My very first call as a paramedic was for a middle-aged dude with a HR in the 20's whose implanted defibrillator kept firing about every minute or so.
I'd say the biggest way it affected me was to show me how little I knew about AICD's and electrophysiology in general.
Traumatic arrest with brain matter showing is considered a do not attempt resuscitation in a lot of systems.
You ran a traumatic code with injuries not consistent with life ( brain matter showing)?Traumatic arrest: Motorcycle dump into a wire guardrail. Patient HAD a helmet on, but it didn't need to be removed by EMS, and his face had "the Joker smile" and two more parallel lacs running across his temple, brain matter showing through them.
By the time I arrived on scene BLS crew had patient loaded and were preparing to transport. Attempted to drop a tube, couldn't see anything from all the blood, and instead of wasting time auctioning and tubing, just dropped a King. Listened to breath sounds, noticed diminished left side, and decompressed. My preceptor had dropped an IO and administered 2 epis, and I gave the third. Before the third, noticed NSR on the monitor, but was PEA, two minutes later patient had NSR with a pulse and a BP.
Sadly the fact that we got him back in the rig and that he was alive at the hospital. We all knew/know that this patient was dead regardless what his heart was doing.
I believe he ended up being transported from the smaller capital district ER to Albany Medical Center and was kept alive long enough to harvest.
MD at smaller ER said that the airway and decompression was key to bringing this individual back and that as a new medic I handled myself well. Preceptor had nothing but glowing remarks for me.
Now for myself, being an individual who is overly critical of every little skill I use or med I push, I replayed the call in my head over the last two years and thought of anything that I was weak and strong in, and I do this for almost every severe call because of this and another call. But it played out those first arrest jitters for me and allowed me to feel confident in myself as a new medic and go on to trust my instincts and knowledge.
Does your county/district not have an organ recovery team?You're right it was, except care had been initiated and he was loaded. So at that point I chose to give it a shot. If he had been on the ground when I arrived both my preceptor and myself agreed that we would have called it.
That being said, because we did work him, he was able to save lives through his harvested organs.
You ran a traumatic code with injuries not consistent with life ( brain matter showing)?
@medic6676, good experience. It was your internship and the wheels were in motion before you got there. Sure, you could have called it but why not get some interventions, eh? You know what you'll do on the next one... And the organ donor portion is a bonus.
DesertEMT is a newer medic as well and trying to be a fireman; he likes to call people out. COmedic has lots of good of good posts and is generally worth listening to. Just don't let the wet blankets get you down; I'm curious to hear about their first stat call on their internships.
DesertEMT is a newer medic as well and trying to be a fireman; he likes to call people out. COmedic has lots of good of good posts and is generally worth listening to. Just don't let the wet blankets get you down; I'm curious to hear about their first stat call on their internships.
Not so much a personal attack, just a general characterization. You are obviously smart and motivated. Often, this is paired with a certain degree of cockiness which you have likely been told about by others at various times.I wasnt attempting to call anyone out. It could have been his system that made him transport or some other circumstances. What does wanting to be a firefighter have anything to do with that post or are you just trying to make a personal attack?
Since you asked my first critical call during internship was a 62 year old diabetic not breathing. BVM + OPA. Attempted a line 3 times myself and my preceptor attempted 3 times without success. 1mg glucagon given with no response. Drilled an IO and infused D10. Brought his sugar up to 23mg/dL. Base was contacted and ordered D50. D50 brought his sugar up to 76mg/dL. Patient was now AOx2 and breathing on his own.