Cardiac Arrest. Your first time..

[LanCo EMT]

Well, had my first code last night. FD rescue was on scene by the time we got there and had initiated CPR. I took over compressions and a firefighter EMT was bagging. Medic tubed her and pushed 3 rounds of drugs, but according to the family the Pt was last seen alive about an hour ago so down time could have been significant. When we first showed up, the Pt was very cyanotic which tells me that down time was more than a short while. Online medical command called it after working her for about 25 minutes.

 

[emtstudent04]

I had a similar code to that. Shift started 0730 get our first call at 0800 comes up on the computer as pt in cardiac arrest not breathing no pulse so we leave the station code 3 half way there we get an update cpr in progress. FF's already initiated cpr we arrive, Cpt. tell's me to get in the rotation. I start bagging for 2 min and then switch with the other FF and start compressions for 2 min and then back to bagging for 2 min then back to the chest for 2 min. I then got rotated out and we got on the radio and the pt was pronounced 25 minutes later.

 

[BlakeFabian]

Those pediatric calls are hell, for even the most experienced technician; especially in a code situation. I don't really think anyone here can tell you how to "deal" with the emotional aftereffects of a code. You're going to have to find what works best for you and stick with that.

I find, for myself, it's easiest to emotionally detach myself from my patients. I pump on their chest, splint their bones, or simply lift old grandma off the floor then I go home and sleep soundly knowing that I did the best I could with the situation at hand.

 

[Adsy]

Hello, one from the UK for you with a (typical) arrest. About 4 months through my placement as a Student Paramedic.

Working with an Ambulance Nurse (AN) on an RRV got called to a male who suddenly stopped breathing in a car. Lights and sirens on the way up, other road users not yielding.

Got there, male cyanosed, CPR in progress in the back seat of the car by a relative. Had to move the patient out of the car onto the road, AN took the road side while i got the patient's head. Manoeuvred him out of the vehicle, where upon i managed to fall out of the car head first. Started CPR while the AN prepped for airway management and defib, one of the relatives runs over shouting "mind his head!" Look down to see during CPR that the patient's head was bouncing up and down hitting the tarmac. A few minutes in we get backed up by a different ambulance service with an EMT and Paramedic, they load the patient up while I get some details from the family.

En route we had had a bit of reckless driving from the driver, resulting in the patient nearly coming off the stretcher, me ontop of the patient and the AN ontop of me. I remember feeling a few ribs go, and what could only be described as a look of horror, i looked at the EMT, and just said "I think...i've just broke this guys ribs..."

Patient didn't make it but despite the shortcomings we gave it our best.

 

[dstevens58]

First one was back in the 70's, mouth-to-mouth at first until EOA was put in. All I remember is doing CPR the 14 miles to the nearest hospital. Van-type ambulance, dripping sweat, the cracking ribs, the abdominal distention.

Been on a couple throughout the years since, usually not witnessed or started by a bystander......but it wasn't until a few months ago I went to a call and the patient was fine, AOx3, then coded in front of me (she didn't make it either).

 

[EMSrush]

I enjoyed reading some of these. I wasn't going to contribute, but I changed my mind. My experience wasn't particularly glamorous or special, but I remember it well...

My first code was during my first hospital clinical rotation for medic school. Apparently, a 46 y/o female had walked into the ED (difficulty breathing) with her husband, and coded right then and there, in the doorway. I didn't see it happen; I was busy starting an IV in another room at the time. A nurse walked in and discreetly told me to go help out with the "code blue". I walked into the room, and was shocked to see that the Pt had been "code prepped"- that definitely took me by surprise! I switched between compressions and bagging, and I remember looking at her open eyes, seeing her carefully applied eye make up, and thinking to myself, "Wow... she didn't plan to die today..."

The doc finally called it, and I left the room. I watched on the security camera as the doc went in to talk to her husband in the waiting room, who was completely unaware of the finality of the circumstances. There were a couple of other family members there, anxiously awaiting to hear the fate of their loved one. I watched them collapse into each other and cry. I felt a lump in my throat; the emotion was quite raw. It was similar to things that I had seen on TV before, only this time it was real, and this time, I wasn't watching actors. My preceptor walked up behind me and asked if I was okay. I replied that I was, and he said, "Good. Now get in there and help make her presentable."

I cleaned up the room, and prepped the body for her husband and family. I tried to make her look as peaceful as possible. I left the room as the husband and nurse walked in to give him some privacy.

Just when I thought my job was complete, I was asked to help place her in a body bag and help bring her down to the morgue with security, down in the basement of the hospital. I helped lift her body into her temporary resting spot. Talk about running a code from beginning to end! I needed a few minutes to decompress and process it all, but I was fine. Subsequent codes got easier for me.

As much as I had disliked continuing my "relationship" with my first code, from beginning to very end, it was a very humbling experience. In hindsight, I think it was a great experience for a paramedic student.

I later learned that she was 1 week post op from having a bunion removed. She died of a PE.

 

[Fish]

My first arrest was when I was an EMT at 19, on a 40 y/o in his driveway that we pronounced on scene. Since then I have become a Paramedic and I have worked my best friends dad, a friend from high schools mom, a Pediatric Drowning and somewhere in the hundreds for Adult codes. For me, the worst part of the code is the families reaction, when I was still new this bothered me a lot more than it does now. I think with time the "emotional" effects of the call will get to you a lot less. It was really hard for me to see family members cry and say things like "My poor wife, 56 years together now what? I am all alone" I don't know if it is just me, but I find that working a 85 y/o Cardiac arrest at a Nursing home with multiple health problems has a lot different of an affect than the 42 y/o mother of 3(on scene) that coded infront of us with no known health problems. I guess this is just because it is an expected for an Elderly person with Multiple Health Problems than the Mom who still has kids in HS and no known health problems.

 

[Yarbo]

Arrived for pt. c/o gallbladder attack continued to assess the patient of course. During the vital signs/ecg application the patient was so diaphoretic, we needed a cloth to put on the leads. The paramedic had taken this call over and just getting into his questions the patient goes into vtach on the monitor. Patient starts to do some really funky agonal breathing and once we get the patient on the ground I'm delegated to BVM.

As I start ventilating the patient the arms are moving up towards me but the patient is in vfib now. After rounds of cpr and shocks the patient is conscious and starts talking to us. Transport the patient in a sinus rhythm but once we arrive at the hospital the patient goes in and out of vtach as they're wheeling her to the cath lab. (LAD Blockage)

The next day the patient is in the coronary care unit with her family.