Friday, January 13, 2006

Purple

“Good morning, thank you for coming so quickly,” said the lady at the door.  “It’s my husband, I think he’s dead.”  She was being extremely calm about it all.

She led me through the flat and into the bedroom where her husband lay with his legs over the edge of the bed as though he’d been about to get up.  He wasn’t breathing and he had no pulse.  I quickly checked him. His hands were cold, and his chest was vaguely warm.

“When did you last speak to him?” I asked.
“About an hour ago.  I just found him like this when I came to bring him a cup of tea.”

I attached the defibrillator and switched it on.  I knew what I would see on the screen, but I had to do it as there wasn’t yet any sign of post-mortem staining, where the blood pools at the lower part of the body after death leaving a purple mark on the skin, nor was there any rigor mortis – stiffening of the body after death.  There it was, asystole (flat line) for more than 10 seconds.  He was dead.  At this point, the crew arrived.

“I’m very sorry,” I said, “but there is nothing we can do for your husband.  I’m afraid he’s died.”  We have to say it like that.  Any other way just becomes embarrassing when the relative says “What do you mean?”  There can be no mistake using words like died and dead.

“Oh I thought so,” his wife said, still with the same calmness that she’d greeted me with.  Inside, I guessed she was an emotional mess, but was determined to hold it together at least until we’d gone.

She told us her husband had a brain tumour, and it was terminal.  She was glad he’d died peacefully at home.

One of the crew took her through to the lounge and made her a cup of tea while with the help of the other crew member, I got her husband back onto the bed properly and covered him up to just below the chin.  He looked peaceful.

He was, as the LAS term it, Purple.  We have a code that we enter on our sheets for “Deceased, not removed”, and I entered that into the patient report form (PRF).
I was working with a paramedic colleague once and we went to a patient that was Purple.  He accidentally entered the code for “Gone before arrival” onto the PRF.  It’s really intended for calls where we turn up and the patient has already left the scene, but I suppose it fitted the situation quite well really.

2 Comments:

Blogger Learning Nursing said...

Good, I'm glad you didnt have to start all the trauma of cracking ribs, sticking tubes down and lines in.

"a good death" I think they call it when you pass away peacefully.

Sad.. sure, but well done.

3:49 pm  
Blogger Spike said...

A peaceful death like that must be a relief after some of the things you see.

My granddad had four brain tumours of some sort and was in the terminal hospice for the last month. He just didn't wake up one morning and I'm bloody glad he went that way.

10:00 pm  

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