Life.....

It is amazing to think that someone who is clinically dead can have a pulse and be making breathing efforts some 30 minutes after they collapse, this happened to me last night. I was working with a paramedic and we had a call for a female who was unconscious and having difficulty breathing, as we sped along the country roads with lights flashing and sirens sounding we were updated by the EMDC (Control room) that the patient was now in cardiac arrest and CPR was ongoing. (Now any of you who have red my blog will know I have a kill to save rate of 100% kill so you can imagine what is going through my head) Upon our arrival we are met by the patient's brother who is relatively calm for the situation, we are shown into the house to see the patient's husband bouncing up and down on her chest and blowing air into her mouth whilst talking to someone on the phone in the EMDC to receive further guidance (Telephone CPR instructions is a standard protocol within the EMDC and all staff are trained to give these types of instructions out as and when required). We quickly take over and do our checks, Airway? Clear, Breathing? No, Circulation...? No, I take over at the head and secure her airway with an OP airway and start breathing for the patient using a bag and mask (anyone who has seen ER and Casualty will know what I mean) and doing chest compressions whilst my colleagues connects up our defib, the machine shows PEA so I continue doing CPR whilst my paramedic colleague gains IV (Intra Venous) access for a drug route. We give the woman 1mg of Epinephrine and swap places, my colleague then secures the patient's airway with an ET tube and continues to ventilate the patient whilst I do CPR, I listen to make sure that he has placed the tube in the correct place and I hear bilateral breath sounds and I get him to stop for a moment, he looks at me with that "Oh shit I have not got the tube in correct" face, but I tell him it is in and I can also hear a heart beat, we check for a pulse and yes it is true there is one to be felt. I get the brother to help me collect some more equipment from the vehicle and go back into the house, we get the patient onto our stretcher, secure her and make sure the ET tube is well secured and begin our tricky exit (up a flight of stairs, along a dark path, up another steep hill incline to avoid the second set of tight steps and then into the Ambulance) all whilst breathing for the patient. Once we have her in the vehicle, we check the ET tube again to make sure it has not dislodged and prepare for moving off. The patient's husband and daughter are in the back of the vehicle with my colleague and I request the A&E department resuscitation team be standing by to accept the patient. We arrive and the family are shown the door to A&E for public, my colleague and I take the patient into the Resuscitation room where we are met by the team (2 Doctors, 1 Operating Department Practitioner , 2 Nurses and 1 Senior Nurse) who accept the patient into their care and take our handover. My colleague and I then return to our vehicle and start the task of clearing up and completing all the necessary paperwork. Once this is done we return to the station for our meal break and celebrate with Pepsi and chocolate bars (imagining them to be alcohol and expensive take aways!!!) We checked on the patient some 10 hours later and found out that she had been transferred to the ITU and was still making some efforts to breathe on her own.....

Death Nil Scotsmedicman and paramedic partner 1