True Life is Stranger than Fiction

True stories from the ER, and the streets of EMS.

Wednesday, December 21, 2005

Despite our best efforts...

You may think you know where this is going, but I guarantee you don't.
It's early on a Saturday morning, duty crew starts at 0800. We're just pulling into the parking lot of a local strip mall for breakfast. Being that early in the morning, staffing is at bare minimum. I have a Firefighter/EMT driving for me, and the Engine Co. has the minimum 3.
This particular Saturday, I was fresh from being precepted and newly on my own as a medic.
We get toned-out for a CPR in-progress. I'm immediately freaking out. We head that way. En-route, my driver tells me she's never been on a code. Great.
I'm grateful to have the folks I do on the Engine Co., we have a great relationship and I know I can count on them. I also hear Ambulance 12 being dispatched, and am glad to hear that-MedicChris and MedicCat are both on board, and they are a solid BLS crew at the time. This transpired when MedicChris was still in class to be a Medic and MedicCat had not started the process yet. I was glad to have at least a Medic-in-training coming along.
We arrive on scene and grab everything plus the kitchen sink off the unit. We proceed inside a small, single-story, single-family home. Once through the door, we are in a tiny living room with a sectional taking up two whole walls. On the sectional, there are several children, staring down at what will be my patient-a pulseless, apneic 38yo M, lying supine on the living room floor. There is also an audience of adults in the kitchen. Nobody is even attempting to shield the children from the horror on the floor.
I essentially throw my clipboard at Curt, the Firefighter on the Engine, and order him to write down everything I tell him to. I needed to keep track of things while I worked, and I sure as heck wasn't going to be writing anything down unless I sprouted five more arms in a hurry.
When we hook up the pt. to the LifePak12, he's in Asystole. Thanks to said LP12, I don't have to switch leads to verify-I get three right on the screen, and I can print a Code Summary later. Check.
We've gotten from the bystanders that he has been down for an unknown period of time. They tell us he's been drinking and smoking crack all night. I'm getting the feeling this will just be practice, but I'm still nervous.
I have the officer from the Engine Co. and MedicChris take the airway. I have Chris appy Cric pressure while Clancy bags the pt. so as to cut down on gastric distention. I proceed to estabilsh and IV and get the 1st round of drugs on board.
I then proceed to set up for intubation. I get my stuff together and then pull out of my airway kit a piece of equipment I've never seen before. This thing was the sorriest excuse for an ET tube holder I've ever seen. It was basically a piece of string and what barely resembled plastic. I hold it up and say "What the hell is this?" and get nothing but blank stares back. Whoops, I'm supposed to know what I'm doing! I abandon my temporary lack of sanity and intubate the guy. I apply the wet noodle device, but poor Chris ends up holding the ET tube in place the rest of the call anyway. Hindsight being 20/20, I don't know why I didn't just grab some dang tape.
Once I tube him, I push the second Epi and Atropine, and we load him up and move him out to my unit. We get him in the back, and I call report while Chris and Curt keep up their end of things. At this point, poor Chris is not only holding my ET tube in place, but bagging and chest compressions with one hand.
I tell the ED we're bringing in an Asystolic pt. who's intubated, has an IV, and has two rounds of drugs on board, a third to follow. ETA 5-6 minutes or less. I hang up, then push the third Epi. Chris says he sees something on the monitor. I look over, and sure enough, the pt. is in VF or VT (I can't remember which, either way it was a shockable rhythm!). I'm flabberghasted, as is Chris. So, I shocked him. He goes into a Sinus rhythm. At this point, I don't know what to do. This outcome is completely and totally unexpected.
So, I suction his airway and by then we're at the hospital. We practically sprint in and I announce (nearly gleefully) that he's got a pulse-NOT what they were expecting. They get a BP (he has one!).
My complete shock and awe continues as he is released from CCU within a few weeks and then released from the hospital all together later on. By this time, I've met the man and talked w/him at some length. He swears that he'll never do drugs again, but I've heard it before. I don't hold my breath on that one.
A year later, he has ZERO deficit, and is still drug-free. His children have their father, and in a way they never did before. They keep him another year before he goes back to drugs. I'm not surprised, but am disappointed.
Yes, I've made my contribution to society-another crack head. Despite my best efforts, he lived.

1 Comments:

  • At 8:13 AM, Anonymous Anonymous said…

    Wow, that /is/ incredible. Sad that he went back to it.

    -val

     

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