Wednesday, March 18, 2009

I broke some ribs today...

...but they weren't mine.

We were sent to a cardiac arrest call this afternoon, inside a local nursing home. The lady was old and we didn't get any of the circumstances surrounding how they found her in arrest. As is usual with many nursing homes, we were told CPR was in progress. The truth? 3 Dr's and 2 nurses were in the room watching her die. They'd placed a CPR board under her and that was it.

We immediately put the defibrillator pads on her and she was in a workable rhythm, but pulseless and it wasn't organized enough for a pulse anyways. Since everyone else was just standing around, I started doing CPR while the paramedics split tasks, one intubating and the other drawing drugs from the drugbox. The other EMT attempted to start an IV.

The cardiac monitors we use gauge how effective your compressions are. I was watching the monitor screen as I did CPR and I immediately felt 2 ribs pop, back to back. Within another minute, another 3 had popped as well. It's always a horrible feeling for me to do that. My only bit of consolement is that I was doing CPR effectively, the patient was very old and frail.

Once we got a tube dropped and finally got an IV, the first round of Epi and Atropine went in. No changes noted on the monitor, so CPR continued. We pushed the 2nd round of drugs a few minutes later and prepared to call the hospital to ask for orders to terminate CPR. We double-checked the lack of pulse and found good radials. By the time we got her to the truck, the pulse was gone again. CPR was resumed and I bailed out to drive my own truck to the hospital. My partner rode in to assist the other medic.

When she was rolled into the ER, she had a pulse again. Unfortunately, it was probably only the drugs working, I doubt she is still alive.

I'm not very used to this territory yet, so I can't really speak about how all nursing homes are, but my first impressions are not very good. I know not all are bad, but most of the ones I see are. This one is very clean and they were great about leading us to the room. It's just a shame nobody was actually doing anything to help the lady survive.


The Dispatcher and Her Officer said...

How sad! I'm so glad you were there though.. She needed someone nice and caring like you to come in and give her the chance she deserved!

yoely said...

I had a call last night, it was a 104 y/o women with no pulse, and i was the forst on scene and i begain CPR and i heard abot 10 cracks of what i think were the ribs, i freaked out cause it was my second time doing CPR, but the good part is that we got a pulse back!! i couldnt sleep all night the sounds of the cracking ribs were just in my head all night, i hope that i cant be sued for this?