I'm covered in the urine from the five year old child.


We get the call as a child having a fit.


There is a solo responder there, he's giving oxygen to the child while it lies on the floor.


I look at the child's eyes, he's still fitting, his body isn't moving but his eyes are darting around in an unnatural fashion.


His chest isn't moving in the the way it needs to in order to breathe.


I pick him up, covering myself in the urine and race downstairs.


I kick the door release button to the block of flats, my crewmate jokes about me being able to get my leg up that high.


I lay the child on the stretcher in the ambulance. My crewmate hands me the ambu-bag.


Fitting the mask over the child's mouth I start squeezing the bag, I'm now breathing for the child.


My crewmate jumps into the cab of the ambulance, she weaves through the traffic towards the hospital.


I sit calmly, I explain to the child's mother what I am doing.


I keep checking the child. Good pulses and an oxygen saturation level of 100%. It means the child is getting the oxygen it needs.


We reach the hospital. I scoop up the child and jog into the Resuscitation room. The nurses and doctors take over.


Someone else is squeezing the bag now. I stay and watch a while, the child stops fitting.


We head back to the ambulance station, I need a shower and a change of uniform. I have to shower with cold water as it appears the heater is broken.

I sit on the station sofa, I can still feel the ambu-bag in my hand. I sit and look at the TV, my mind is empty.

24 thoughts on “Squeeze”

  1. We can and do give diazepam both IV and PR. We did give it in this case but I didn't write about it because it affected the flow of the story. This wasn't supposed to be a 'factual' account like that where we do X, then Y, then Z.

  2. Slip, WHAP! as I land on my ass courtesy of the fool in the housing project (council housing) who decided to use the hallway as his own personal commode.I'll take the kid peeing…………

  3. Well thank you for answering my question. I was just curious, since I do not know much about the english paramedic system and the techniques and medicals you guys use. It just sounded far more dramatic than any fitting child i ever experienced.And beeing a paramedic for quite a while I do tend to read from the technical point of view and miss out on the literary intentions. Sorry for that. 😉

    Was it an infection/fever related fitting?

  4. Dealiing with children who are ill/injured is traumatic whether you are emergency personnel or parents; thanks for doing things like this.

  5. Thankfully it was just his respirations that needed assistance…They always say you can become adjusted to so much, but working with children never gets easier.


  6. really liked this one.the repetition kind of gives the post a beat.

    i don't know how you do it.

    long time lurker btw, finally posting =)

  7. Yep, kid made a full recovery after sleeping off the effects of the medications given to him to stop the fitting.

  8. I know you're not looking for this, but I can't read your post without saying a thank you from this little corner of Joe Public. Maybe because I'm a dad these days, with boys of one and three, that this got through to me more than others. (Or maybe just the great way you tell it.) My insides go cold thinking of either of them in such a situation, but everything then gives a whoop of gratitude that there are people like you out there ready to scoop our children up and do what it takes to get them better. A silent bow from here to you.

  9. Poetically poignantAnd ty for the update.

    Always good for positive outcomes especially with children

  10. Tom, one day you are going to have to work as a consultant to some of these medical programs, casualty, holby etc.. your writing is superb and really makes the reader sit up and think and feel part of the scene.You have a gift…


    ps – glad to hear that the youngster made a good recovery

  11. Another great post.Why on earth can't/aren't you allowed to give midazolam?

    (Love you're posts when you're on topic tom!)

    Queensland Ambo

  12. Same question as Mr.Queensland Ambo….Why didn`t you guys apply an anticonvulsivum? You don`t even need an I.V. for most of them, its easy to apply and works almost immideatly.And the calls work out way more relaxed than the one you described.

  13. Now I'm home and can write a proper response.The kid was still fitting when I got in the room, with ineffectual breaths. Gave the PR Diazepam (incidentally the first bum in some time that I didn't have to delve around with first) – kid kept fitting.

    Actually the fitting became worse.

    So that's why we scooped and ran to the hospital (that and the whole 'not breathing terribly well, O2 sats of 85%, tolerating a Guedel airway…) Bagging him brought him back up to 100% o2 sats despite the fitting.

    It took a whole load of sedation in A&E to arrest his seizure.

    When it came to write it up, I didn't really want to go into the technical details (maybe the next one I will), instead I wanted to do the 'beat' style – Each squeeze of the bag terminating a very short sentence or two, it mixes things up a bit from the 'I did this, then I did this, the patient did this so I did this' sort of blogpost.

    Didn't know you folks got midazalam though, I bet that works better than diazepam.

  14. You really are a fantastic writer.I cannot imagine what it must be like to witness such an incident, especially when it is a child that is involved!

  15. Thank you for reminding me, Tom, after a hellish bank holiday yesterday, that whenever I have a bad day at least nobody dies. Sometimes it is good to keep things in perspective.

  16. Your awesome Tom. People who help children are all awesome…. I can't do it, I start crying.

  17. Great post Tom. For paediatrics fitting in NSW we can give midazolam intra-nasal (via a mucosal atomising device or M.A.D.), intra-muscular or IV dependent on your clinical skill level.

  18. “You really are a fantastic writer.”Absolutely. It's like a slap upside the head to read most blogs, most online content in fact, then come here… just, WOW.

  19. Probably the best and the worst jobs that you can do in the ambulance service involve children. I have certainly had a my fair share of “naughty” jobs. I work on an FRV so I would have been that guy in the room on my own waiting for the backup to arrive. Sometimes it can only be a matter of minutes, but boy does it feel longer when the kiddie isn't breathing or breathing properly.Out of interest, if you hadn't required a shower and change would your guys have given you some time out after that job for a clinical debrief? or would it just have been time to get on with it? I know after my last one the crew that backed me up and myself had a chance to collect some thoughts amongst ourselves and the station manager, not because there were clinical issues, but just to allow the body and brain to get back to some sense of normality. Although if you are anything like me, you tend to only start thinking about it properly about six or seven hours later……

    Glad to hear littleun is making a full recovery, hope you, your crew mate and the FRV pilot did too………

  20. Glad the lad was OK, and a great piece of writing, Tom.A bit like a verbal strobe, flashing the story up like a stop-motion animation.

  21. Oh, no worries. It was a more dramatic fit than I normally go to as well…I would guess that the seizure wasn't fever related as he wasn't hot and some of the types of seizure he went through would suggest a neurological basis – he's probably about to be diagnosed as epileptic.

    Sometimes the technical approach works, sometimes I go for something else – I'm just trying to show off…

  22. I'm sure we could have asked for a clinical debrief, but my crewmate and I are hard-hearted bastards on the quiet, so we didn't really need it.I also have a crap memory, so one or two jobs later and I've forgotten about it unless I write it down.

    I remember waiting 45 minutes on the FRV for a kid with meningitis and a stabbing – and boy, did it feel like it. One of the many reasons why I gave up the FRV.

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