I am writing to express my heartfelt appreciation for the exceptional care provided by Labor and Delivery nurse Emily Johnson-Surratt during a recent medical emergency on a United Airlines flight from Houston to San Francisco. I am a nurse at Stanford's main campus. Emily and I found ourselves on the same flight early Saturday morning, where we encountered a critical situation involving an 81-year-old gentleman with a history of cardiac events. In the face of this emergency, Emily demonstrated remarkable agility, promptly assisting the unresponsive gentleman while I performed initial assessments, triage, and coordinated with the flight crew for medical support. Together, we assessed the dire condition of the elderly gentleman, characterized by pallor, clamminess, unresponsiveness (to pain, sound, or name-calling), shallow breathing, severe hypotension (64/48), barely palpable pulses, and unattainable oxygen saturation levels. We ruled out an array of potential concerns that ranged from diabetes hypoglycemia, hypoxemia, cardiac tamponade, stroke, hypovolemia, cardiac arrhythmia, and septic vs. cardiogenic shock. 

Working seamlessly in tandem with the United Airlines staff, Emily and I provided medical aid despite the challenging environment marked by plane turbulence, cramped space, and limited resources. Emily's exceptional skill and professionalism shone through as she adeptly established an IV line so we could subsequently administer life-saving IV fluids to address the patient's critical condition.

With her composed demeanor and reassuring presence, Emily played a pivotal role in stabilizing the gentleman's health until emergency medical services could assume care upon landing. Recognizing the complexity of the situation, it was evident that my contribution alone wouldn't have sufficed. There were numerous intricacies regarding the patient's non-responsiveness, pale, cold, clammy state, hypotension, and barely palpable pulse. Emily's collaboration was indispensable in addressing these challenges effectively. I wish to commend Emily for her unwavering dedication and collaborative spirit during this critical incident. Her actions were instrumental in achieving a positive outcome for the patient, whose condition markedly improved upon transfer to the care of paramedics.

The collective effort of other United Airlines passengers and staff who rallied to assist further underscores the significance of teamwork in moments of crisis. The entire aircraft was in absolute silence while we ran the code, except for the occasional toddler cries. 

While some have labeled us heroes and praised our efforts, I am humbled by the opportunity to work alongside Emily, whose commitment to delivering high-quality care amidst adversity epitomizes the values of our nursing profession, especially as it reflects on the Stanford mission statement and our nursing pillars. I am deeply grateful for this experience, which underscores the importance of collaboration and resourcefulness in ensuring optimal patient outcomes.

Thank you, Emily, for your exceptional teamwork and professionalism. Your contributions have made a profound difference in this patient's life and that of his wife. I will always treasure the invaluable lessons gleaned from this extraordinary experience high upon sky altitude of 40,000 feet.