Tuesday, February 14, 2006

28C01

Well this is the code that means you are going to a patient who is "Not Alert" following a CVA (Stroke).

So we arrive and because of difficulty in parking, I walk to the house with my oxygen and response bag and my colleague follows eventually with the defibrillator, once he can safely park the Ambulance without drivers thinking that they have the right to totally ignore all rules of the road and common courtesy. As I walk towards the house the patient's son tells me "I think my Dad is now dead!" so in I go and true to his word the patient was lying slumped in his wheelchair not breathing and no pulse.

I get the patient on the floor and start my CPR protocol, securing this 78 yr old mans airway with a plastic curved tube called an oro-pharyngeal airway (OPA), breathing for him with a Bag and Mask connected to my oxygen and start jumping up and down on his chest. As I am doing this my colleague walks in and quickly connects the defib to the patient and we find that he is Asystolic (flat line) so my colleague (who is a paramedic) confirms that I have a good airway for the patient and begins to cannulate (place a small plastic sheath and needle into a vein) him, we give some cardiac drugs and continue with CPR, because of the tightness in the house, we decide not to intubate (pass a larger tube into the patient's airway) until we are in the vehicle. Following this decision my colleague gets the son to help him gather further equipment and returns, but whilst my colleague is away the patient decided to change his heart rhythm and I am able to deliver an electric shock to stun his heart (defibrillate) into a rhythm that is able to sustain life! With one shock his heart starts beating normally and he slowly starts breathing!!!

Once in the Ambulance we intubate him to secure his airway properly as he was still not breathing sufficiently on his own, we blue light him into hospital and are met by the full resuscitation team in AE and hand over his care to them.

Upon cleaning and clearing I pop back in to check on his condition and his heart is still beating, he is breathing with less assistance and he is being prepared to be moved for further investigations.... as I walk out the Consultant who was looking after him says "Well done" now I know that it doesn't sound much but when you have worked as hard as my colleague and I did it is nice to feel as if you have at least given the patient and his family a chance!

Will see how he is getting on tomorrow and keep you all updated.... if you want?

4 comments:

olivia said...

Well done for saving this man, and I hope that he's doing well now. Please keep us updated!

Druss said...

Good job, but are you valued by the management look at your A4C letter for the answer. let them meet the patient and ask them your worth. Was the job a real ambulance success did you make it in eight mins. what pt? what do you mean?

'Sorry but had to have a slight strop was asked again what took so long to get to a job. feel free to delete this.'

scotsmedicman said...

Druss totally agree with you in regards to A4C, and bonus we made it in 5 minutes, but the next job we didn't and go questioned why, bloody typical of the management!

M2KB said...

Well done. Very well done.

How is the patient?