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Arrest Numero Dos

The day began more slowly than any other weekday shift I’ve been on. I was driving for a medic and dispatch sent us to post up at nursing home close to the base (typically in case we need to transport a “vent” (patient on a ventilator). The first hour-and-a-half went by fast enough, but then boredom rapidly set in. To pass the time, the medic (a very laid back ex-army guy from “Care-oh-line-uh”) decided to take me through every last item in his medic bag (drugs, intubation kit, IV supplies), the cabinets on the bus, as well as explain how to control the LifePack, portable ventilator, and IV pump. As if it wasn’t obvious before, medics can do a lot of interventions we can’t.

This took nearly two hours, and as we finishing packing away the last items the radio comes to life, “7-Adam, could you head upstairs for a low pulse ox? Sounds like they’re having trouble.” So, in what must be one of the fastest response times ever, we simply stepped out and rolled the stretcher to the front doors.

Upstairs, we found several concerned-looking staff members standing around a very elderly patient that wasn’t moving, but had an oxygen mask on her face and a pulse oximeter on her finger not showing a reading.

“We don’t think she is breathing,” the nurse says.

Okayyy, you’re a nurse, the word “think” shouldn’t be in that sentence. My partner and I walk over to her and check for ourselves, no lung sounds, no chest rise. Yep, not breathing. Neither of us finds a pulse, but she’s still warm and there’s no rigor.

“She has a DNR.”

Great, so our perfect response time is meaningless. The medic has me setup a quick 4-lead EKG anyways. There’s a clear rhythm on the monitor. Crap, did we miss something? That’s about the time we realize she has a pacemaker, obediently putting out a perfect sinus rhythm… electrically at least. At that point there was nothing we could do, no CPR, no ventilations, no drugs.

One of the nurses wanted to leave the oxygen on her, not that it would help someone that has no heart beat and isn’t breathing.

On a more positive note, we took out the mod that day (modular ambulance, the ones that are box-shaped, think FDNY), which is a joy to drive compared to the old junky ones we use on the weekends. That is once you get comfortable knowing that if the mirrors clear then the rear will clear (the rear compartment is wider than the cab) it’s pretty comfortable. Before that, it feels like you’re driving a tank down the street and you get the tendency to drive in the middle to avoid hitting anything. Not the most relaxing thing to do in NYC.

Categories: EMT
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