When the ambulance arrived on a recent weekend, Michelle Palmer’s blood pressure was 64 over 40.

That’s not good.

“I was in a lot of pain,” she said.

Palmer, 32, of Lawrence, knew she was about six weeks pregnant. She didn’t know she was carrying two embryos – one in her uterus, the other in her left fallopian tube.

Her fallopian tube had burst. She was bleeding internally.

“I felt like I was passing out,” Palmer said. Her mother, Linda Condra, called 911.

When Palmer got to the Lawrence Memorial Hospital emergency room, she had more than two liters of blood in her abdomen.

“That’s half the blood in her body,” said Dr. Sabrina Prewett, one of two emergency room doctors on duty April 1.

Prewett spoke with paramedics as they were rushing Palmer to the hospital.

“I know the paramedics (Eric Lessig and EMTs Greg Murray and James Ziegler). I trust them,” Prewett said. “They’re very, very good.”

Though she hadn’t seen or spoken to Palmer, Prewett suspected a ruptured fallopian tube and alerted the operating room. When Palmer arrived at the hospital, she was weaving in and out of consciousness. She was in shock.

Within minutes, Prewett and her crew stabilized Palmer’s blood pressure and put a tube in her lungs that kept her breathing.

“I remember there were 10 or 12 people around me, doing things to me. It seemed like they all knew what they were doing,” Palmer said.

“I could hear them, but I couldn’t say anything,” she said. “I heard them tell my mom she needed to leave.”

Minutes later, Palmer was rushed to surgery.

“Basically, they cut me open right there,” she said. “They stopped the bleeding.”

Her tubal pregnancy was lost; her in utero pregnancy remains.

“I just had a sonogram,” Palmer said April 10. “They said it looks good, the heart rate is good – we don’t know the sex yet.”

Palmer remained hospitalized until April 14. Her husband, Francis, is in Africa visiting relatives. He is not expected to return until April 29.

Palmer is lucky to be alive.

“The thing you need to understand is that in a situation like this, the bleeding isn’t subtle. It’s more like an open faucet,” said Dr. Scott Robinson, medical director of the emergency department.

Prewett’s diagnosis, he said, saved Palmer’s life.

“We see a fair number of people who are in shock with life-threatening symptoms,” Robinson said. “What was remarkable in this case was Dr. Prewett being able to pretty quickly come to the conclusion that (Palmer) had both an intrauterine pregnancy and an ectopic pregnancy, and that the bleeding was coming from a ruptured ectopic pregnancy.”

If Prewett hadn’t prepared for the worst, Palmer easily could have died. Her condition was rare.

“They told us the chance of something like this happening is like one out of 130,000,” said Palmer’s father, J.R. Condra.

Asked if she agreed with Robinson’s assessment, Prewett, who has 25 years of emergency room experience, replied simply: “It was a team effort.”

She added, “You plan for the worst and be glad when it doesn’t happen.”

Palmer doesn’t remember much about her emergency room experience, but she praised Lessig, Murray and Ziegler – “They were awesome” – and her surgeon, Dr. Samantha Durland.

“She is the most caring, the most comforting doctor I’ve ever met,” Palmer said. “She is incredible.”