Journal Entry: Saved To Death
Disclaimer: the Journal Entry series are personal stories that I have written about my own experiences and are taken from my personal diary. They are written as a form of therapy for myself and as a way to bring understanding to my loved ones. This series is meant to provide examples of the reality of life as a first responder. Content may be traumatizing or triggering to some.
“Hey Sam, phone for you.” It’s seven in the morning. I was working a reverse 24 hour shift, meaning I had started at 6 P.M. the night before and still have 11 hours to go in this shift. Night shift always makes you groggy and it’s tough getting through the rest of the day sometimes. My partner Jen and I were up most of the night and we were just about to get more coffee to meet the demands of the busy start of the day shift.
My chief holds up the phone and says, “It’s the son of a lady you transported last night. He wants to talk to you.” Of all the calls that I ran last night, this could only be in regards to one in particular and would likely be a conversation I didn’t want to have. At least not before having my coffee.
The call came in around four o’clock this morning. It was to a trailer home for an elderly female complaining of chest pain. Pulling up to the trailer, I can see it’s a rather nice double wide. The front door is open and the lights are on. I walk up the front steps and knock while calling through the screen door, “Hello, EMS!” There’s no response from within. My heart sinks just a little. Opening the door and stepping inside, I yell “EMS!” again, but no response. I don’t see anyone so I make my way through the trailer to the back bedroom. I find her lying on the bed, unconscious, a ruddy blue color, and not breathing. “It’s a code, grab the shit,” I yell back to Jen who had followed me in. “Ah fuck.” She turns around and heads back to the truck to grab the aforementioned “shit” which of course is all the rest of the equipment needed to treat a cardiac arrest.
I put my fingers to her neck and quickly confirmed the absence of a pulse. I needed to move her to the floor to begin CPR, and being as she was quite large, this was not going to be an easy task for me to do by myself. I unceremoniously grabbed her arms and pulled hard. She began to slide, and I realized she would definitely fall out of bed and I would not be able to fully catch her. Weighing this against the fact that she was currently clinically dead and would not become more dead, and the fact that CPR needed to be started as soon as possible in order for her to have any chance at returning to life, her falling out of bed seemed like a reasonable compromise.
Thump! Her legs and lower half hit the floor while I awkwardly lower the rest of her to the ground and roll her onto her back. Noticing she has a rather large skin tear on her knee as a result of the fall, I cringe a little and begin chest compressions. Jen comes huffing back in, loaded down like a pack mule with the rest of our equipment. I continue compressions while she places the defibrillator pads on and hooks them to the monitor. V-Fib, cool. “Clear!” Zap, compressions resume.
The automated CPR device gets placed next. It’s a barbaric machine with a plunger fixed with a suction cup that mercilessly pummels the chest one-hundred times a minute. It’s not unlike a horrible version of a toilet plunger affixed to the center of the chest. As awful as this device appears, it saves lives. It never gets tired, it remains consistent in timing and depth of compressions – all things that are very important to maintaining blood flow. It also frees my hands up to do other necessary treatments. It’s a device that is as much a part of the team as myself or my partner.
I place an IO and administer EPI, then shock again. I place a breathing tube into her trachea and Jen provides ventilations. We shock again, and again, then give Amiodarone in an effort to stabilize the cardiac cells. Firefighters arrive and they start preparing a way to carry her out of the house. This is not a pristine scene. There is vomit, she is incontinent, there is blood oozing from her knee. I am tired, sweating, and overall not having a good time. But then it happens. “She’s got a pulse!” Finally! We spend a few minutes assuring that not only does she have a pulse but is stable enough to begin transporting. The EKG shows she is having a heart attack, so off we go to the hospital while the firefighters mop up the scene as best they can. The ER staff takes over care, the ambulance is cleaned up, and we go on our way.
But now I’m being handed a phone with her son on the line.
“Hello, this is Sam.”
“Hi, are you the ambulance guy that took my mother to the hospital last night?”
“Yes, how is she doing?”
“Not well, she had a heart attack. The doctor says they may not have been able to fix it due to her having CPR.”
“I’m very sorry to hear that, she was a tough case and very sick.”
“So the reason I’m calling is, she has a large bruise on her chest and a big wound on her knee. I’d like to know how that happened.”
“Well sir, the wound on her knee happened when I pulled her out of bed. At that time she had no pulse, and CPR needed to be started immediately if she was going to have a chance of surviving.”
“So you just dropped her out of bed? You couldn’t have been more careful or waited for help?”
“I guided her to the floor, but trust me sir, she needed to have CPR performed right away. It’s unfortunate that it happened, but there was no time to waste.”
“Well what about the bruise on her chest?”
“That’s from performing CPR. It’s not pretty, and it’s a pretty aggressive thing to do, but it is necessary for patients in cardiac arrest to survive.”
“Well it seems to me that you were overly aggressive, and now they can’t fix her heart because you did CPR. Why couldn’t you have just done your job and taken her to the hospital and let them fix her?”
Ok, deep breath Sam…
“Sir, please understand that your mother had no pulse and was not breathing when I found her. She was clinically dead at that time. If early, aggressive treatment was not started immediately, she would have remained dead and would have had no chance whatsoever of even being cared for at the hospital. I understand she is currently alive, which is due to CPR, and although her condition is not good, there is still hope for her. As Emergency Medical Services, it is our job to provide this level of care to our patients. Is there anything else I can help you with?”
“Well, it looks like there’s blood still in her carpet. Are you guys going to replace that?”
“I’m very sorry sir. I’m happy to let you talk with my chief if you have concerns.”
“So who is going to clean up your mess?”
“I’m sure there are cleaning services or products available. If you have concerns or would like to speak to my superior I would be happy to refer you to my chief.”
“Just so he can take your side? I don’t think so.”
“Well if there’s nothing else, you have a better day.”
I hand the phone back to the chief and walk off to find Jen. “Let’s go get coffee.”
