Dinner and a Cardiac Arrest
You think you are having a bad day? I am sure you cannot hold a candle to a man I responded on many years back. We’d gotten our butts handed to us on this particular shift. It was early spring and the amount motor vehicle accidents we responded to more than doubled. It was something about the warm weather that brought more people out on the roads and onto their ATV’s. I will never understand how someone could ride a four-wheeler or motorcycle without a helmet on. I will save that soapbox for another day.
We’d run ten calls already and finally made it back to our station to grab a bite to eat. The pit of my stomach ached for sustenance. I tended to become angry if I didn’t get to eat. While transporting a patient to the hospital, our communications center alerted us we had another call. This went on the entire day.
Now back at our station, I just warmed up a chicken potpie when the station tones blared over the speakers. I couldn’t believe my ears. Another call? Enough was enough! I shoveled the scorching potpie into my mouth as I ran out the door toward the ambulance bay. I am sure I burned the top four layers of skin on my tongue, but my stomach was satisfied.
My partner and I climbed into the ambulance and she sped down the main street toward a busy eatery. It was her third shift on the street and I had to hold her hand on every aspect of the calls. We were all new once, so I did not hold it against her. Normally I enjoyed teaching new people, but we were on the way to a cardiac arrest. Not the type of call you wanted a new person with you.
I glanced over and noticed my partner biting down on her bottom lip. I flashed back to my first cardiac arrest. I will not bore you with the details, but let’s say I was as useless as a one legged person in a butt kicking contest. I wore out a circular path in the carpet from running around like a chicken with my head cut off. My partner was more than understanding and laughed at me. Back then, I did not find the humor in it, but now I laugh at the rookie I once was.
My partner weaved in and out of cars racing toward the call. She only knew one speed and it’s called warp speed. I held onto the handle and all you could see was the whites of my knuckles. We pulled up in front of the restaurant and before my partner had the ambulance in park, she started the exit the ambulance. I yelled and got her attention. She realized what I was screaming about, smiled, and shifted the ambulance into park. The truck jerked to a stop. My neck cracked and I felt tingling in my fingertips, but I did not have time to worry about that, we had a dead person in the restaurant.
We exited the ambulance, grabbed out equipment, and ran toward the front door. Once inside of the restaurant I looked around, but no one flagged us in the direction of the patient. I am sorry, but if I had someone on the cusp of death in my establishment, I would’ve met the paramedics in the parking lot.
The smell of cigarette smoke and grease wafted through the air. It did not sit well with my stomach and nausea rolled up toward my mouth. I choked it down. A haggard looking waitress carrying a pot of coffee walked from the kitchen.
“He’s over there,” she said in her manly voice pointing over to the right.
We walked in that direction and then around a corner into a room full of tables with chairs around them. A pasty looking male was supine on the floor. I ran over, knelt down next to him, and felt for a pulse on his neck; there was not one. I glanced over my shoulder and my partner stood behind me, staring at the man.
“Put the monitor on him and start CPR,” I instructed her.
She did not move.
“Hey! I need you on this call. Snap out of it and help me!” I bellowed.
That did the trick and she snapped out of her daze. She walked over, knelt down next to him, and stuck the electrodes to the cardiac monitor onto his chest under his shirt. I handed her the defib pads. She studied the picture on them trying to figure out where to place them. A volunteer firefighter joined us and I instructed him to initiate CPR. He placed his meaty hands on the man’s chest and started compressing.
Two older men sat at the table with the patient.
“What happened?” I asked in their general direction.
“I dunno. He grabbed his chest and fell over,” one of the men offered.
“Does he have any medical problems?”
My agitation level rose at a rapid rate. “What do you know?”
Par for the course! I opened up my equipment case and pulled out the necessary IV supplies I needed. I wrapped a tourniquet around her arm and a large antecubital vein bulged. I successfully established an eighteen gauge IV in her arm and hooked up a bag of saline to it. I rolled the blue clamp down and watched the normal saline drip into the chamber in rapid succession.
I glanced over and my partner finally had the pads placed on the man’s chest. She had a triumphant smile on her face. I turned on the monitor and the rhythm showed ventricular fibrillation, one of the two rhythm’s we shocked. I charged the monitor.
“I’m clear, you’re clear, everyone clear!” I yelled. I pushed the shock button and the man’s body violently jerked.
The volunteer firefighter continued CPR.
The sounds of dishes clanking and quiet chatter was all around us. I could not imagine watching a life or death situation and eating dinner before I started a career in EMS. To each his own, I guess.
Something did not seem right as I grabbed my medication bag. I noticed my partner had not cut off the patient’s shirt yet. I instructed her to do so as I grabbed the preloaded vials of Epinephrine and Atropine. She pulled out the trauma sheers from her pants leg and cut up from the bottom of his striped polo shirt.
I administered the medications. But when I looked at the cardiac monitor, a dotted line scrolled across the screen. Checking the cable connections, everything appeared intact. I glanced up to my partner, but before I could say a word, a tear streamed down her cheek.
“I’m so sorry,” she mumbled.
I looked down at her trembling hands and I could feel the color fading from my face. My rookie partner cut through the monitor cable while cutting off his shirt. Are you kidding me? How in the world could she do that? We do not carry spare monitor cables. No monitor meant no shocks, which is what he needed. Electrical therapy was the only chance the man had.
“What’s wrong?” The volunteer firefighter asked.
I held up the cut monitor cable.
“Oh, is that bad?”
“Just a little,” I responded and then sighed.
The other unit we shared the station with went on a long distance transfer earlier in the day, so we were out of options. Two more volunteer firefighters showed up and I instructed them to retrieve our cot. They came back with it and we loaded the patient onto it. Once we gathered all of our equipment, we pushed the man out toward the ambulance.
The haggard server stepped in front of us, blocking our path out of the restaurant. She had her hands on her hips. “Who’s going to pay his bill?”
I looked over my shoulder. “Ask his friends that know absolutely nothing about him.”
We pushed passed the server and out into the ambulance. I instructed a volunteer firefighter to drive and had my rookie partner climb in the back of the ambulance with me; she was not in any shape to drive.
I grabbed the intubation kit and slid an endotracheal tube into his airway. I hooked a bag valve mask onto it and misting appeared with each ventilation. After securing the tube, I gave the firefighter a break and took over CPR. The hospital was only a few miles from our location. My partner sat in the CPR seat with her arms crossed over her chest. I felt bad for her to some degree, but her mistake was a monumental one.
We arrived at the hospital. I filled in the doctor and nursing staff with everything that transpired; including what happened to the monitor cables. They coded the man for another thirty minutes until the doctor called the code.
“Time of death is eighteen thirty-two,” the doctor said.
My partner covered her mouth with her hands and wept. She dashed out the emergency room toward the ambulance parking. I walked outside and sat down on a short retaining wall.
“I killed him,” she said barely in a whisper. She hung her head and would not look at me.
I placed a hand on her knee. “No, you didn’t. What happened was an accident.”
She shuttered and tears trickled down her cheeks dropping onto her navy blue duty pants. “I’m so sorry. I don’t know if I’m cut out of this job.” She glanced up at me with red and puffy eyes. “How am I ever going to forgive myself?”
I sucked in a deep breath and slowly exhaled. “Right now it doesn’t feel like you can to the job, but I know you can.” I grasped her hand and stared into her eyes. “Trust me, what happened was an accident. This is not going to be the first thing you do wrong. We have all made mistakes. You learn from it and move one. It will get easier, I promise.”
I patted her on the back and went back inside of the emergency room to fill out my paperwork. She worked for a few more shifts, but ended up quitting. One of my colleagues told me she went back to school and became schoolteacher. From what I had heard, she was doing well and was happy.
Not everyone is cut out for our job. It takes a special person to have someone’s life in your hands and not go into a panic mode. Everyone has a calling in life and I think she found hers in a roundabout way.