Emergency Care

Joe Davis (ER)

Joe Davis (ER)

Meet Joe Davis, EHS Class of 2019. ASB President. Football, basketball, and track. An adventurous spirit, ready and willing to take on life’s challenges with the vigor of a healthy 18 year old.

Until the day in December when he ate his first macaroon.

“I figured I’d try it,” says Joe, who took one bite, not knowing the cookie was loaded with almond flour. It wasn’t long before he felt a reaction. “I thought, ‘Oh, there must be some nuts in that.’ And I went to my next class.”

This wasn’t Joe’s first tangle with nut allergies – a condition he shares with his mother, Janet. “There were times where he would accidentally eat nuts,” she recalls. “He’d have itching around his mouth, and his mouth ‘felt weird’ and swollen. Sometimes he’d tell me and sometimes he wouldn’t, but the symptoms would always resolve with time.

“It’s never been a real issue,” declares Joe. “I wait, drink some water, and it’s gone in 10 minutes.” He’d never had to use an epinephrine (“epi”) pen or mobilize the emergency plan established with his school.

This time was different.

“I went to a class for an hour. I wasn’t feeling better, so I stayed at school for lunch. Then I started getting hot and my body was really irritated, so I laid down on the couch in the ASB office.” At fourth period, Joe was joined by fellow ASB officers, who told him in no uncertain terms that he looked horrible. 

“By then I was having a hard time breathing. My breath was really raspy.” Enter the white knight in Joe’s story: his best friend Connor Timko. Experienced with his own peanut allergy, Connor heard the labored breathing and knew what was happening. He told Joe, “You’re going into anaphylactic shock.”

“Thank God for Connor,” says Janet, who in the midst of a busy afternoon was on her way out the door when Joe called her, his voice barely audible. Once Janet figured out what was wrong, she had Joe put Connor on the phone. Her son’s friend described the symptoms he was seeing, and they agreed he should immediately drive Joe to the ER.

“Connor could get him there faster than I could,” she says. “I dropped everything and sped to the ER and met them there.” Within twenty minutes, she was joined by her husband Bob. By then, emergency staff had dosed Joe with epinephrine, steroids and Benadryl, and were closely monitoring his condition.

As a social worker on staff at KVH, Janet often serves in the emergency department. She considers it familiar territory. Nevertheless, “It’s so different when it’s your own kid. Joe is our youngest,” she says quietly, her voice catching.

The ER team involved in Joe’s care included provider Jocelyn Judd, and nurses Doug Henson and Susan Penick. “I have colleagues that hit the ground running and know exactly what to do,” says Janet. “I never felt like there was a question about the exact treatment. I could just be the mom and rely on them to do what they do best.”

It’s been over six months since that fateful evening, and Joe’s life is back to normal, with one glorious exception: certain nuts are now a regular part of his diet. Shortly after the ER visit, Joe had extensive allergy testing, which narrowed down the list of culprits to three: walnuts, pecans, and the one that sent him to the hospital – almonds.

Freed by this new information, on their way home from the allergist, Joe and his mom went shopping for things he’d always wanted to eat but never dared – pistachio ice cream, Nutella, and pesto sauce. “He loves it all,” laughs Janet.

Later this summer, the Davis family travels to Italy. This fall, Joe heads to Japan for a two-year mission, then to an out-of-state college. As terrible as Joe’s anaphylactic episode was for his entire family, Janet has found a silver lining. “Now, Joe can travel knowing he needs to be very careful and carry an epi pen. And he can enjoy foods that used to be off-limits.

“Things were lined up in the perfect way for Joe to get help and information he could use through the rest of his life,” she says, which according to Joe will include college track, and possibly a career in international business or cardiology.

“Whatever the future holds, it’ll be busy,” Joe grins. “I’m excited.”

Mike Knutson

He’d suffered life-threatening injuries in a crushing accident. When Mike Knutson woke up at Harborview Medical Center after ten hours of surgery and four days of being unconscious, he thanked the physician who saved his life – and got an unexpected answer.

Actually, the surgeon said, the first place that saved his life was the place he came from – the emergency room at KVH Hospital.

Flash back to the afternoon of February 6, 2017 when then 58-year-old Knutson, who lives in the Manastash, was injured. With a broken scapula and clavicle, a collapsed right lung and fifteen broken ribs, six of them broken at both ends so they weren’t attached in his chest, Knutson found himself reeling from pain and struggling to breathe.

“I couldn’t lay down,” he says. “I was on my hands and knees. It was the only way I could breathe.”

Medics from Kittitas Valley Fire and Rescue responded, treated him at the scene and rushed him to KVH Hospital where a real-life emergency room drama was about to unfold.

Notified en route of Knutson’s injuries, the hospital activated a full trauma response, summoning a coordinated trauma response team – including a respiratory therapist, additional nursing staff, and staff from laboratory, radiology and pharmacy– to the emergency department.

Dr. Frank Smith, the on-call surgeon that day, was waiting when Knutson arrived. Dede Utley, director of emergency services at KVH, was in the emergency department giving a tour to two board members, and witnessed what came next.

With Knutson sedated, tests and x-rays were done and a tube was placed in his chest to remove blood pooling around his collapsed lung. Immediately recognizing that Knutson needed a higher level of care than KVH could offer, staff began coordinating his transfer to Harborview, the only Level I trauma center in Washington, Alaska, Montana, and Idaho. Other staff were busy notifying and updating Knutson’s family.

When Knutson continued to struggle to breathe, a decision was made to intubate him and put him on a ventilator for the transfer to Harborview. Utley said one of the paramedics did the intubation under the supervision of a doctor.

Two days after he was crushed, Knutson underwent surgery at Harborview to have titanium straps placed on his ribs to hold them in place. Two weeks later he came home to Ellensburg where a friend spent several weeks caring for him.

Mike Knutson

Knutson is not a man who takes gratitude lightly. Two weeks after he got home, he stopped by KVFR to thank the paramedics who saved him. “Oh,” one of them said, “I didn’t expect to see you again.” Then, Knutson went to the KVH emergency department to say thank you there. How close he came to death isn’t lost on him.

“It’s a miracle,” he says. “I have to believe the Lord had a hand in this. There’s a couple or three times I could have cashed ‘er in. Things had to happen in the right way for me to survive.

“There’s the EMTs who knew exactly how to handle me. There’s the emergency room where they knew exactly what they were doing, placed the tube in my lung and got me to exactly where I needed to be. There’s the docs at Harborview who did the surgery on my ribs.

“The right people where there at the right time.”

Knutson, who worked as a tugboat builder and designer for 24 years and now owns a crane company in Kittitas County, hopes to return to work soon but says doctors have told him he may never fully recover.

While no one likes to see a serious trauma injury, Utley says what transpired in the KVH emergency department that day showcased how good it is. “I’m proud of how this event went,” she says. “We stabilized him and got him ready to go to Harborview. It worked exactly the way it was supposed to work.”

As for Knutson, he’s impressed. “KVH might be a small hospital but it’s a good hospital,” he says. “People don’t understand how good it is. They did a good job – and I’m alive because of it.”

Hunter Rogala

Hunter Rogala

He greets a visitor with a smile, takes an imaginary call on a toy phone, joins his 7-year-old sister Presley for some forward rolls on the tumbling mat in his family’s living room, then hurries off to push a toy lawn mower across the floor.

At 2, Ellensburg’s Hunter Rogala, who weighed in at 9 pounds 10 ounces at birth, looks the picture of good health – and most of the time he is.

“He’s our chunky monkey. He’s got linebacker written all over him,” his father Josh Rogala says with a laugh.

That doesn’t mean Hunter hasn’t given Josh and his wife Sarah panicked moments along the way.

Hunter was three months old when he developed a serious respiratory infection and began struggling to breathe. “He was turning blue,” Josh says recalling how he and Sarah rushed Hunter to the emergency room at KVH Hospital where Hunter was diagnosed with Respiratory Syncytial Virus (RSV), the most common cause of lower respiratory infections in children less than one year old.

Given fluids and medication to reduce inflammation via IV, Hunter also got treatment to open his airways. But staff told the Rogalas that Hunter needed to be in a bigger facility – one that specialized in treating children – and he was transported to Seattle Children’s Hospital.

“We appreciated that they immediately told us he needed to be in a larger hospital,” Sarah says. “There was absolutely no hesitation about sending him somewhere else.”

A few days later, Hunter was home for his first Christmas.

By late January, though, he was back in the emergency room, this time for pneumonia. Then came the day Josh, who works as a wildlife biologist, got a call from Hunter’s daycare saying Hunter had a fever. “I picked him up and immediately took him to the doctor,” Josh says. “I was holding him when he suddenly had a seizure. I’ve seen seizures before but seeing your baby have one is another thing.”

The pediatrician diagnosed Hunter with a febrile seizure caused by an ear infection and prescribed antibiotics. “After that,” Sarah says, “whenever he had a fever we worried.”

Fast forward to August 2016. Josh was just home from work, barefoot and cleaning out his vehicle. Sarah, a social services supervisor for DSHS, had picked Hunter up after work, noticed he felt a little warm, given him Tylenol and was holding him when he suddenly “flopped over” and began seizing.

“We were counting minutes. With febrile seizures, you’re supposed to go the emergency room if they last more than four minutes,” says Sarah, her emotions visible as she recalls that day.

Barefoot, Josh drove the family the short distance from the family’s home to the emergency room as Presley, terrified that Hunter would die, yelled questions.

Diagnosed with a febrile seizure and an ear infection, Hunter got medication to bring his fever down, started oral antibiotics and was happily coloring by the time he was discharged.

“They got us in immediately,” Sarah says. “The nurse was wonderful, totally calming, totally gentle. Everyone was wonderful.” That includes the male nurse who calmed Presley by taking her under wing and pretending that she was his helper.

There’s no question Hunter has given them “stress – and some medical bills,” the Rogalas say. He’s also given them something else: an appreciation for having an emergency department close to home that delivers high quality care and real compassion.

“I’m happy we live close by,” Sarah says. “I think we’ll stay where we are.”