Wednesday, April 05, 2006

Saved One!

I had just “greened up” – that is, become available for calls after completing the paperwork for an old lady fitting in a nursing home.  I’d pulled out of the driveway and turned onto the main road when the MDT (computer in the car) rang with another job.  

The call was given as a diabetic collapse.  Diabetics usually collapse for one of two reasons – either the sugar levels in the blood are too low (hypoglycaemia) which is the most common reason, or they’re too high (hyperglycaemia).  It was literally just round the corner, so I was on scene about 30 seconds after the call had finished in control.

I walked into a rather cluttered kitchen to find a 70-something year old lady laying on the floor with her head being cradled by a neighbour.  I paused in the doorway to look for chest rise to indicate breathing.  I couldn’t see any.  Bollocks.  I asked the neighbour to lay her down, and take her elderly sister into the other room so I would have space to work.  I had to stack a couple of chairs and push a table out of the way, then I was able to get to the patient.

I felt for a pulse and couldn’t feel one, then attached the defibrillator pads and looked at the screen to see if there was any electrical activity in the heart while I got the Bag and Mask resuscitator out and connected it to the oxygen cylinder.  Flat line, with the occasional blip which indicates what’s known as “dying heart syndrome”.  I didn’t have anything to lose, so I started CPR.  

The ambulance crew arrived shortly afterwards, and a couple of minutes later, the AED announced it wanted to analyse the heart again.  I paused and looked at the screen, expecting to still see a flat line.  Instead, there appeared to be a normal heart rhythm, but very slow.  A check confirmed there was still no pulse.  This is known as PEA – Pulseless Electrical Activity.

The paramedic on the crew put a line in, and gave adrenaline.  After about 10 minutes of continuous resuscitation, pausing only to re-analyse every three minutes, we finally felt a pulse.  She still wasn’t breathing, so we continued ventilating her.  We loaded her onto the ambulance, and I went with the crew to hospital in case we needed to re-start CPR – I could do the chest compressions while the paramedic gave drugs.

The patient still had a good pulse when we arrived at the hospital, and after cleaning my equipment, and helping the crew to clean the ambulance, we checked in the resuscitation room to see how the patient was doing.  She was still going – in fact she was making respiratory effort to the point of almost gagging on the tube that the paramedic had placed down her throat to make sure her airway remained clear, and the doctors were preparing to send her up to Intensive Care.  The patient’s sister was in the relatives room, and she thanked us for saving her sister.

It was a great end to a satisfying job.  It’s not very often we can save someone’s life after a cardiac arrest – but it’s one Hell of a feeling when you do!

I hope she’s still alive, but if not, at least we gave her sister time to say goodbye.


Anonymous Anonymous said...

Sounds like you did a fine job! Well done. I'm currently doing my EMT training with the LAS (University of Hertfordshire degree course)... I've got a lot of respect for crews currently on the road, and look forward to working with you soon.

10:59 pm  
Blogger rob said...

Well done. Nice to hear a fairly happy ending. It doesn't happen often enough. And whether your patient walks from hospital or not, I think many people forget the value of that time you have managed to give the relatives (in this case, the sister)to say goodbye, or gather their thoughts etc. I've been told on several occasions how much this means to people, rather than having a family member just drop to the floor - end of story.

8:53 am  
Anonymous Renal said...

Did you get a BM during resus?

4:24 pm  
Blogger Kelvin said...

Good Job!!

10:08 am  
Blogger Steve said...

renal - yeah, her BM was 23 mmols - for those that don't know, that means her sugar level was high.

6:17 pm  
Anonymous Anonymous said...

I've just seen your blog for the first time and wanted to write and say well done for not only a really informative journal but also one that shows a caring spirit - something that seems to be missing much of the time these days. And also thanks for writing so well!
Best wishes.

12:18 am  

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