Dealing with the facts of life

[RPM89]

So I was dispatched code 2 ( GT/IF ) for a 5 yom who was in Respiritory Distress (o2 in mid 70's) and hx of heart problems ( unspecified ) we were 30 mins out and decided to updrage purselfs code 3. We notified dispatch pf upir intentions and were promptly called on our personal phones and informed that dispatch is DEMANDING US TO DOWNGRADE code 2. they were unable to provide add'l information on the pt.

When we arrived ONS the 5 y/o was in obvious repiritory distress, closest ER (PEDS) is 25 mins away. Pt became apnic en route and was now a code.

long story short, kiddo didn't make it. I'm a father of a beautiful 2 y/o girl, This call has messed me up something fearce. Knowing dispatched forced us to downgrade and the kid died. I'm super stressed and for some reason find myself taking it out on my family.

Does anyone have tips as to help me out? I'm not big on putting this kind of stress on my family so talking to them is out of the question. :sad:

p s I apologize for the bad spelling

 

[Amberlamps916]

Why were you dispatched code 2?

 

[Tigger]

There are many studies out there suggesting that driving emergent does not save a clinically significant amount of time.

You did the best you could and that was not enough. Ask your employer about mental health resources if you think you would benefit talking to a professional about the call and your reaction to it. Many do, there is nothing weak about seeking professional help, especially considering your own personal situation.

 

[chaz90]

Not that it helps at all with the horrible outcome, but your Code 2 response most likely had nothing to do with the child's death. How long was your response time? Unless you were dealing with traffic instead of distance, L&S response doesn't really help with times all that much. Also, this patient probably would have still gone into respiratory arrest, even if you arrived a few minutes earlier. Bottom line is you don't need to blame yourself or your Code 2 response for an outcome that was most likely going to happen anyway. That being said, if I want to upgrade my truck to an emergent response, I will.

 

[Sublime]

So I was dispatched code 2 ( GT/IF ) for a 5 yom who was in Respiritory Distress (o2 in mid 70's) and hx of heart problems ( unspecified ) we were 30 mins out and decided to updrage purselfs code 3. We notified dispatch pf upir intentions and were promptly called on our personal phones and informed that dispatch is DEMANDING US TO DOWNGRADE code 2. they were unable to provide add'l information on the pt.

When we arrived ONS the 5 y/o was in obvious repiritory distress, closest ER (PEDS) is 25 mins away. Pt became apnic en route and was now a code.

long story short, kiddo didn't make it. I'm a father of a beautiful 2 y/o girl, This call has messed me up something fearce. Knowing dispatched forced us to downgrade and the kid died. I'm super stressed and for some reason find myself taking it out on my family.

Does anyone have tips as to help me out? I'm not big on putting this kind of stress on my family so talking to them is out of the question. :sad:

p s I apologize for the bad spelling

How much faster would going "code 2" have been? Do you think that was a deciding factor in the childs death? I doubt it. Not saying it shouldn't have been a high priority response, but don't get too hung up on that part.

Does your work not have a stress incident management program for this type of situation? Talk to someone at work you trust if not. No matter what pediatric death's are going to be hard.

 

[TheLocalMedic]

One of the hardest calls you can deal with in a career involves the death of a child. As a parent, this can hit you even harder. For many it ends their careers or causes huge issues at home.

If you can't talk about it with your family, you darn well better talk to somebody else. I know it can be hard, but try and talk with your partner or others who were involved. Find a therapist who specializes in PTSD or grief counseling.

My career was almost ended by a kid dying, and I know that it had some lingering effects on me. I was never a big fan of "getting therapy", but until I talked to someone else, someone who was impartial and trained to help me cope, I was having some serious stress issues and my home life sucked. After I was able to start talking and open up to a therapist a whole flood of black, sticky crap flowed out of me. But you know what? I felt a whole lot better afterwards.

Talk about it. People idly giving the platitudes of "it's not your fault" or "I'm sure that you going code 2 wasn't that bad" or "the kid probably wouldn't have made it anyway" won't cut it. Inside there's probably a part of yourself that's eating you up with doubts about what you did and whether there was really something that you or your partner could have done differently to change the outcome.

You need to talk about it with someone.

Don't let this hurt you or your family.

 

[Wheel]

One of the hardest calls you can deal with in a career involves the death of a child. As a parent, this can hit you even harder. For many it ends their careers or causes huge issues at home.

If you can't talk about it with your family, you darn well better talk to somebody else. I know it can be hard, but try and talk with your partner or others who were involved. Find a therapist who specializes in PTSD or grief counseling.

My career was almost ended by a kid dying, and I know that it had some lingering effects on me. I was never a big fan of "getting therapy", but until I talked to someone else, someone who was impartial and trained to help me cope, I was having some serious stress issues and my home life sucked. After I was able to start talking and open up to a therapist a whole flood of black, sticky crap flowed out of me. But you know what? I felt a whole lot better afterwards.

Talk about it. People idly giving the platitudes of "it's not your fault" or "I'm sure that you going code 2 wasn't that bad" or "the kid probably wouldn't have made it anyway" won't cut it. Inside there's probably a part of yourself that's eating you up with doubts about what you did and whether there was really something that you or your partner could have done differently to change the outcome.

You need to talk about it with someone.

Don't let this hurt you or your family.

Great advice. I wish therapy didn't have the negative stigma that it can in our society. There's no shame whatsoever in needing to get your thoughts out so you can see them objectively.

OP, for the sake of your happiness and that of your family, go see a professional. Good luck and I hope you get this figured out.

 

[mcdonl]

I dont look at Code 1, 2 and 3 as how fast we can drive... it is what all about using lights and sirens. In Maine, there is really only 1 and 2 as you cannot drive with just lights and no sirens. We always respond code 3 because dispatch is not always correct in the information. But, that does not mean we drive fast or with disregard for safety. It just means we use lights and sirens to help clear the way.

That being said, it is unlikely the time you would have saved by going code 3 would have made a clinical difference.

 

[Mariemt]

We respond as we see fit from dispatch complaint. They don't tell us how to drive. However, my guess is they may have had you drive non emergent for emotional reasons. Is it protocol? We rarely drive emergently as it doesn't save much time and only do so if we need to clear traffic in serious cases.
I think dispatch may have been considering emotional response.
Safety first per protocol and emotional driving is not safe

 

[Carlos Danger]

I'm super stressed and for some reason find myself taking it out on my family.

This is a very typical manifestation of this type of stress.

You need to see a therapist. Or, at the very least, someone who is trained in grief counseling. Asking for help is harder than just trying to ignore what you are going through, but, like any other big problem, dealing with it head on - rather than just ignoring it and hoping it goes away (it won't) - is a sign of strength and intelligence and courage. Like any other serious and potentially damaging issue, the sooner and more directly you deal with it, the better.

FWIW, as others have pointed out, the downgrade likely had nothing at all to do with the outcome. Probably none of your actions did. It's natural to focus on and "what if?" those things, but I would really try to de-emphasize that in your mind.

Seriously, get some help, for your sake and your family's. This is the type of thing that can end careers and destabilize families if not properly handled.

 

[exodus]

We respond as we see fit from dispatch complaint. They don't tell us how to drive. However, my guess is they may have had you drive non emergent for emotional reasons. Is it protocol? We rarely drive emergently as it doesn't save much time and only do so if we need to clear traffic in serious cases.
I think dispatch may have been considering emotional response.
Safety first per protocol and emotional driving is not safe

It's not up to dispatch to decide if we can handle the emotional stress.

 

[Fire51]

Like everyone else has said, dealing with a death of a child is the most sickening and hardest calls we as EMS providers will deal with. It affects everyone emotionally and mentally weather it is a little or a lot. Go talk to someone, my best advise is someone in your company that you know has dealt with this like a supervisor or someone you trust. It may help you more then you think, I hope you still find love in you job and find a way to cope with this call.

 

[Mariemt]

It's not up to dispatch to decide if we can handle the emotional stress.

It isnt up to dispatch to tell us how to drive either. They may have different protocols

 

[Bullets]

I dont look at Code 1, 2 and 3 as how fast we can drive... it is what all about using lights and sirens. In Maine, there is really only 1 and 2 as you cannot drive with just lights and no sirens. We always respond code 3 because dispatch is not always correct in the information. But, that does not mean we drive fast or with disregard for safety. It just means we use lights and sirens to help clear the way.

That being said, it is unlikely the time you would have saved by going code 3 would have made a clinical difference.

Responding code 3 to every call is idiotic. I feel it is the sign of immature and new EMTs and responders, not just EMS but fire and PD. There is no reason to go CODE 3 to non-life threats. Driving is was kills most EMS every year, and Code 3 only increases the risk to you, your partner and other motorists. Going Code 3 to calls that dont need it is negligent

It's not up to dispatch to decide if we can handle the emotional stress.

And they dont get to decide how you respond to a call. You respond based on information they give you. If they tell you its diffuclty breathing, then you respond Code 3, if they say its a post-choking, then you respond code 1. You are the medical provider, you are responsible for delivering the most appropriate care based on the information you have. You dont transport every patient code 3, why respond to every patient code 3?

If you claim that your dispatch gets it wrong with such frequency that they will send you to vomiting when it really cardiac, then you need to have a chat with the dispatching agency bout their personnel.