Monday, March 5, 2012

It was in the afternoon. I'd been volunteering for about two months at this point and had seen all the "basic" calls - diabetic with low blood sugar, shortness of breath, transfers to hospice, chest pains, etc. It was another shortness of breath call and I remember thinking "Another one? When am I going to get to see something good?"

I'm aware that wanting something interesting to happen makes me morbid and inconsiderate. But in my mind, "something interesting" happens all the time anyways, I just wanted to be there when it did.

It was still sunny when we arrived. He had his shirt open, exposing his chest, and looked "sick". Or apparently looked sick, because I didn't notice, and it was only because the medic noticed and later talked about it that I can relate that. Seventeen years on the job will give you those sorts of instincts... I hope to someday have them too.

He only said he couldn't breathe, and then his spouse took over. He'd had recent surgery. She had been at the store and came home to find him complaining of having trouble breathing, so she called us. He passed out almost instantly, and we moved him to the floor. The medic and the other EMT started assisting his respiration. I took over bagging while they did other things.

The medic was trying to intubate and asked for "cricoid"... the other EMT was confused, maybe he didn't hear her correctly. We talked about that two weeks prior in my human physiology class, so I placed two fingers over where I imagined his thyroid was. Later the medic told me she was impressed that someone who'd never been on an arrest call knew what to do. It made me glad I study.

Another medic showed up to provide "Advanced Life Support Backup" (ALS Backup, so they say.) He started an IV. Fluids were pushed. I felt nothing while this was occurring. I was too busy counting to 8 and squeezing the Bag-Valve-Mask (BVM). He was packed up into a Reeves stretcher, and moved to the actual stretcher waiting outside. Somewhere between the house and the rig, he lost his pulse. The medic started chest compressions while everyone else strapped things down and got ready to move.

At some point during the ride, I took over compressions. I still felt nothing, but couldn't stop counting to eight. Just a continuous 8-8-8-8-8, this time with no punctuations of squeezing a bag. His eyes were open, seeing nothing. Emesis was coming out of his mouth, on the outside of the ventilation tube. I did compressions until I needed a break. The other medic took over.

We arrived at the hospital. It could have taken five minutes or an hour, I was unable to account for the passage of time. The medic directed me up onto the rails of the stretcher to continue compressions while we wheeled him into the ER. Later I was informed this was the "glory spot" and was called "riding the rails."

Report was given at bedside. I removed my gloves and washed my hands. I stood in the room and watched the nurses, doctors, and other professionals take over. I became aware of beads of sweat running down my abdomen, inside my uniform shirt. I was not shaken, did not have the jitters, and was not consciously aware of any adrenaline rush. But I could hear, see, and smell everything. I was focused on the task at hand. I felt no emotion.

They recovered his heartbeat at the hospital. We cleaned the rig. While I cannot guarantee how long his heart continued to beat, it was beating when we left. I do not know if he woke up. I don't know what happened next. I know only that I crossed the line that afternoon, from the group of people who've learned CPR and never used it, and into the group of people that have.

I felt unsettled the next morning. Not unhappy. Just unsettled. I couldn't get a grip on how I felt about the experience until several days later.

I feel good. I feel like I was a taught a skill and then trusted enough to be placed into a situation where I needed to use it. The classroom did not prepare me adequately, but does it ever? I got an "A" in my class, and had the top score for the state test. It was not a lack of preparation, but simply that nothing can prepare you for that experience.

I hope to be better prepared next time. I hope to provide better assistance. I need to learn where the leads go for the monitor, and how to set up the capnography apparatus. I don't want to let this whole thing go without examining it and trying to figure out what I need to learn.

What I learned most of all is that I can respond appropriately in an emergency and that my adrenaline rush comes in the form of increased focus and a methodical approach. The world for me slows down, and I with it. I learned... that I chose well for my future profession. That I want to be here, dealing with these issues, and that when I get there, I'll be completely unprepared but totally willing to learn.

(details have been changed in order to mask identity)

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