Wake Up Call

I walk into work at 6:15am, I've been awake since half past five – Well, I say awake – what I actually mean is that I am somehow moving around, and have managed to drive to work, my mind is still comfortably asleep in bed back home.
I start to check the equipment in my FRU, most of it is there, but I'm missing a few pieces of kit. Expensive pieces of kit, probably sitting on a vehicle elsewhere in our complex.

Then my phone goes off. “Hello”, says Control, “We've got a cardiac arrest for you”.

I jump in the car, check the address, then I see the age of the patient.

42.

Control has also sent a message that the patient's wife is doing CPR. This means that he might just have a chance of surviving this…

I race towards the address, it doesn't take long, although because of recent rainfall, I'm sliding all over the road.

It's only when I turn onto the road that I realise that I've been to this address before. I've spoken to this man previously, he seemed like a decent person. I know him.

I run in through the door, the hallway is clean but I can't see anyone, so I shout out.

“Up here”, comes the cry of an obviously distressed woman.

“Sounds genuine”, I thought.

So I bound up two flights of stairs and into the bedroom, where I see the wife performing pretty effective CPR on her dead husband.

She is crying.

I take over, connecting the patient to my monitor/defibrillator I see the patient's cardiac rhythm is Asystole – There is no activity in his heart at all.

Now comes the tricky part. I'm on my own, and there are a lot of things that I have to do very quickly.

I do fifteen chest compressions, this will hopefully get some oxygen to his essential internal organs. But to continue doing this I need to get his lungs full of air. So the next thing I do is connect up the 'ambu-bag' to my oxygen cylinder.

I tilt his head back and use the ambu-bag to inflate his lungs twice.

I start another fifteen chest compressions.

Downstairs I hear the crew entering the house.

“Top floor mate”, I shout, “Job is as given”.

When I say the 'job is as given', I mean that it was given to us as a cardiac arrest, and that it is indeed a cardiac arrest and not a faint/panic attack/cough or belly ache

It seemed like ages, but when I later check the times, the crew were less than two minutes behind me.

Three people come bounding up the stairs – the FRU from another station jumped into the back of the ambulance, he was waiting on station for the previous shift to return when the crew got the call.

I continue the chest compressions, one medic puts a breathing tube down the patient's windpipe. The other is getting access to a vein, so we can give essential medications. The last crewmember is doing the very important (but often underrated) job of looking after the wife.

After about nine minutes of this treatment, the rhythm on the heart monitor changes. It looks suspiciously like a decent heart beat.

I check for a pulse.

I find one!

The patient then spends the next couple of minutes (while we are preparing to move him) slipping in an out of either having a pulse, or having a 'shockable rhythm' which needs an electric shock to revert this back into a heart rhythm 'compatible with life'.

He ends up getting defibrillated twice before we can load him onto the carry chair, lug him down two flights of stairs and into the back of the ambulance.

We then find a member of the public upset that we are blocking his parking space. He is currently blocking the only exit that the ambulance has.

One of the crew has a word with him. She is much politer than I would have been.

He moves out of the way rather quickly.

As there are three crew in the ambulance, they don't need my help – so I follow behind them so that I can get my equipment back. By the time I reach the hospital the patient is being prepared for transport to the intensive care unit.

The wife gives the crew a hug, and sobs how grateful she is. Even the doctor at the hospital compliments us on a job well done.

But, failing a miracle, the patient will die, he was without oxygen for too long.

Once more it seems that we are just making time for the relatives to say goodbye. But for us it still seems like a success.

13 thoughts on “Wake Up Call”

  1. Re your last line – if the family get the chance to say goodbye, it IS a success. You and all your colleagues have my unswerving admiration and respect.

  2. Tom, it was a success, as you know. Well done to you, the other crews and to his wife. Nothing more to be said. Sleep well tonight mate

  3. When I read he is 42, my first reaction was “Oh shit”, this could be me in sometime, or this could be me NOW. Then I read through and couldn't hold back a rush of happiness – you have a way with words (I'm sure someone said this before).Now I'm back to feeling oh-shit-i-must-start-getting-fit-cos-i-have-kids-and-a-wife-and-i-don't-want-to-die-young

    Cheers mate

  4. Success has a lot of different measures. Especially in a world with a lot of different people in different situations. The only time anyone is a failure is if they don't make an effort.You know your job, you do your job, to the best of your ability, every time, and that's what counts.

  5. Speaking as someone whose father suffered a fatal heart attack out of the blue, also aged 42, thanks you for doing what you could. Nothing could have made the day my father died bearable but even being given the chance to adjust to him being critically ill and being able to see him first would have helped. My admiration and respect for EMTs and ambulance crews, in fact for all NHS workers, is immense.A cautionary note to the “oh-shit-i-must-start-getting-fit-cos-i-have-kids-and-a-wife-and-i-don't-want-to-die-young ” poster – don't panic yourself into doing too much too soon – my father died playing squash.

  6. Tom, how do you have such a way with words.The more I read the more I am really reconsidering my options regarding medical school v paramedic degree

  7. You make me realise that the rubbish I call work means nothing. Absolutely zip. How could working for an advertising agency have any value in comparision to the incredible things you do day in and night out? You have my admiration for what you do and how you write about it.

  8. I wept when I read this – my husband has heart failure and I just pray ( and I am not a religious person) that if or when we need the help of the ambulance service we meet someone withyour understanding and compassion

  9. You bought his family some time to say goodbye mate we all know if its a cardiac arrest when you get called you dont really stand a chance. I had a similar job myself the other week ( im a community first responder not an ambo ) – Got called to a 37 year old male cardiac arrest on my arrival CPR in progress by a neighbour (nurse) put the AED on but no shock advised started work on him after a few mins the FRU turns up and he tubes him and gets on with the drugs. The crew then turn up as well and eventually we get a rythum on the monitor although he still isnt breathing we move him to the ambo and the crew take him away i understand he died a few days later. The thing that really gets me is as first response on scene all the family were there the kids stood in the bedroom door the wife absolutely distraught crying for hewr husband not to leave her, you divorce yourself from this at the time but its afterward it hits you.

  10. Hello, I am paramedic from the Czech Republic. It is interesting to read the same feelings I have after every “successfull” resuscitation, only from another country and in another language. Good night, Jan Bradna, Prague

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