hugging me and hanging on to me. And I'm just like, are we really putting him into another helicopter right now? Wow. Wow, it's gonna be okay, Amanda. Because I knew if he didn't get in that helicopter, he was going to die right there. He was so critical at that point, and he needed to be at the burn center.

SPEAKER_01 25:30

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SPEAKER_00 26:04

And, you know, even though I knew everything that I knew when that flight crew showed up, uh, you know, everybody was asking, can Amanda go in the helicopter? And I wanted to because I honestly thought Dave was dying in that helicopter. And uh, you know, of course, they were amazing. And I think back to that crew because when they first walked in, it was not our flight company. And my instant reaction was, where's flights? Because I wanted the people I knew and our friends to be taking care of Dave. And they just looked at me and they're like, Amanda, we're grounded. And so it was a flight company that was on the front range. I believe they were in Boulder, and they were the closest one to come in. Um, and we've talked to the crew since this has all settled down, and I just keep thinking, God, what was gone through their minds showing up, knowing that it's another flight crew and just how professional they were, and how they were the calm in the storm uh during that situation. I came back into the ER and I just collapsed on the floor. I thought I was gonna be sick. They put me on a triage journey. At that point was when the travel nurse, and remember remembering right, his name's Ron, and I didn't know him either because he was a travel nurse, came to me and he said, Amanda, you don't know me. But I need to tell you that the last thing Dave said I was tell Amanda I'd love and those words stayed with me through some very, very dark times. And so for people who are listening, you know, for him to have the presence of mind to come find me and tell me that in the midst of all the chaos, that was such a gift that you know I've I've never seen him again or been able to thank him for that. But that was huge.

SPEAKER_02 27:54

That's so true. Well, I guys out there listening, you know how many times you maybe don't see enough, you don't know what's gonna happen. And you tell the patient or their family member one thing, and especially if you're ER trauma, we don't ever know. We never very rarely do we see the goodness that happens if there is goodness on the other side. So those little things that you guys do, just like you said, I have to tell you what he said he found her. They carry a lifetime and we don't ever see it, but this could be the story that Amanda's telling right now, how it meant something. Let this sit with you. Let this sit with you the next time that you have that nurse feeling that, hey, I need to say something, or I need to go out of the way, or I need to do something for this family. Because while you might not get it right back, or you may never know what happens, it could last a lifetime with somebody and it could be life-changing and life-altering. So thank you for mentioning that, Amanda. Thank you for bringing it up for us to humanize as nurses and almost feel a healing because I can put myself in the situation of where you were. And Ron, that's your name out there, you know. Thank you. Thank you. So wow. So all right, guys. This is um, even I'm over here tearing up. This is a this is I when I heard the story at the conference, I mean, it was there wasn't people could barely breathe, and there people were crying over there sobbing, sitting next to a flight nurse too, who happened to be there, and he's he's he was upset too. And um, so that this is one of the parts where I remember is you guys get to the big hospital in Denver and you're you're on the burn unit. And and I know I think Amanda, I remember you saying you get there, and every second is with how bad his injuries were. Is he is Dave gonna survive? Is he gonna make it? And it was just, it wasn't even like a minute by minute, it was a second by second. And ER trauma ICU nurses, anybody in critical care, we we know how that is. It is literally you are holding your breath second by second because the injuries are so severe and you're you're stuck in your nursing mode. But Amanda, you're you're not only in nursing mode, you're in this is the love of my life mode. Tell us how that got. Once you get here, walk us through what happened once you got to when you got to Denver.

SPEAKER_00 30:26

Well, in the drive down, um uh Dave's stepdad, Dave, uh, drove us down, myself in Maryland. And it's interesting because your memory plays tricks on you, and there's things that I remember very clearly from that drive down, and things that like I don't remember calling my sister. She tells me about the conversation that we had, but um, you know, because it was about an hour and a half to get down to the hospital. And uh what but what I remember very clearly was the flight nurse calling me and how calm he was, and just so reassuring. And the first thing he said to me when I picked up the phone was, he's okay. We got him through the ER, and he's up in the, I think, you know, he they said we got him to the ER and they're working on him right now, and he told me what he knew. So that that was huge for to do that. And once we got to the hospital, he was already in the burn unit at that point, and uh the charge nurse met me at the door very compassionately, you know, approaching me and just saying, Amanda, he's in the uh room, we're working on him, and we just we don't let family members back into it. They call it the tub room. And I was crying and I just looked at him, I said, I know. I said, But I'm a nurse and I used to work here and I've already been with him and I can handle it, and I need to be with him if he's gonna die. And he didn't even say one more word, and he just took me back into the room. And from that moment on, being able to be not just Dave's wife and uh, you know, all that was just being able to be part of the care team. That set the stage for everything that followed. But for that night, for everybody to to have me in there and for me to be next to Dave was invaluable. And I don't know how uncomfortable it was for people, but they didn't care. Everybody was just doing what they could to save Dave. And I do remember it was shift change as we were working on him. He was back in the tubroom for four hours, and one of the techs, just super amazing, just latched on to me, and he was explaining everything, and he was showing me the different burned areas of Dave's skin and and why they were determining what degrees of burn. So I was getting both the compassion from them, but I was also getting the they were talking to me as a critical care nurse, and I appreciated both. And I remember that one of the nurses was leaving, I didn't know who she was, and she had tears just streaming down her face. And I'm sure she thought that she wasn't ever gonna see Dave again, and she just I don't remember if she hugged me or not, but she just looked at me, and that's all she needed to do. Like I could, I could see her compassion and I could feel it. And the burn surgeon, you know, I just remember asking him, can you talk to our family and and explain what's going on? And he went into the conference room. I think there was probably a couple hundred people at that point who had gathered. Um, and he just by the time I got in there, he was already speaking and just telling everybody what was going on and and telling them that he didn't expect Dave to make it through the night, and that if he did, it was going to be an absolute marathon, and that we all just needed to be prepared for that.

SPEAKER_02 33:46

So I'm I'm sitting here going through this as a nurse, and but also as somebody, my loved one we're of this position. You're surrounded by family. You guys are hoping Dave is gonna pull through. You're surrounded by nurses, and you're a nurse as well, but that that's probably the worst part is being a nurse and knowing exactly what you were up against, because we all know what 90% TDSA, and I'm not sure did you have inhalation burns as well?

SPEAKER_00 34:18

So the um the burn surgeon told me that Dave was one of the worst inhalation injuries he had ever seen. Uh, they bronked him pretty quickly um after coming in. And uh when he told me that, it was just more, even more devastation because he went into retal failure as soon as he got there. So he was on the continuous renal replacement therapy right off the bat, and then combined with knowing that he had such a severe inhalation injury, and I I remember, you know, seeing soot around his mouth when he was first in the the ER in Frisco. And and and so, yes, being a nurse, I knew what we were facing, but it also was helpful to not have to have everything explained to me. So it was a double-edged sword.

SPEAKER_02 35:07

Yeah, yeah, I can completely sympathize with you on that. So obviously we made he made it through. He made it through that that first night, and and you guys wake up and uh that first day, you know, second day, third day become harder. But when did you realize at what point, or if he did, did you realize he actually might pull through? Or was it just an everyday reoccurrence when you woke up of we've gotta fight another day? I don't know if he's gonna survive. Tell us a little bit about that.

SPEAKER_00 35:41

It was an everyday, every minute. I don't know if he's going to live battle until he got to the rehab floor, honestly. That was um 11 months in. I mean, towards the 10-month mark, we started to see the light, but at the beginning of the 10-month mark, he almost died again. I mean, he got incredibly critically ill in April. The crash happened in July, and he was on death's door again in April of 2016. I just have to say, the next morning, um, you know, he started developing basically full-body compartment syndrome. And he had one of the most experienced burn nurses taking care of him that morning, Kimberly. And I there's so many pieces of this puzzle. Dave calls it the perfect storm of good, that everything had to come together for us to still be here. And Kimberly's just instant pulling the trigger. He he's he's actively dying on us right now. We've got to get him to the OR. And getting that process happening when she did was another factor right there. Um, you know, they had done the um escarotomies um when they first brought him in because he didn't have pulses in any of the extremities. At that point, they had to take him to the OR and open up his abdominal compartment and full fasciotomies. And believe it, unbelievably or not, in the midst of all of this happening before he went to the OR, the ophthalmologist came in the room and she knew enough to do the procedure to release the pressure in his eyes, which, if that wouldn't have occurred, he would be blind today.

SPEAKER_02 37:27

Wow, absolutely unbelievable. The perfect storm of good. The perfect storm of good. Wow, Dave, I have to say that that mana says that you said it's the perfect storm of good. That really says a lot about who you are and that probably why you survived. Because I we're gonna keep going because I know this story and it just gets so much worse. So when I hear her say the perfect storm of good, I just have to look at you, both of you. And um it was there are just these so many things that these nurses, and and if you guys will hear them, Dave and Amanda constantly are referencing nurses and the good that the nurses did, and the whole team doctors, we're not we're not taking away the entire team, the text, the RT. I mean, I'm sure every pharmacists, EDS, this is a team. This is truly healthcare coming together, serving, doing their best for the people that they love. And it's such an encouragement. So I hope everybody, too. If you're I had to, I myself had to take a little reader right there, which is so intense. And um, I want you guys to remember that the perfect storm of gay as we moved through this because it it does get worse. And um, I want to bring this up because this is this is one of the most intense parts. And please feel free to fill in anything I missed you. But on month five, I believe it was on month five, Dave, you woke up. And what were the first words out of your mouth when you woke up?

SPEAKER_03 39:07

After all this, right? I you know, I I said earlier, like this is a black hole for me, and it it really was. Like, I I just remember that day, it was like, and I describe it as like a camera shutter, if you think about it. It was just like went from like one side to the other, it was just like light to black or black to light, and it's like all of a sudden I was awake, and you know, I I kind of had an idea of what had happened, but I didn't know my surroundings or passage of time or anything like that. And so you know, I didn't know if I would if this is a matter of days, months, or years. And but all I knew was that I couldn't move any of my limbs, I couldn't talk, all I could do was mouth words, and I was terrified like being on the other side, right? Like seeing, you know, what the human body can withstand and go through and how long we can keep people going. Like it's it's truly you know amazing what you know the body can withstand. And so it was it was my nightmare, like that I was like in some persistent vegetative state for years and years, and I was just tucked away in some corner bed for you know, 100% dependent on care. And I was just terrified. But that's not how I wanted to be or how I wanted to live. And after all this, and you know, again, I had no passage of you know, knowledge or passage of time, but you know, just just to fill in here a little bit was you know, for the past five and a half months, Amanda had was left to pick up the pieces of our lives. You know, life life doesn't stop for this. And you know, I'm I'm terrible with finances, I'm terrible with books and all that kind of stuff. And you know, like Amanda enlisted a an uh an FBI friend of ours to try to break into my Yahoo account uh to to take care of stuff, you know, like the check on my you know, delinquent payments, whatever it is, you know, like it, you know, it and that's important to remember, like, especially if we're talking to the healthcare team here, is that you know, life doesn't stop. And you know, a lot of the focus is on the patient, you know, naturally, but like you know, the family's left holding the pieces here, and and uh, you know, everything that is left behind, the bills, the you know, we didn't have children, but you know, like there's that whole side of it too. But you know, so that you know, you're really taking care of more than the patient, you're taking care of the family members just as much because you know their stress level is is dramatically more uh, you know, trying to figure everything out here, and especially you know, maybe more so for folks who who aren't medically uh trained or whatever. Like this is a whole new language forum, it's a whole new situation for them. That's everything's foreign. So like trying to just keep that in mind is that you're taking care of a lot more than just the patient at a lot of times, and that's you know, that's truly just goes along with the job, I guess. But so here I am after all that, she's making life and death decisions for me for months and months on end. And the first thing I tell her when I woke up is that I want to die. And just mouth inwards, and which was how I felt at the time. And it was just because I didn't want to be in that situation. But I had again I had no how unfair this is to Amanda, who's been by my side every day making these decisions without the knowledge, without knowing my exact knowledge of what I want to go through. And that's the person I tell her. And you know, I'm still confused, obviously, a little bit, but uh had I known, uh, and Amanda can, you know, I'll let Amanda fill in the you know the rest here, because there's my version of what happened in the hospital, and then there's the real version of what happened in the hospital. So and so Amanda can fill in what happened just before I woke up.

SPEAKER_00 42:53

Yeah, so how we got to that point was that um Dave ended up um having uncontrolled bleeding in his chest. And at that point in time, he was on the continuous dialysis. He had pneumonia in both lungs, he was on really high vent settings just to deal with that. But he was in septic shock. He was literally in septic shock for 10 months. And I know sometimes people with medical backgrounds look at me like I'm not being truthful when I say that, because how's that possible? But he was, he was on vasopressin for the constant entirety of that time, and then we would add in LeviFed, and at times we had to do epinephrine when the septic shock would go in peaks and valleys and waves, and that was one of the other things, too, with being part of his care team that the team actually welcomed me in to take on that role. And I was kind of the canary in the mind because when the septic waves would hit, I could see it happening with his mental status prior to it showing up on the blood pressure and the temperature and all of the. Stuff so we could get a jump start on throwing the antibiotics at him. And so going into that situation, the team had discussed for days what they were going to do about the uncontrolled bleeding in his chest. And they finally made a determination that they were going to do a thorough synthesis to relieve the bleeding. And they did that. And then the several hours following that, it just spiraled into massive decompensation where Dave was just hemorrhaging in his chest. And so it was the middle of the night, and the CT surgeon burst into the room and you know, was just like, we gotta emergently take you to surgery. And I'm like, what do you mean we have to emergently take him to surgery? And um at that point they were starting the massive resuscitation protocol, and so the CT surgeon was taking over, and um, they started explaining the procedure to me. And I said, Whoa, stop! You can't do that, you can't extubate him or take his trach out because um a few days ago we had to emergently bronch him at the bedside, we lost his airway, he had a discal occlusion, and he just looks at me and he's like, Okay, well, then we're not going to take the trach out or we're gonna change our procedure. And I tell people that story because it's uh just an example of no matter how good the care is, how things can happen. And you know, you don't expect that CT surgeon in an emergent situation coming in to do an emergent thorcotomy to sit down and read the chart for the last few months and weeks and even know what they're looking for to find that. So, you know, that was just another example of the perfect storm of good. But so when they opened Dave up, they ended up, it was a total of um five liters of clotted blood and active blood that they pulled out of his chest. Uh, because they put a chest tube in prior to taking him to the OR, and then he came out with two chest tubes. They weren't able to close his chest because um of the burn scarring. So he's laying there with an open chest, inseptic shock, double pneumonia, post-open boricotomy. I mean, for the all of us, like the statistics for a healthy person coming in for a car crash and getting an open thoricotomy are not in your favor. And so when you just wrap your head around what exactly was going on in that situation, how crazy that is. Um, and I remember talking to the CT surgeon and I asked him, you know, did you find the source of the bleeding? And they didn't. They they do they did mention that there was a section of the lung that was very damaged. And so I think what happened was he had a tamponade on a damaged piece of lung tissue, and then once they pulled the blood out, it created a cavity where it then it just became a massive, you know, flush of of bleeding. But um, so it took three days before they were able to take him back in and close him back up, and they still couldn't close him all the way, so then he had, and during those three days, it was just constant at the vent trying to adjust the settings, trying to do anything we could. We didn't know if his brain had taken a hit. We were running ABGs the whole time during the massive resuscitation, and he developed superior vena cana syndrome. I mean, his head was like twice its normal size, completely purple. It was the same nurse that was with me in the tub room, was with us in the tub room that first night that left crying. One of my favorite nurses, Jill. Um, and that's not to um disparage anybody else that I'm not mentioning your name. There were a lot of incredible nurses. But she and I just looked at each other and we were just like, he's gotta go to the OR now. He's gotta go now, he's gotta go now. And we knew, like when the anesthesia team came in to take him down to the OR, I thought the anesthesiologist was gonna pass out. He went ghost white looking at Dave. Everybody knew he was one foot in the grave at that point. Um, and it was a, you know, it was a judgment call doing the massive resuscitation. When do you take him back? When do we have coagulation stable enough to open him up? But so even though we were seeing the ABGs, we didn't think he had taken a hypoxic hit. We had to start peeling away the medications because we couldn't take him to the MRI. He was too critical. Eventually, from peeling away the medications, as Dave explained, it was an instantaneous wake-up, like the camera shutter. I was at the bedside when it happened, and I knew instantly when it happened because yeah, he looked straight at me, which he hadn't done for five and a half months, and he started melding. I want to die. And I of course fell apart, grabbed the nurse and said, I think this is what he's saying. Can you confirm it? And she did. And um, so we had a a big meeting with family and and all the medical crew, and we just all determined that this was a shock to Dave, and we were going to uh just see how things went over the next day or two. And um and I told everybody, I said, if these are Dave's wishes, I'm going to respect him. And I just was like that night I cried harder than I've ever cried in my life, I think, despite everything that had happened up to that point. And I I just was hoping that it wasn't gonna go that direction. So what Dave didn't know is that right before that, he had been sitting on the edge of the bed doing physical therapy, and he was interacting with his environment. He could move all of his extremities, in fact, and he could talk, but we had just taken his pasomere valve off. Um, we were doing some maintenance in his trach. And so he wakes up and he can't move, he can't talk, and he's in this horrible state.

SPEAKER_02 49:57

Okay, well, right here, guys, we're gonna pause. We're gonna take a pause, and uh, there is a part two of this because I do know the whole story. And um, I want you guys to come back. I want you to take this and process it because it it you think it can't get worse, but he goes through so much more, and so does Amanda. But the perfect storm of good ends up with a lot of good things, and um, a lot of um rallying for safer standards came out of it. A lot of encouragement is gonna come from this story. So I really want you guys, we're gonna in this episode here, there's gonna be a part two, so come back and join us there. And uh until next time, stay safe, nurses.

SPEAKER_01 50:41

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