Thursday, July 30, 2009

Three Minutes Out

So my time in the ED started off at a crawl. Did lots of urine samples and EKGs. Three hours in and (finally!) there is a code 1 three minutes out. My brain tunes out everything else that was said. I sort of went blank. I knew that if CPR was in progress or needed I would be called upon. I was fine with that, just a bit nervous seeing as how I had only ever practiced on a limb-less plastic dummy.

There are two EMTs and two Paramedics wheeling the patient in. One of them is riding on the side performing chest compressions. The patient is an 83 year old male who was found pulseless and apneic by his daughter. He had been that way for at least 4 minutes when the medics arrived. By the time he was rushed into the red pod he had been intubated and had vomit dripping down the sides of his face. With each breath his stomach kept filling with air.

Within ten seconds that vacant room filled with 15 people, 1 patient, and myself. It was sudden chaos, and I was being called to the opposite side of the stretcher to take over compressions. I weaved my way over, dodged a few flailing arms, and stepped up onto the stool. Adrenaline took over and I found myself with my hands on the patient's sternum doing my first real chest compressions. It was nothing like I expected. Although, I'm not quite sure what I was expecting in the first place.

Meanwhile, doctors were shouting orders at nurses and asking the medics question after question. Three minutes go by and the nursing student takes my place. Before I even have time to try and figure out where I should stand the medic at the patient's head asks me to take over bagging. Lucky for me there was a little yellow light that blinked every six seconds, prompting me to squeeze the bag. Two minutes go by. The head doctor stops compressions, checks again for a pulse, and says to continue with cpr. It's my turn. I got out just in time. Not twenty seconds later does the patient vomit and it sprays everywhere. Specifically onto the face of the medic (not wearing proper BSI!) who took over bagging.

Another two minutes, compressions are stopped. A weak femoral pulse is felt. It is short lived. Compressions begin again. This goes on for twenty three minutes. Finally the patient has regained a pulse, at least for a short time, and the doctors kick us out to do their thing. Whatever that might be.

I don't know what happened to the man. His daughter had disappeared when EMS arrived on scene, and she never showed at the hospital.

That was 24 days ago. I can still picture every detail about the man's face, and I remember all the tattoos he had on his chest and arms. And sometimes I find myself wondering who he was, what kind of life he lived, how he ended up exposed on a backboard with a tube down his throat and me pounding on his chest.

So, that was exciting. I wish I knew the outcome, but I suppose that's just the way it goes sometimes. Time to return to my studies.


peedee said...

Yay!! Comments work this way!
Thanks Medic999 for helpin us out!

I must say, the initial compressions were the most gross for me. Crackin a sternum is a nasty feeling.

You ask about our first call we ever ran the other day and mine was so long ago, I cant really remember what it was. But this post of yours does remind me of the first time for something.

We get on scene early morning to a chest pain/trouble breathing call in a very nice over 55 community. I was still a very new EMT at the time. The wife is frantic, she's trying to gather meds and tell us his medical history. We walk into the bedroom and there sat on the end of the bed a very short of breath older gentleman. He looked 50 although he was 65. In very good shape and quite honestly very handsome. (wierd things stick with you years later) He was having chest pains, and eating rolaids like they were candy. The medics got a line and 02 on him, hooked him up to the monitor and gave him a nitro.

I chatted with him doing the assesment and getting history. He was such a gentleman. He was talking to me and telling his wife in the next breath he loved her. He told her he would be alright. As we transfered him to the stretcher he coded. The rest of the story is the same as every other code as they tend to blur together. Although it was my first time doing CPR on a live/dead person and not "annie". He was called by the ER doc an hour after he arrived in the ER.

What remains with me to this day is I was talking to him one minute and watched him die the next. I listened to his last words to his wife of 48 years. Some calls just stick with you. This was the first of many I remember like they were yesterday and it was an awakening of what I'd really gotten myself into. And although I was sad he died, I knew I loved my job at that moment.

Ckemtp said...

Ahhh the memories.. To think of all of the great times I've had throwing EMT students into codes. I tel you, the look of shock and horror on their faces is just priceless.

It's not to be mean, just to acclimate them to the show.

I remember one where the Pt had a colostomy bag that kept filling up with each compression. We had to keep "burping" it to keep it from exploding in a shower of gastric contents.

Guess whose job it was to burp the colostomy? Heh heh.. I love EMT students.

Nice blog, keep up with it. I'll check in from time to time.

Bernice said...

Well hi there... I just noticed you are following my blog so I thought I would stop by and say hello. I'm looking forward to reading more of your blog. :)

Micp2683 said...

Welcome to the world of EMS. I saw today that you are following my lonly single Blog. No worries more to come. It is tough becoming the boss, my desk is never clear for very long.
I wish you the best of luck, remember the passion even after 10 years of low pay and too many calls.
Remember your basics and that patients are people, treat them that way.