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| Wildflowers |
Running cardiac arrests is a fact of life as an EMS provider. We call them codes. Usually, if they are dead when we get there, they tend to stay dead. We do our best, but few un-witnessed codes actually end in a "save." In my five years with the Rescue Squad, I've been on at least 6 codes, not counting the one described below. Only one of them made it to the ER alive, but he died in the ICU a couple days later. The one that died in front of us...well, he had a massive Pulmonary Embolism (blood clot in the lungs) and never had a chance. I've never truly had a cardiac arrest "save" who made it home from the hospital...until this week.
This past week, I was on duty as the regional medic in the west end of Loudoun County--Region A. Think of this as being the EMS equivalent of a K-9 unit. In the 1/4 of the county that I cover, there are a lot of ambulances with EMTs, but I'm the only medic--or ALS provider. If I need a medic for backup, they are about 15 minutes away. To continue the story...I'd gone out to dinner with the ambulance crew from my station. It was a hot, muggy day and a large storm center had just hit the town we were in. Thunder, lightning (lots of ground strikes) and a huge downpour.
In the middle of this, our food had just arrived when the tones were dropped at 19:28 for a 15 year-old-female having and allergic reaction w/trouble breathing at another restaurant in town about 1/2 mile away. I had a bad feeling about this one, and beat the ambulance to the scene by about a minute. As I pulled into the parking lot, the mom came running out into the storm to tell me the girl was barely breathing. I unlocked the drug cabinet on my chase vehicle, grabbed my drug bag and went into the restaurant. The girl was lying there on the floor next to the bench near the entrance breathing like a fish out of water. I didn't have enough time to give her anything before she stopped breathing. Praise God the ambulance crew came in just then, because respiratory arrest very quickly turned into cardiac arrest. We did CPR for about 2.5 minutes before we got her back, and went through the allergic reaction protocol.
Another medic just happened to be at the restaurant and jumped in to help. I was incredibly glad to have him there helping because the next closest medic was coming from 12 miles away and I needed help yesterday. We got her to the hospital alive (she was complaining that her chest was sore), although three minutes out from the hospital the medications wore off and in less than a minute she breathing like a fish out of water again. We were assisting her breathing with a BVM again by the time we arrived. She was quickly sedated, intubated and placed on an Epinephrine drip by the ER doc before being transferred to a children's hospital. She was extubated about 11:30 that night, was discharged from the hospital later the next day. For me, this allergic reaction code was a big deal. Not only was it the first severe allergic reaction I have run since getting released as a medic, not to mention the first code, but the patient was the same age as my youngest sister. Very scary. All things considered, the call went well. Praise God this one ended so well!
I've found several ways to de-stress after a significant call like this one. Usually after a call like this, I end up reviewing and criticizing the actions performed on scene to see what can be done better the next time. But when that's over, it's time to deal with the stress. Some form of exercise usually works, running, swimming, hiking, taking a ballet class. I also like to make a trip to the library for a new book and will spend hours working on my garden while listening to music. This time around, I picked up a book on the science behind the Sherlock Holmes stories. As for music, I'm currently into a CD of harp concertos I picked up from a thrift store and the soundtrack for Captain America: The Winter Soldier that I found on YouTube. The garden looks lovely now after a bit of cleaning up.
