Highs and Very, Very Lows…!!!

February 17, 2009

 

The Pathway Back to Life...

The Pathway Back to Life...

The night shift started with our first job…‘male, unconscious, not breathing’. Two minutes after booking onto the shift we were heading towards one of the estates edging my patch. En route control updates us ‘CPR advice being given to the family, RRV arriving scene!’

My crew mate gives it a bit more leather on the accelerator. Blues and twos are helping us to wend our way through the evening traffic but still we come up against the occasional idiot who thinks he owns the road and will not yield. This makes us slow down having to circumnavigate the clown who gives us ‘the look’ as we pass him!

Soon we are at the top of the street but we are further slowed down because of the speed bumps. Eventually after scaling several of these tarmac hills we pull up outside the address. The RRV is parked outside and there are members of the family running around flapping…not a good sign.

We dash into the house and are met by two women consoling each other and pointing to a door…‘Hes in there!‘  Opening the door we find the RRV pilot doing CPR on a collapsed male. I can see that there is vomit everywhere around the head end. The RRV pilot is covered in it! Grabbing hold of the collapsed male we turn him onto his side and using the #1 suction unit (index finger) we sweep out the worst of the vomit from his mouth.

Getting him onto his back the RRV pilot recommences chest compressions and ‘bags’ the patient whilst we set up the defib/monitor. A quick look through the paddles of the defib shows VF (ventricular fibrilliation where the heart rattles and shakes like a bag of worms) and I shock him once telling the RRV pilot to crack on with a minutes worth of chest compressions straight after. Another look at the monitor and checking for pulses reveals that we have a good cardiac output. 

His heart is beating but he is still not breathing for himself. Whilst my crew mate inserts a line and sets up an IV, I intubate the patients airway first time and connect him to our automatic resuscitator. Although I have to ly in the patients vomit to do this I think that things are looking good. After less than a minute the patient  makes some attempt at respiratory effort.

We put the call into the A/E resus and we take our patient in ‘on the light’. Handing over to the team in A/E the prognosis for our patient seems to be getting better by the minute. It will be a matter of time to see if there is any neurological damage if he does regain consciousness…but the signs are good. The chain of survival has helped.

After cleaning our truck and equipment we grab some fluid replacement in the form of a cuppa and reflect on the job we have just done. It went well…it makes a change to get one back, to deny the reaper his quota for the day. Now its back to station for cover. A couple of minutes later after setting off for our base station the MDT squawks into life again. ’20 year old male, nosebleed’  Its back to normal then!

For the rest of the shift it is a relentless procession of inappropriate jobs that should be dealt with by GPs or even themselves. How hard is it to take a ‘Lemsip’ for a cold?  The nights darkness is tempered by the high spirits we are still in from our first job…plus the job we attend where the ‘patient’ thinks he is having a stroke makes us laugh. He has been asleep and woke up to use the toilet only to find his left arm would not work!  After a few tests and a couple of questions we find out why his arm went dead…hes been sleeping on it! Pins and needles…nothing more!

Coming towards the end of our night shift we are driving back through the city centre heading for base. Only half an hour to go…then its back home to snuggle up in a nice warm bed and sleep. My eyes are closing and my head is doing the bobbing thing as I momentarily dream of dreaming. I’m just glad its not my drive. My crew mate is just as knackered as I am but hes now ‘vehicle commander’ and has to get us both back safely.

‘Squawk, squawk f*****g b******d squawk!!!’ goes our MDT screen. ‘Bollocks! Bollocks! and b******d bollocks!’ go us. The dispatcher comes on the radio….‘I’m really sorry lads but you’re the nearest crew…and I’m really sorry but its a baby not breathing!’  The swearing stops and the complaining from us abates. We switch on and head out to the other side of the city hoping against hope that its a false alarm!  

Minutes later we are pulling up to the address. I can see through the front window a woman holding a baby in her arms and screaming! Another woman is out in the street running towards us! My heart sinks even further, its not a false alarm! All thought of sleep has vanished and the adrenaline is kicking in big time! I grab the resus bag from the truck and dive into the house.

Mum is stood there screaming at me to help and clutching the lifeless, grey baby its eyes surrounded by a bluish, reddish tinge. Trying to control mum and my own emotions I gently ease the baby out of mums arms and place the baby onto the settee. No pulse, no breathing…the baby is dead. But we still try…bagging the baby with our smallest face mask and using only finger tips or thumbs for chest compressions. Mum is falling apart, her other child is being comforted by grandma in the same room. I decide to run for it…the A/E is only minutes away.

Holding the baby with its head in my hand and its body laid along my arm we make our way to the truck. Continuing with the CPR we belt it to the hospital. During the short ride mum tells me that she had the baby in bed with her and found her unresponsive when she got up! That explains why the baby is still warm! Arriving at the A/E I still perform CPR whilst quickly negotiating the inappropriate ‘patients’ hanging around the entrance smoking their cigs.

The resus room is waiting and I hand over the baby to the doctors who carry on with the CPR. Relaying the history to the senior doc I then leave to complete the paperwork. As the adrenaline starts to wear off the tiredness floods in and I have to fight back the tears. The reaper has got one back! I remember thinking out loud…‘I don’t want to do this job anymore!’

life-and-death


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