Wednesday, February 06, 2008

Be Careful What you Wish For (Part 2)

For part one of this post, see Mark's post here

Barry's off sick at the moment, and I've been single manned for most of this week, so I was asked to work on the FRU for a few days.

Since I stopped working on the FRU a few months ago, car staff have been asked to update control about cancelling ambulances/needing them on the hurry-up directly to the appropriate sector channel, so our radio in the car is now left on the SW channel.

I'd just parked up on standby when I heard a familiar voice on the radio. I couldn't quite place it until there was a General Broadcast (done when a call is being held and they're looking for any ambulances to come available,) which ended with the initials that confirmed my suspicions..."General Broadcast at 24*, my initials Mike Mike, Red Base out."

I'd done a couple of jobs that were, frankly, ridiculous calls that could have easily been dealt with by the GP when I got the Vaginal Pain for two weeks call. I'd sent Mark a text message and said I'd find an excuse to call up when he was on the radio. This was the perfect opportunity, as the call certainly didn't warrant receiving attention from a Fast Response Unit, especially with the patient already having been given pain killers by the hospital, so I called up. I could hear the humour in Mark's voice as he answered me.**

I was only joking when I asked him to find me a suspended. His reply had been "If someone calls in your area, I'll get them to murder someone". He was, of course, only joking. When the call came down to the screen. "Cardiac Arrest - Not Breathing At All" I realised it was a bit of a run, so I set off, briefly wondering if Mark was taking the call, but wasn't sure cos the text on the screen didn't say "dead" - Mark's the only person I know in control who will put that word on the screen.

It was a cancer patient, just 68 years old.

I arrived at the address***, and hurried up to the first floor with my kit, the ambulance pulling up just as I got into the flat. The patient was in the bedroom - up another flight of stairs.
As I entered the room, I was faced with pandemonium. The son was fighting back tears, his wife was crying as she was doing CPR, and their daughter was hysterical in her bedroom.
Unfortunately, the daughter-in-law was doing CPR with the patient on the bed. My heart sank. Good effective CPR is only possible if the patient is lying on a firm surface. Because she was on the bed, I had to mark it on my paperwork later as "ineffective CPR" which is a shame, because apart from the patient being on a soft bed, the daughter-in-law was doing good CPR.
I introduced myself, and the son said "It's ok, the paramedic's here" and hung up. I appreciated the senitment, but I haven't done my paramedic course yet...

I got the son to help me get his mum onto the floor, and I started CPR just as the crew came in.
I was relieved to see they were both paramedics. I continued CPR while one paramedic attached the defibrillator, and the other started preparing to put a tube down the patient's throat to secure the airway and put a needle in a vein to give the vital drugs to try and stimulate the heart back into action.

The defib showed the patient was in asystole (flat line). We carried on with the resuscitation attempt, with the son and his wife looking on, trying to hold their mum's hand, but only succeeding in getting in our way, and shouting encouragement to her, hoping that their words would somehow make her start breathing again. Meanwhile, the grand-daughter kept running in, screaming hysterically, and running out again. The crew got the patient intubated and cannulated, and we did over twenty minutes of resuscitation with all the drugs etc that the hospital would have given her. When we still had asystole after 15 minutes, the son asked if we were unsuccessful, not to take her to hospital. Up to that point, we'd been preparing to take her - purely for the family so that they could see we'd done all we could, but the son said they knew we were doing everything possible.
The last dose of Adrenaline was given, followed by two minutes of CPR. At the end of it, the defib still showed asystole. We all agreed that it was right to abandon resuscitation.
We pronounced life extinct at 1546.
The son cried.
The wife cried.
The grand-daughter came in and asked what was happening. I looked at her dad, a question in my eyes and he nodded. "I'm sorry sweetheart, you're Nan's died."
The house erupted in sorrow. It was heart-wrenching. I knew exactly how they felt - my mum died from cancer nearly 5 years ago at just 63 years old.

We put the patient back on the bed, removed the tube (we should really leave this in, but the family asked us to take it out because they wanted the children to say goodbye and they didn't want them to be scared by it) and made her look comfortable and peaceful.

The family just kept saying thank you to us. We'd failed to bring their mum/nan back to life, but they still thanked us for what we'd done. We felt very humbled, and left them in peace to do our paperwork and summon the GP.

I only knew Mark had taken the call when he e-mailed me to say how freaky it was that we'd joked about him taking a call for a suspended on my patch, although this wasn't really my patch, but get pulled into that area quite often.

I'm working on the car again tomorrow, and Mark said he might end up on the FRU desk - you never know, we might get another cross-blog post out.

Our last cross-blog post was so well received, not to mention so long ago, we jumped at the chance to do it again. Maybe next time we'll get a happier outcome.

* 24 is the minutes past the hour, so in long hand he would have said "General Broadcast at 0924, my initials Mike Mike, Red Base out."

** I wasn't really complaining about being sent - I simply asked if he was running an ambulance that might be nearer. In the end, she waited over an hour at least - she only lived ten minutes walk from the hospital.

***To add to the freakiness (is that a word?) of this call, three years ago, I went to a cardiac arrest in the flat directly below this one.