It’s hard to imagine a worse
case of mistaken identity.
Chaun Williams, 27, a St. Louis City
emergency medical technician
(EMT), was doing his laundry
at a University City laundromat
one evening last summer.
After leaving to run a quick errand, he
returned for his clothes. As he was getting
out of the car, he heard footsteps quickly
coming up behind him and saw the flash
of gunfire. He ran but didn’t get far. Falling
between two cars, he heard more gunfire
and managed to call 911 before he passed out.
When he awoke, he was riding in the back of
an ambulance. This in itself wasn’t unusual
for the EMT. But this time, Williams was the
patient, having had the misfortune of being
mistaken for someone who looks like him and
drives a similar car.
As the University City EMTs gathered the
standard information from Williams, he told
them he was having trouble breathing, that
they needed to decompress his chest and
that he himself was an EMT.
When the ambulance reached Barnes-Jewish
Hospital, Williams was rapidly deteriorating.
Brian Fuller, MD, was the attending
emergency room physician on call. “He was
clearly critically ill from a number of gunshot
wounds. At the time, we didn’t know how many,
but we did know he had collapsed lungs,” says
Fuller. Bilateral chest tubes were inserted and
a quick ultrasound of Williams’ heart and
abdomen was completed. It showed a lot of
bleeding. “We got large-bore IV access started
immediately to help with resuscitation including
fluids and blood transfusions,” says Fuller.
Williams was hypotensive and in shock.
His blood pressure was dangerously low but
the ED team didn’t give him medication to
raise it. According to Fuller, Williams was
allowed to be permissively hypotensive,
which means that instead of giving a patient
medication and excessive fluid to raise his or
her blood pressure, the trauma team works
to resuscitate the patient maintaining a lower
blood pressure. “For a patient like Williams
with a hole in a bleeding vessel, it helps that
they are a little hypotensive because it keeps
the blood clot intact, creating less of a chance
of re-bleed,” says Fuller.
Literally minutes after Williams came through
the Barnes-Jewish ED, he was on his way to
surgery. John Mazuski, MD, was the trauma
surgeon on call and was assisted by Matthew
Porembka, MD, chief surgical resident at the
time. Still in dire condition in the operating
room, Williams' heart stopped beating briefly,
causing the team to defibrillate his heart
and perform CPR. Mazuski and Porembka
performed what is called damage control.
“We stopped the bleeding but didn’t close the
wounds. We then sent him to the surgical
intensive care unit (SICU) with the sole
purpose of keeping him alive,” says Mazuski.
During the nearly 24 hours that Williams was
in shock, the team continued the resuscitation
and worked to stabilize him.
Williams’ care truly was a team effort. Two
days after he was brought in, Robert Southard,
MD, closed Williams’ chest and repaired his
colon. A day later, Bradley Freeman, MD,
closed Williams’ abdomen in his third and
final operation. Porembka assisted in all of
Williams’ surgeries and Fuller, who has a dual
appointment in emergency medicine and
critical care, treated him while he was in the
SICU. Doug Schuerer, MD, and John Kirby, MD,
cared for him in the ICU. Schuerer discharged
Williams almost three weeks later.
Although multiple physicians and nurses cared
for Williams while he was at Barnes-Jewish,
the common denominator was the trauma
multidisciplinary model of care reflecting
best practices during the entire chain of
survival. “The EMTs who brought him to the
hospital did the right thing by getting him
here as fast as possible. They didn’t stop to
start an IV or to intubate him, providing him
access to definitive care as soon as possible,”
The team also credits Williams for playing an
integral part in his own recovery. “Chaun was
young, healthy and in great shape to begin with.
This went miles toward helping to make him
better,” says Fuller. Mazuski, too, was amazed
with what Williams was able to do. “Usually
for a patient with these types of injuries,
it takes six to nine months to fully recover.
Chaun was an extremely determined young
man,” says Mazuski.
Williams was back at work in two and a half
months. Initially, he was frequently short of
breath but now says he is as capable as he was
before the shooting. After his experience, he
feels he can relate to his patients even more.
“I was an EMT for several years before the
shooting but now I know the very personal
feeling when it’s your emergency.”