Cardiac Arrest

So last night I ran my first cardiac arrest call. Arrived on scene after Fort Worth Fire Dept. (FWFD) to find the man in his RV in the back yard. I placed a back board on the steps of the RV and the man was placed on it by FWFD. So we got the man on the ground on the back board as a hard surface is needed for good CPR. I confirmed there was no pulse and began chest compressions as one of the FW firefighters began using a bag valve mask (BVM) for ventilations. The other Paramedic I was with attached the heart monitor/defibrillator and we confirmed the patient (Pt) was in coarse ventricular fibrillation (V-fib), which is where the heart is just quivering and not pumping. Seeing that heart rhythm, we immediately shocked the heart with 150 joules and began CPR again. After about a little less then two minutes we stoped CPR and had a heart rhythm that looked like it could of been a sinus rhythm with ST-Elevation or just peaked T-waves. The rate at first was about 40, checked for a pulse and found that a very weak pulse was present. The other paramedic had already established an IV and has already given one "round" of epi at this point so we gave some Atropine and that got the heart rate on the monitor to around 60-70. Since the Pt did have some what of a pulse but still wasn't breathing we went ahead and placed the pt on the stretcher and moved to the ambulance, where the other paramedic intubated the pt. As we were leaving the scene we lost the pulse even though there was still a sinus rhythm on the monitor (known as pulseless electrical activity or PEA). CPR was started again by one of the FW firefighters that went with us while I ventilated the Pt. A end-tidal CO2 device was attached to the monitor and we had a ETCO2 reading between 10-20 which is very good in a full CPR event. We also were able at one point to obtain an SpO2 reading of 6 (SpO2 is the amount of oxygen in your blood). We were able to obtain the SpO2 level because the the good CPR that was being done by the FW firefighter and at this time I would like to thank him (and his crew) for there help. Even with all the things that we were doing and all the good readings on the monitor that we could get, it wasn't enough to save this man. It's unfornuate and I wish we could of saved him but it was his time. I can't even begin to explain the feelings I had when the doctor "called the code" at exactly 2100 hours (9 pm). Its a mix of sadness, I've done everything I could of done thoughts, he's too young to die, and it's his time, all racing through my head at the same time.

Update

Ok so finally finished with the new hire academy and now I am doing a month long of driving training with a driving training officer (DOT) where I am actually driving to calls. Started doing that on October 4th. I am currently working 16 hour shifts which seem long but it's nice to only have to work three days a week right now.

So yesterday was my fourth shift with my DTO and earlier in the day we were talking about how he (my DTO) has never had anyone that he's trained that had been involved in a preventable accident with one of the ambulances. Well guess what... he jinks it. I was sitting at a red light, first in line, at a complete stop, and I got rear-ended. Lovely!!! Wasn't anything serious, in fact barely felt the collision and no one was hurt.

I haven't had any really "good" calls per say, but have had some interesting ones. Yesterday was probably the best as far as calls go. Had two different motor vehicle accidents with each having a vehicle that had rolled over. One of the calls had a total of six patients but none critical. I also went to an assault call where the victim was on the side of the road and while taking care of the patient the police were driving by really fast with lights and sirens and there was a police helicopter flying around with its spot light on looking for these punk kids who attacked this poor guy because he didn't give them any money. My guess, they already planned to assault him anyways.

We'll see what tomorrow's shift brings....