Quick, calm action by Akron Children’s home nurse saves mom’s life

Juanita Montiel and Nicole Pamias, about two weeks after Nicole’s medical emergency.

Nicole Pamias had an EpiPen® but had never needed to use it.

By the time she needed to use it, her eyes were almost swollen shut – and she unable to read instructions.

She could feel her windpipe closing in.

Panic was setting in.

But, as fate would have it, she had a nurse in the next room ready to help her.

Nicole had just been stung by 27 bees.

While she expected an allergic response, it came much faster and much stronger than she ever imagined.

The right place at the right time

Juanita Montiel, a licensed practical nurse through Akron Children’s Home Health Care, was in the house June 28 caring for Nicole’s 10-year-old son, Malcolm, who has spina bifida and is dependent upon a tracheostomy and ventilator.

It was a last-minute decision to request nursing coverage for 3 hours that Saturday night while Nicole planned to do some errands, including some yard work in her mom’s backyard nearby in the same Copley neighborhood. Juanita, who had been caring for Malcolm for several months, was available for the shift.

Juanita arrived at 6 p.m., and around 7:30 p.m., she could hear Nicole come in the front door and enter the kitchen.

“I heard her going through cupboards,” recalled Juanita, who was in Malcolm’s room. “She said, “’I got stung by bees, and I’m highly allergic.’ When I got to her, I could see the panic.”

While at her mom’s, Nicole pulled back a tarp on the ground. A swarm of bees attacked her. She was stung on both legs, her stomach, back and forearm.

“The bees were under my shirt; they were in my shorts,” she said. “My right hand was the worst with the hives. It quickly began to look like a softball.”

By the time she drove the short distance back to her own house, she said hives felt like someone was pouring hot coals over her head.

Nicole was diagnosed with a bee allergy about three years ago. She had been stung, and her reaction was so bad she ended up in the emergency room. She had long thought about that moment when she might need to use that EpiPen for the first time. But now here she was.

“You don’t think about your eyes swelling shut and you losing your vision right when you need it in a critical moment,” she said.

Calm under pressure

Nicole remembers Juanita calming her with words like, “I’m a nurse, and I will help you.”

“Even though my vision was pretty much gone by then, I know Juanita administered the EpiPen perfectly,” Nicole said. “I honestly believe – and the hospital staff agreed – that she saved my life.”

Juanita had experience using an EpiPen on her own son but agrees Nicole’s situation was dire.

“The hives were spreading down her face, and she was having some difficulty with her speech. I think her tongue was swelling,” Juanita said. “I called 911 and said, ‘Nicole, are you ready for the injection?’ She said yes, and it went into her right thigh. You have to hold it for 10 seconds. I made sure she was OK, and then I went to check on Malcolm. He could hear his mom and was trying to climb out of bed.”

‘Take care of yourself’

The EpiPen kept Nicole’s symptoms from progressing, and the paramedics arrived within minutes. They administered more epinephrine, antihistamine medication and oxygen.

As Nicole left with the paramedics for the hospital, Juanita assured her that she would be with Malcolm and update the night nurse who would relieve her.

“Nicole, take care of yourself,” she said. “I checked on Malcolm. He’s doing fine.”

Nicole and Malcolm enjoy Akron Children’s recent “Dream Night at the Akron Zoo,” a rare outing since his recent spine surgery.

The two women spent the next weekend, the Fourth of July weekend, together as Juanita was again on duty with Malcolm. Nicole and Juanita, both single mothers of children with special needs, discussed the previous weekend and all the things that went right and how it could have played out very differently.

“There was already a deep trust between us,” said Nicole. “Malcolm is a child with acute respiratory care needs. So, when I go to sleep at night, I put trust in her.”

Juanita, a mother of four, added, “I know how hard it is to let someone else take care of your child. Yes, I make a living as a home care nurse, but every patient is special to me.”

EpiPen usage tips

Juanita said people who are prescribed EpiPens should:

• Have the medication with them at all times. The most common causes of death from severe allergies are waiting too long to inject or not having the EpiPen with you.
• Make sure the EpiPens have not expired.
• Do not store them in refrigerators or in hot cars.
• Familiarize yourself with the instructions. They may differ between brands.
• If you have an allergy, have it noted on a medical alert ID bracelet for first responders.

“I’m just happy I was there to help,” said Juanita. “In that moment, when you are having trouble swallowing and having trouble breathing, you may not be able to focus on what you need to do. The important thing is she [Nicole] is recovering well, and everything ended well. That’s my biggest thing. Malcolm needs his mom.”

Nicole saved the packaging from the EpiPen that saved her life after being stung by multiple bees.