Emily Raines and her boyfriend, Daniel Shifflett, were still in vacation mode on their flight home from Fort Lauderdale to Baltimore, when they heard an urgent voice on the plane's loudspeaker system.
A passenger was having a medical emergency, a flight attendant on Southwest Flight 553 said, and any medical professionals onboard were asked to come to the front of the aircraft immediately.
"We just kind of looked at each other," said Shifflett, 28.
Raines and Shifflett - both of whom are licensed nurses - sprung out of their seats.
"I could hear the panic in the flight attendant's voice," recalled Raines, 31, who was seated near the back of the plane. Right away, she said, she knew "this is going to be serious."
A flight attendant led the couple - who met in 2018 when they were both working as nurses at Sheppard Pratt, a psychiatric hospital in Towson, Md. - to a man slumped over in his seat.
The man's face was blueish-purple, Shifflett said, and he didn't have a pulse. They were about halfway through the nearly three-hour flight when the man fell unconscious.
"A flight attendant was trying to do compressions, but the guy was on his chair," said Shifflett, who worked as a nurse for five years before transitioning to a career in finance in 2021. "You need to be on a flat surface. Otherwise, the compressions aren't going to do anything."
Right away, the couple carried the man - whose full name they did not disclose to protect his privacy - to the ground and began doing chest compressions.
The space they had to work in was tight.
"It was difficult to do, because we were in the middle of a plane aisle, which is very thin," Shifflett said.
Initially, "when I gave him a rescue breath, I could see that his chest wasn't rising," Raines said, explaining that his airway was blocked.
Fortunately, there was some medical equipment on board - including an oropharyngeal airway, a device used to open a patient's airway. Surrounding passengers helped sift through and organize the equipment to support the rescue effort.
"There were a few people that were definitely trying to help," Shifflett said.
In addition to an oropharyngeal airway, Raines used an other medical device called bag valve mask, which provides positive pressure ventilation to a patient who is not breathing properly. Shifflett continued doing chest compressions.
"It was very overwhelming," said Raines, who is an acute care nurse at Greater Baltimore Medical Center (GBMC) and has been a nurse for 10 years.
Shifflett felt overwhelmed, too, but "I was very confident that we would be able to give the best care possible in that situation," he said.
After about 15 minutes, Raines said, "we were able to get his heartbeat back," just as the plane was about to make an emergency landing in Raleigh, N.C.
"He was awake when we got there," Raines added.
Seeing his eyes open "was amazing," Raines said. The man - who she described as middle-aged - was immediately taken to a nearby hospital by emergency personnel.
"Not a lot of times when you give CPR or have situations like this do patients truly make it," she said. "It doesn't happen often."
Her boyfriend agreed.
"Thank goodness this worked," Shifflett remembered thinking as the man regained consciousness.
The couple - who were on their way home from a four-day cruise in the Bahamas - said they had tried changing their flight twice that day, but it was too expensive to switch. They were hoping to catch an earlier flight, as they had gotten off the cruise ship around 9 a.m., and their flight wasn't until 4:20 p.m. In hindsight, though, they said they're relieved they remained on their original flight.
"I'm not sure what would have happened," Raines said.
Since the flight on May 1, Raines and Shifflett have stayed in touch with the man and his family. His wife sent a thank you message with an update one week after the emergency.
"We are still not completely sure what happened," the wife wrote in a text message, explaining that "he didn't have a heart attack" and that it was probably "due to low oxygen levels."
"I cannot possibly thank you enough for saving [his] life," she added. "There are no words."
"He's at home now and he's doing well," Raines said, adding that the man's wife contacted them a few days ago, telling the couple to expect a box of homemade cookies in the mail shortly.
Neither Raines nor Shifflett had previously dealt with an in-flight emergency. The first thing they did when they got home was call their families to fill them in.
They also told their colleagues what happened.
"We are so proud of Emily and her quick response during this emergency, and we are glad to hear the gentleman is now doing well," said Angie Feurer, the chief nursing officer at GBMC HealthCare.
The couple said the ordeal made them even more appreciative of their medical backgrounds - and each other.
"It's not every day that these things happen," Raines said. "I'm really glad we were able to be there to help."