Third cardiac arrest and first respiratory arrest

So last shift (Sunday) was actually pretty busy for a Sunday. Ended up working 17 hours instead of the usual shift of 16 hours because we got a call five minutes prior to our end of shift and of course that put us the 16 hours.

The entire morning there just wasn't anything good going on call wise. Which really isn't a bad thing because if its something good for me then it's something bad for someone else unfortunately. Then we got a string of 4 calls in a row that were good.

So around oh, if I can remember, about 4pm we got a call for an accident involving a car vs pedestrian. Call notes showed the person hit to be a 4 year old boy. So of course I am thinking this is going to be a pretty good call but since its a kid I start to get that depressed feeling of oh no something poor is happening to this kid who's probably not even in pre-school yet. So we arrive on scene and of course fire is already on and there is a little crowd surrounding the kid, his grandmother, and the fire crew. I had to push my way past this little crowd to get to the kid. Turn's out luckily the kid only sustained an abrasion to his right side and no other serious injuries.

Second call was for a woman in labor. That's one thing that I have been waiting for, because I think it would be cool to deliver a baby in the field. Well we get there, baby not coming yet, but the patients husband who speaks English (patient doesn't) said that her water has already broke. So we hurry up and get her loaded and get going to one of the local hospitals. On the way I heard the patient not really scream but just a really loud moan, then she said something that I couldn't hear (plus it was in Spanish) but I heard my partner say something like "sorry I don't have any water to give you." And in my head I am thinking: "She's not asking for water, she's saying her water just broke." Well we get to the hospital and move the patient over to the hospital bed and sure enough her water broke during the ambulance ride because it was all over the stretcher. Soon after the baby was delivered there at the hospital and I got to see it. It's not the first delivery I've seen but the first natural (other was a c-section). It's a pretty cool ordeal but definitely after watching that, it's not something I want to do in the back of an ambulance. Oh and it was a baby boy! Yay!

Third call was for what started out as a call for an choking turned into a cardiac arrest call when we turned onto the street. We got to the house and the patient was on the living room floor (we have to find a new term for "living" room b/c every cardiac arrest or dead on scene person has been in the living room so far). And the patient wasn't breathing but had a pulse (respiratory arrest). So my partner quickly intubated him there in the living room and we moved him to the ambulance and got going. When we got to the hospital he still had a pulse which was very good thing because respiratory arrest turns into cardiac arrest very quickly. As far as I know the patient is still alive but on a ventilator. I hope he gets to go home.

Fourth call and my third cardiac arrest. Get a call for a diabetic problem. Arrive on scene to were the patient's roommate stated that he tried to wake the patient up about 15 minutes ago and couldn't. Then tried again and still couldn't so he called 911. There was no light switch where the patient was (bedroom this time) and the only way to turn on the lights was to pull the string on the ceiling fan. Which was no minor task as the ceiling was 9 feet tall and the string was about two inches. So I managed to get the light turned on and look down to my left to find the patient on his bed and he looked dead. There's just this dead look that you see on patients and you know there dead. I could tell he wasn't breathing so I checked for a quick pulse and there was none. My partner was just about to pronounce him when he took a grasp of air (known as agonal respiration's). So we attached the monitor and it showed v-fib. Shocked once and it went into asystole (flat line). I attempted intubation and couldn't get it. My partner attempted with a view scope and couldn't get it so we placed a King airway (future post to come on the King Airway) and my partner also got an IV using the external jugular vein. I pushed a round of epi and atropine and then off to the hospital we went. Pt was pronounced on arrival at the hospital by the doc right at 2200 hours (10 pm).

So as you see Sunday was eventful and all 4 of those calls were back to back. So it was a fun and long day.