Thursday, October 7, 2010

Really? To me? Right Now?

A normal run of the mill call, mid 70s patient, family states pt has a change in mental status with a period of severe cyanosis.  upon assessment pt is complaint free, 12 lead is unremarkable, probably would have released if their bp wasnt under 100 systolic.  So we are riding into the hospital, pt seems lethargic but nothing esle is abnormal.  Suddenly I call the pt's name when I notice seizure like activity, within seconds they are completely blue, as I reach for my phone to get orders for ativan, I notice nothing other than V-fib on our monitor.  All I could think was really? wtf, right now?  A breif second passed as I realized whether or not they die depends on my next actions withing the next few seconds.  I contemplated is being a medic really for me, to be honest I was scared shitless.  Within 15 seconds of noticing V-fib I was able to apply the pads and deliver a 200J shock ( of course all of this happends like 15 ft from the hospital entrance).  With a 3 second pause of asystole i feared I had chosen the wrong treatment, but just as I began to have my doubts, a beautiful text book normal sinus appeared on our lifepak 12.  The pt immediately regained their color, and was able to respond to my questions.  Needless to say the ER did not believe me until I was able to print a code summary.  Since the docs were  busy with another code that arrived just before we did my partner and I hooked the patient up to lessen the load on the ER staff.  I heard later that the pt coded again in the ER and was flow to the local interventional cath lab for 2 stents in the RCA.  They were discharged 3 days later.  A victory against the grim reaper, finally.  I feel like a medic, happier than ever, and wow, I LOVE what I Do!

Resurrections...

So lately I have been having good calls when I work the truck.  A few months ago I had a pt under 40, CPR in progress upon arrival.  I was able to get the tube in less than 2 minutes on scene, which always is an ego boost.  We worked the pt for quite sometime, I think around 45 minutes, when I noticed they had suddenly went from asystole to sinus tach... holy cow... upon arriving at the ER, the chaos between the nurses was nothing out of normal, our patient survived a few days from what I understand they were pulled off of life support days later... a victory short lived.