Busy shift yesterday with various calls to medical emergencies that required some interventions before taking to the A/E.
One job we got sent to about halfway through the shift was to a collapse, unconscious, ? breathing. We,ve all been sent to these calls and it turns out to be nothing!
This one was something!
Arriving on scene we saw the patient on the pavement with the RRV Paramedic bagging away and the defibillator attached. (We were not informed en-route that an RRV was on scene) I quickly de-bussed and went over and took over chest compressions. The monitor showed V.F. (ventricular fibrillation…where the entire heart muscle is firing off in all directions and not pumping blood around the body) so I adminstered the second shock. This put the patient into spurious asystole (transient flat line due to myocardial stunning) so we continued with CPR for two minutes.
On checking the monitor we could see a cardiac output and listening to the patients heart with my stethoscope I could hear it beating normally again! Then we intubated quickly and attached the tube to the ventilator. Things were looking good…for a change!
The patient was a 76 year old gentleman who was on his way to the doctors as he had haematuria (blood in his urine) when he suddenly collapsed in the street. Luckily his grandaughter was with him and she dialled 999 straight away.
A bystander/passerby realised that he was in cardiac arrest and started CPR (chest compressions and mouth to mouth breathing). This was continued until the arrival of the RRV a couple of minute later.
The paramedic on the RRV adminstered one shock straight away to revert the ventricular fibrillation and carried on bagging (bag & mask which is squeezed to get oxygen into the patient)
Cardiac drugs were given via a cannula placed in the patients right external juglar and we made ready to place the patient onto the stretcher and into the vehicle. En-route to the hospital the patient started to spontaenously breath for himself. A pre-alert was put into A/E and we arrived at the resus room 6 minutes later.
It was nice to see everything in place and that this gentleman has a fighting chance of making a good recovery.
The Chain of Survival