25 September 2007

Arrests

Personal experience with ambulance staff on either cardiac arrests or trauma calls are one of the biggest reasons people give for deciding to pursue EMT training of their own. But once you start working more than a couple of cardiac arrest calls, they really aren't that great. Here's the run-down of the past month's trifecta of arrests.

The first one was the bystander witnessed, clutch your chest and teeter over type of arrest. ZM and I arrive to FD doing CPR after using the AED, and when we got the patient on the monitor there was nothing but asystole. We went through the whole arrest protocol, even getting to use the IO when IV access wasn't readily available. Nothing resembling life ever made it back to the patient and the hospital worked him for less than 20 minutes before pronouncing him dead. So, a whole lot of sweat and work summed up into the same outcome as if we'd never shown up.

The second one was with the Asian and the medic student riding with us. Called for mutual aid to a neighboring town for a cardiac arrest at a nursing home. We're debating on the quick ride over (this part of their town is closer to our station than many parts of our town) whether the patient will be "workable", i.e. will the medic student be able to do any of the skills he needs to accumulate? On arrival, we load up for a presumed arrest, backboard, monitor, drugs, first-in, 02, and I think someone may have grabbed the stretcher at some point. We and the FD stampede into the room and are brought up short by the vision of our patient lying peacefully, eyes closed, on the PT bed with a nasal cannula and the staff standing around looking at him (nursing home version of Folded Arm Observation technique). What the ?!? Since nobody was doing CPR, I asked if the patient had a pulse, and yes, he did. Not so much a cardiac arrest. In the end, the story was an initial complaint of chest pain, 2 NTG followed by a fainting. He did come around a little in the ambulance and I'm still not entirely sure why he was not able to respond to commands initially, but I believe he ended up okay.

Third one was again with ZM (who now thinks I'm bad luck because we've had one each shift). He's grumbling at me about the amount of work this is going to be, patient is on the fourth floor, it is again unseasonably hot, etc. etc. We arrive to find a FF walking back out to get his SCBA so at least one of them can enter the place against the smell; one other was gagging in the hallway. Apartment manager went to post the eviction notice after non-payment and complaints of the smell, and for whatever reason, opened the door. This patient was long past saving. When people rot, like any other meat, they acquire maggots, and then flies. The description here was "condominiums of flies". We don't know how old the patient was, or even the name, nor how long he'd been dead.

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