JERAMEDIC

It was late morning on a weekday in August, and It was my second shift with my new partner Bobby. The day was going rather slow, and we had only had one call so far. It wasn’t very serious, and after we cleared the hospital we were sent to post at Lucy’s  panadería.  The assignment was not for any pastry purposes but rather district coverage. Lucy’s was the half way point between our response area, and that of our sister station to the north. When ever coverage got low, you could guess someone would end up at Lucy’s.

“chrrrr 802?” the radio crackled. Bobby keyed up the mic “802 at post.” “chrrr 1455 Bridgetown on a fall at south end commercial in the dealer lot, code 3. ”   Bobby answered back “802 en rout.” He looked at me and said “do you know that is?” I pointed up the street  “Over there a ways”  as started flipping through the map book. “just get going, I’ll find it.” This was bobby’s first day driving, not ever, but the first on our shift, and he was still learning the area. He started the ambulance and headed north up the street in the direction I had pointed.

I found the address ” Bridgetown is coming up, it will be the second major  intersection.  Make a right and we’re almost there” “got it” Bobby said. “chrrr’ dispatch was back, “802, updated info your call  is now a full arrest.” “copy” I said back. Bobby sped up some ” do you think it’s legit?” he asked. “maybe…. here’s Bridgetown, make a right” We turned  “ok slow down some, I don’t think its too far… let me look” I said.  Bridgetown was a large street occupied primarily by car dealerships and industrial type companies. Judging by the dispatch info I’d be looking for some mix of the two…. fun.

“Wait there it is!” I shouted and pointed as we drove past. “Ahhh! sorry” Bobby said as he made a some what dangerous U-turn. We parked near the front gate just as a fire engine came around the corner. Bobby took out the gurney and through a backboard on it, as I grabbed the jump bag and swung the defibrillator over my shoulder. We walked in and were met by a man who lead us past some commercial vans and trucks to the patient. I know the whole the time he was talking to me, but honestly I never heard one word. I Stopped abruptly when I got to the patient. He was in his late 20′s, laying supine next to a ladder. He had a large hematoma to the left side of his forehead, and the sleeves of his shirt and his hands looked black and burnt. The aluminum ladder stretched up a lamp post with exposed wires at the top.

Now Bobby and the firefighters were at my side. Are the wires still hot? Do we go in? Is it safe? were all questions running through our minds. “screw this!” a firefighter said. “He’s not touching the ladder.” He put on his turnout gloves, grabbed the patients shirt collar and pulled him some yards away from the lamp post.

We all ran up and I felt for a carotid pulse… he was in arrest. I cut of his shirt and a firefighter started chest compressions. Bobby got the defibrillator ready and put the pads on. I moved to the patients head and dropped in an oral airway. With his head between my knees to hold C-spine, I was able to get in two breath with a bag valve mask before checking the monitor. “he’s in V-Fib, we’re gona shock.” Everyone stepped back and we defibrillated. I took over compressions as Bobby and Bearto, a Firefighter/Paramedic stated an IV and intubated. Another rhythm check and  “Damn!” he was in Asystole. I continued CPR and a round of epinephrine and atropine went in. We checked his rhythm and he was back in V-fib. Another shock and Bobby and I switched, with him on compressions and me ventilating.

Now, when one is  ventilating an intubated patient with a BVM whilst CPR is in progress. There is a rather distinct “squelchy honking” noise that is produced by the pop off valve of the BVM. This “space goose” of a matting call is caused by air being trapped in the lungs, and by the increase of intrathoracic pressure  due to chest compressions. The ResQPOD is a great device  to handle such an issue. Needless to say we did not have one. anyway, back to the story.

While ventilating and hearing the familiar “honk” there was a breath that went in without resistance. And then another. “Wait.. Hold compressions” I said, thinking maybe the tube was dislodged. Just then the patient’s chest rose and fell on it’s own. “I think he’s breathing” I said. I felt a pulse and the monitor read sinus tach at 130bpm. “Holy crap it worked” I said in almost disbelief, “lets get moving”

We got him packed up and in C-spine,  I held on to the tube so as not to lose it for real this time. We loaded the patient up, and Bearto and I got in the back. I sat in the jump seat at the patients head to mange his air way. He was breathing at around six a minute on his own and only needed assistance and monitoring. Bobby was driving, and between breath I’d turn and yell directions to the hospital up to the cab. We were about five minute from the ER, and when we got there he still had a strong pulse and was now breathing at ten a minute on his own. Reports were given, test were ordered and teams were assembled. Bobby took the gurney and I left to do my paperwork.

Later that day we were back at the same hospital, and learned that our patient had survived and was now in ICU. For the next two shifts that week we visited him in the ICU. We then had a few days off, and heard that he had been discharged with expectations to make a full recovery.

This was not my first cardiac arrest, or my first critical call. It was my first save. A real honest to god save, where the patient walked out of the hospital healthy as if nothing happened. This was also Bobby’s first save, and I’m glad we were able to share that amazing experience together.

Bobby and I would stay partners for the next two years. And that day set the tone for the kind of  calls we would face together.

It was my first, but it will not be the last.