Yesterday started well, we had the only new “yellow” vehicle on the complex, and it really is an improvement on the old motors. But then we got a job that should have been routine.
We were given a “34 year old male, seizure” at a nearby football pitch in the middle of a park. Also leaving from our station was the FRU (a fast car, designed to get to a scene before the ambulance). As we had a new motor, we were able to keep up with the FRU.
Arriving at the top of the street, we were met and directed by some of the patients football team-mates. Unfortunately the patient was 200 yards into the park, and there was no way we were going to get the ambulance onto the field – The council had built a little moat around the park to stop joyriders tearing up the grass in their stolen cars.
The FRU paramedic had reached the patient first and I ran across the field to get to the patient as the Paramedic looked worried, and this isn't someone who normally worries. As I reached the patient, carrying the scoop which we would use to move the patient the paramedic asked me if I thought the patient was breathing.
The patient was Nigerian, and it is not racist to say that sometimes detecting signs of life on a black person is harder than if the patient is caucasian. White people look dead, black people often just look unconscious. Also a windy playing field in dusk is not the ideal circumstance to assess a patient.
“He's not breathing” I told the paramedic, just as my crewmate reached us. “Shit” replied the paramedic, “I left the FR2″ at my car”. So I had to run 200 yards back to our ambulance to get this, now vital, piece of kit.
An FR2 is a defib machine, which is used to shock a heart back into a normal rhythm, in the UK EMT's are allowed to use this piece of equipment, and rapid defib shocks are essential in certain forms of cardiac arrest.
Returning to the patient my colleagues had started to “bag” the patient, which means using equipment to “breathe for” the patient, and to perform CPR, which is the procedure to keep blood flowing around the body in the absence of a pulse. Attaching the defib pads I saw the the patient was in “fine VF”; this is a heart rhythm which means the heart is “quivering” rather than pumping blood around the body to the brain and other vital organs – technically the patient is dead and without immediate treatment, the patient will remain dead.
We “shocked” the patient once and his heart rhythm changed. It changed to Asystole.
This means that the heart is not moving at all, and it is much more difficult to restore life to the patient with this form of rhythm. We decided to “scoop and run” to the nearest hospital. So the paramedic secured the patients airway by passing a tube down the windpipe, and we got the patient onto the scoop, all the time continuing the CPR and giving potentially lifesaving drugs. We then carried him, with the help of his team-mates to the ambulance and rushed him to hospital.
Unfortunately the patient never regained consciousness, and died in the resuscitation room.
34 years old, normally fit and healthy – and he drops dead on a football pitch. Despite our best efforts there was nothing more we could have done for him; the treatment went according to plan, and the resuscitation attempt went smoothly. This was a “proper” job, but one we would have happily done without.
Your post has really put things into perspective for me.I've been sitting here at work, feeling stressed and frustrated, as if nothing I do has any effect.
… but in my job – even when I do a good job and it goes wrong anyway – nobody dies. It's not life threatening. Someone's world has not and will not end as a result.
I need to remember that more often.
I really admire you for being able to do that job and deal with that kind of pressure and frustration – I'm pretty sure I couldn't.
Man, that can be frustrating to put all that effort, physical and mental, and get a null result.When I worked in the Bering Sea with the US Coast Guard, sometimes we'd get a distress call and go full out for 15 hours to get there and all we could do is either collect wreckage or collect a corpse.
Now I feel bad for giving you grief on the running bit.
–maddog
What was strange is that it was the first time I felt the need to run in over a year – and it came just 12 hours after I posted that I never run towards a job. So no grief recieved.And you wouldn't get me out in the Bering sea…
To be honest, it's just something you do – and the funny stories make medics an interesting dinner guest…But I do have a (possibly strange) attitude to life – that if I'm still breathing, it can't be all bad.
And if you wait around long enough things do eventually get better.