My partner and I once responded on a Sunday afternoon in
autumn to an elderly cardiac arrest. If I were feeling poetic, I would tell you
that the leaves were changing and a chill was in the air. It was a long time
ago, and I know that because it was the first time I placed a King airway in the field. It
was planned – a few weeks before, I said to myself: Self, the next arrest you work, you need to use one of those
new-fangled King airway things. So I did.
We arrived at a little bungalow on a quiet street to find
the fire department demolishing the torso of a little old lady. She was alone
in the house, with an unknown downtime, but was warm and non-rigored. She was
asystolic, got one round of ACLS love, and then I pronounced her. As per my previously designed plan, my first King
airway was placed. It was a
run of the mill arrest, beyond that. I
rarely go to the second round of ACLS with an asystolic patient if I can help
it. Asystole isn’t a rhythm – it is a
sign of death. That isn’t to say that I don’t put effort into resuscitating
patients; I have high hopes for every arrest I run. But this patient got one round of ACLS and
was pronounced.
There were a few memorable things, though.
First, I wonder how I would feel to have the terminal events
of my life be described as being “…asystolic, got a round of ACLS love, and we
pronounced…” Seems like a big event, after a long time on this Earth, to
distill into a simple sentence like that. If I get the choice, I want to be a spectacular
resuscitation, not a run-of-the-mill arrest. Something involving multiple etiologies. I want the medic who runs me to say, "I once ran a dude in cardiac arrest. He had an MI during intense sexual activity and then got struck by lightning! He may have survived all that, except for the rattlesnake. And actually, the snake didn't do him in, per se, but the fall that followed being bitten..." Something awesome like that. Yeah.
Second, I think she may have been close to deaf when she was
alive. The television was still on while we worked her. It was quite loud. Really loud. We had to shout to be heard over QVC. This comes into play later in the story.
Third, I discovered a profound new piece of knowledge: Once Fire has bagged
up a patient’s belly to a profoundly tympanic state, it is a sub-optimal
time to insert a King. Vomit squirts out
of the suction port. A lot of vomit.
Like, a lot. Vomit. Lots. I didn’t think it would end. The amount of vomit
being expelled under pressure was disconcerting and made me hesitant to ever
place a King airway again. I tried to put my thumb over the hole, but it just shot further; like when you put your thumb over the end of a garden hose.
 |
| No Comment. Source |
Fourth, I remember the cops on scene after I pronounced the
lady. They were going to have to wait on scene for the medical examiner to
arrive. You see, in my city the medical examiner is to be involved on any
out-of-hospital death. In this case, on a weekend, the ETA for an ME to arrive was
probably a couple of hours. One of the officers asked me to help find the
television’s remote control. Which made
sense in my head, being that the television was so loud.
“Here it is,” I said. “You’re right – the volume is crazy loud.
Let me turn it down for you.”
“No, dumbass.” The policeman said with a look of incredulity
on his face, “Who cares about the volume? The Broncos are about to start playing…”
Oh. How silly of me. Of course.
No comments:
Post a Comment