Saturday, January 12, 2008

You win some, you lose some

While some calls are inherently worse than others, there's always those calls that we get more involved with emotionally. For some, it's traumas that get the blood flowing, for others the critical elderly patient does the trick. No matter how new or experienced, parent or not, everyone goes on high alert when the call is about a small child, especially cardiac arrests.

Fortunately, most calls that are dispatched as pedi arrests, really aren't arrests. Unfortunately, most that actually are arrests, are extremely hard on all involved. I've been fairly lucky in my career and haven't been on very many of these calls.

I remember my first one very well. We were dispatched for a 3 month old in respiratory distress. On the way, we were updated with CPR in progress. My partner told me to stand by the truck and if the child actually was in arrest, he'd bring her to the truck and we'd work on her there.

Onscene, it seemed like the moment he walked through the door, he was on the way back out with the baby in his arms. She was blue from the nipple-line up.

In the rig, we started CPR while my partner prepared and tried to intubate. As soon as the the tube was in place, a nice little geyser of milk came up through the tube. It was obvious at that point that when the home care nurse was feeding the child, she aspirated the milk.

I still don't know how he did it, but my partner also managed to find a vein and start an IV. I was ready to use the IO needle if needed.

A few months later, I attended a regional Star of Life awards ceremony where I was presented a Star of Life award. These awards are only given if a patient, confirmed to be in cardiac arrest, is able to leave the hospital expected to make a full recovery.

More recently, we were sent to a 1 month old in arrest. There was already 2 units onscene when we arrived. I jumped into the ambulance along with my partner to see what I could do to help. When my partner unlocked the drug box to grab the Epi, I pulled the IO needle out of the bottom of the box and asked if he wanted me to go on and get access. He gave me the green light so I wiped the area of the leg with alcohol and mentally prepared myself for what I was about to do. I also tried to think back to the academy, which was the last time I used an IO needle, and that was on a mannequin. I double-checked my placement and went for it, digging the large needle through skin, tissue, and bone. It went in with a creepy "pop" I could feel. The line was hooked up and flowing extremely slow, which is the best you could ever hope for from an IO.

We worked our hardest all the way to the hospital, and the hospital staff did their best as well, but it just wasn't enough.

In the last couple weeks there have been a large number of SIDS cases. My guess is that this may have been one of them and the parents just happened to be awake and found it early.

If you have kids, give them a hug and tell them you love them.

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