Rollercoaster Shift

[IsraelEMS]

Sorry if I am dumping a bit but I had a real rollercoaster shift this week. We had a TCPA on a 3 year old and had to delare death. It was a multitrauma with absolutley no chance. The father was with us in the ambulance and it was really extemely tragic. We barely finished cleaning the ambulance when we were sent to a CPR of a mid 60's woman, wittnessed arrest. After 3 rounds of adrenalin we got ROSC and by the time we got to the hospital she was breathing on her own and even starting to respond. I don't know if these extremes make it easier or harder to proccess.

I had trouble sleeping last night. I kept waking up after dreaming about airway managment.

 

[NomadicMedic]

I don’t know what your service offers for critical incident debriefing, but if you can get some help, please do. Even if you feel OK, processing these calls with someone who understands the trauma first responders experience can make a real difference. Talking with a qualified counselor gives you a place to unload those thoughts before the grief builds up and shows itself later as PTSD.


Do I think you’re damaged or broken? No. Do I think every first responder who experiences trauma outside the norm should have access to mental health resources? You bet. Take care of yourself. In the long run, it helps you take better care of the patients we serve.

 

[IsraelEMS]

I don’t know what your service offers for critical incident debriefing, but if you can get some help, please do. Even if you feel OK, processing these calls with someone who understands the trauma first responders experience can make a real difference. Talking with a qualified counselor gives you a place to unload those thoughts before the grief builds up and shows itself later as PTSD.


Do I think you’re damaged or broken? No. Do I think every first responder who experiences trauma outside the norm should have access to mental health resources? You bet. Take care of yourself. In the long run, it helps you take better care of the patients we serve.

I actually spoke to them but I found speaking to other responders to be more helpful. Thank G-d I am ok.

I had a second TCPA lasst week. 76 year old jumper. Two units of blood, double sided chest drains and (obviously in the Trauma room) a thoracotomy. There I was able to maintain distance and while it was a sad case (he didn't make it) find the medicine facinating. How often do you get to visualize your pt's heart? The professr who heads the ER did the procedure and took the time to explain about it after. Facinating.

It's just kinda different when your pt is 3, you know? I also found the rollercoaster effect of losing a kid and saving a grandma (it as a relitively dramatic ROSC, the pt was starting to respond not just had a pulse) to be in some was insane and in some ways typical of our profession.

Something else that helps is that from the medicine side I am complete with our decisions. I know that there was nothing more we could have done for the child and that at that distance to the hospital the best decision was to stop. I can site all the studys that Trauma CPR is not effective and even harmful. From the state of his body (we say "lost human form") the case was tragically clear. The best thing for the child and the crew was to call it. I think if the case had been different and I had doubts from that side it would have been much harder (should I have given this or that med, kept compressions goig for one more round, ect). It also brought up an interesting discussion in my mind and that is taking into account the psychological effects on the crew of the descions we make. I don't see a lot discussed about that in EMS.