Seconds likely felt like hours as coaches and spectators came to the aid of Breanna Sudano, a freshman on Perry Hall High School's jayvee field hockey team who collapsed at the conclusion of the Gators' game at Catonsville High School on Sept. 27.
Among the spectators was Catonsville resident Beth Beautz, who had come to see her friend Audrey White's daughter play a varsity field hockey game for Catonsville scheduled for later that afternoon.
"We had just sat down and I was talking to Audrey and I saw a woman run across the field and I knew it didn't look right," Beautz said.
Beautz, a nurse in cardiac units since 1989, saw the situation escalate into a serious emergency when Catonsville JV coach Christine Ehrlichman started giving the fallen athlete CPR.
Having recently completed a course in advanced cardiac life support, which emphasizes more compressions per minute, she immediately ran across the field to offer assistance.
"I just took over for the coach doing compressions," said Beautz, who was joined in the heroic efforts by Ehrlichman, Perry Hall varsity coach Chastin Faith and two Catonsville parents who are both nurses, Shelly Hunt and Melissa Law. "The JV coach deserves a lot of credit. She acted quickly and started CPR."
"You are taught to do CPR until somebody comes to relieve you," Beautz said. "I just did what I was trained to do."
As the rapid compressions continued, Beautz saw a positive sign from an athlete she said "had a lot of fight."
"At one point, I thought she was trying to breathe," Beautz said.
The group's swift response saved Sudano's life.
According to an email from Catonsville Athletic Director Dave Lane, Eichelman asked not to be contacted about the Tuesday incident.
Lane did not want to comment on the event.
Elise Armacost, chief of public safety information for Baltimore County, said Sudano survived what was later determined to be cardiac arrest.
"I could not have done what I had done without the help of the jayvee coach and the nurses," Beautz said. "There is no way one person could have done CPR by themselves. It was a team effort."
The volunteer nurses and coaches continued life-saving procedures until paramedics from Medic Unit 4 came to the scene. When they arrived, Sudano received an electric shock from an AED (automated external defibrillator) that increased her pulse.
Beautz noted that the AED would not have worked if she did not have a pulse.
She was transported to St. Agnes Hospital and later moved to the University of Maryland Pediatric Unit.
While a 2006 state law requires an AED to be on site at every sporting event, the AED at the Catonsville was in the school building, a distance away from the stadium.
Ron Belinko, Baltimore County consultant for interscholastic athletics, said it is up to school personnel to decide whether to have the AED on the field.
He noted that a basic first aid kit is brought to the field and that coaches are trained in CPR and how to use the AED.
"During the last (10) years, there have been three incidents where a youngster has stopped breathing," Belinko said. "The emergency plan is in place, and it's working, thank goodness."
Even though the emergency plan is reviewed regularly, Belinko said an incident like this means his staff will review procedures even more.
Baltimore County has had discussions about increased testing of the heart as part of its annual physical for athletes, Belinko said, but often in a routine physical a doctor will note any abnormalities.
"It's amazing with these youngsters," Belinko said. "We don't know what's ticking inside of them."
Even after the call to 911 had been made and emergency responders arrived, the distress of the fans and members of both teams did not diminish as they saw the emergency vehicles pull into the wrong entrance for access to the field at Comet Stadium.
"What happened Tuesday — going to one access area instead of another — is a common problem when we respond to an address that covers a large area," Armacost said in a Sept. 30 email.
"In this case, the call came out as a cardiac arrest at Stadium Field at Catonsville High, 421 Bloomsbury Ave.," she wrote.
"The notes to the responders, based on the 911 calls, did not indicate where on the complex the patient was, nor did they tell the responders whether the patient was an onlooker in the stands or a patient on the field. The responders said they discussed while en route which access road to take.
"The EMS supervisor saw police vehicles, lights flashing, in the upper lot and took that as a cue.
"Immediately, when they saw people waving them to the lower entrance, the EMS supervisor turned and headed to the lower entrance; the engine quickly followed"
The medic unit, Medic 4, which was re-routed from another call, showed up shortly after the engine, Armacost noted.
Armacost said the situation has brought to light the need for emergency personnel to stay in contact with school officials.
"This whole case has just showed that there is a need for continuous outreach to the school system," she said. "There is a need for outreach to the school system to provide current access routes.
"Sometimes these routes change and our personnel changes, too."
While most emergency responders are familiar with the locations in their coverage area, Armacost said responders transferred to local units may not be as familiar with some access routes.
When responding to a large location, mistakes like this are common, Armacost wrote in the email.
To avoid these errors, it is important for 911 callers to provide all the information the dispatcher requests because it provides a faster response time, Armacost wrote.
As for concerns that the medical responders failed to show up in a timely manner, Armacost said that just isn't so.
Armacost said the engine left 35 seconds after 5:08 p.m. and arrived at the school, which is less than a mile from the station at 751 Frederick Road, one second before 5:12 p.m.
She noted it likely took "another minute or so" for the emergency personnel to get to the scene after taking the wrong entrance.
Armacost said operational regulations allow firefighters 45 seconds to leave the station after receiving a call.
Considering the rush-hour traffic in the area, Armacost said, the response was adequate.
"There's nothing unusual about this response time to this call," Armacost said. "No EMS unit can respond instantly."
Armacost commended the people who administered aid to Breanna.
In cases of cardiac arrest, patients need help immediately and their chances of survival increase significantly, Armacost said, if someone can administer CPR at the scene.
"We recognize that's the first step in the chain of survival," Armacost said."That's what happened here.
"The people who administered CPR to the girl are the heroes."
Three days after her collapse, Perry Hall athletic director Bob Hruz said Sudano was "walking around, eating cookies and playing Wii."
When Beautz heard the news of Sudano's improved condition, she was elated.
"I heard she was up and walking which is a miracle," Beautz said. "A miracle happened and she made it. I am just very, very happy for that family."