08 September 2007

COD unknown

Our company allows ride-alongs of several types on the 911 trucks. From new employees to EMT students to athletic trainers to interested observers, you never know who is going to be riding. This particular day, we had an ER nurse who is considering applying to a flight program and wanted to know more about "street" medicine. Also in-house was our chaplain, but we don't ever take two riders on one truck.

One of the most terrifying types of calls gets dispatched to our truck "4-month old, cardiac arrest". Everybody hops in (after the nurse and chaplain fight it out for the backseat, we get the nurse), I'm driving because The Asian wants the short ride to straighten his thoughts and mentally review pediatric doses for the ACLS drugs. We're hauling ass across town even though these kinds of calls go two ways. We arrive, everyone is fine and there was some sort of overreaction, maybe we transport, maybe not. Or, we arrive, there are lots of panicked people, many screaming or shouting and a rapid transport.

This call is one of the latter. The nurse grabs our pediatric bag out of the back and takes off towards the building, only stopping when she reaches the door and realizes we aren't behind her. The Asian grabs the cardiac monitor and oxygen, shouts for me to grab the med box and the first-in bag and we all head to the building like a stampeding herd. Before we get to the first floor apartment, a firefighter appears carrying the baby and running toward us while trying to perform CPR.

A blue baby being run directly to you by a man who looks relieved to see that help has arrived is one of the most terrifying things I can imagine on the ambulance. "The baby's still warm!" Two more breaths in, then he tries to hand the baby over to The Asian, who immediately calls for a rapid retreat to the ambulance and tells the FF to keep doing CPR on the way because we're going to need his help. The next few minutes are still a blur to me. I know an incredible amount of stuff got done, a decision was made about transport, another about who we were taking, then I'm back in the driver's seat heading back across town as fast as I can convince people to move to the right or at least out of the way.

I catch pieces of conversation from the back, hear the IO go in, drugs being administered, the confirmation of asystole on the monitor. Somewhere along the trip, despite their advantage of an opticom to change the stoplights for them, I lose the engine which was tailing us - in their defense, I don't have to haul a couple hundred gallons of water up the hill to the hospital. En route, I have to patch to the hospital while trying to drive, not an easy task but accomplished well enough I suppose.

We pile out at the hospital and walk in to a strange sight. Normally when you call in a cardiac arrest, security is waiting for you at the door, the first trauma room is open and there is an accumulated crowd in the room. The trauma room is closed, we continue down the hall and find a nurse and patient family standing in the hall and everyone looking as though there is nothing special about us getting here. The Asian hollers at me, "Did you even call THIS hospital?" Yes, I certainly did and finally when we get to the nursing station, someone points us to the second trauma room and there is the crowd we were expecting. I'm pretty much just in the way at this point, so I take as much of our equipment as possible out of the room to make space.

I wish I had a happy ending to this, but the baby was dead before we arrived on scene and we didn't change that fact. The hospital we transported to was the one our riding nurse works at, and we hear later that the baby had a 105 degree temperature at the hospital which is fantastically high considering that was a minimum of half an hour after death. We find out this was the first time the nurse had ever done CPR on a real patient, and we were lucky to have her with us because she was helpful and not panicked. We're trying to follow up with the medical examiner to find out autopsy results, but the EMS system isn't really designed for this, and the PD are usually pretty quiet about the results of their investigations, so I don't know if I'll ever know what happened.

1 comment:

manchmedic said...

To add to that which I am aware of... Mrs. Asian had a 6 month-old a couple of days later - I saw her at the ED that day, and she told me about your call.

Makes them want to hold the baby Asian that much closer, don't you think?