The Stress of losing a Patient

[DowntownMedic]

How have you handled it?

 

[E tank]

I took "me" out of the picture. The phrase "losing a patient" implies "I" lost him in some sort of breech of duty.

Now, there are those situations where a caregiver does drop the ball and a patient dies because of it, but I don't think that's what we're talking about here.

If you can say that you acted to the farthest extent of your training and experience, you didn't "lose" the patient. He succumbed to his illness or injury despite your efforts.

It's good that we're hardwired to feel remorse at the death of a human being. But it's not about us.

 

[Old Tracker]

I had a roll over, possibly an ejection, that was brought to the Port of Entry already intubated and unresponsive, but breathing. Called for an ALS intercept and actually made the intercept. The kid (19) coded on me and CPR brought him back. With the Paramedic in the truck we still had probably 20 some miles to go to get him to a plane. He coded again about 2 miles from the airport and even the flight crew couldn't bring him back. According to them the kid had both a PThorax and a HThorax.

I spent most of the night running it over and over in my head, and came to the conclusion there wasn't a damned thing I could have done differently. Still think about it once in a while and come back to the same answer. It was too much for a Basic and an EMR driver, thr distance was too far, and the flight time for the plane was too long. Plus, we don't know what other internal injuries he may have had that weren't found in the Mx. hospital.

 

[NomadicMedic]

I honestly haven't felt "stress" from losing a patient. Have I felt bad? Yes. Do I remember most of my losses? Again yes.

Does it stress me out? Nope.

I'm not a heartless bastid, but people die despite my best efforts. I learn from those calls, as much as I learn from the ones that go well. There's a big difference between empathy and sympathy. I feel sympathy for the family of the patients who die.

If you're stressed from losing a patient, I suggest talking to a supportive friend or using some of the myriad of other stress reduction techniques. If this is an ongoing issue for you, perhaps EMS isn't the best fit. @E tank nailed it. It's not about us.

 

[cprted]

People die: Life has a 100% mortality rate.

All you can do is your best to maximize the patient's chance at a good outcome. But some of the events we're called to simply aren't survivable. Whether its a gnarly trauma or a massive MI, some of your patients are going to succumb.

When we go to school, most of our simulations are written that if you do the right thing, the patient will get better. That's not how real life works. Even with the best care, some people are going to die anyways.

 

[StCEMT]

It doesn't stress me out. I do my job and the best that I can for them. If it works, great, insert warm fuzzies here. If not, then I don't let it get to me. We can't fix everything (or a lot of things for that matter) and some things even the best medical professionals who are the right people for the job can't fix. People are going to die no matter what sometimes and that's ok, it is not a bad reflection on us or ability.

 

[akflightmedic]

I have never lost a patient. They are always in front of me or next to me until I hand care over at the hospital or leave them on the scene. I always know where they are.

 

[Old Tracker]

It doesn't stress me out. I do my job and the best that I can for them. If it works, great, insert warm fuzzies here. If not, then I don't let it get to me. We can't fix everything (or a lot of things for that matter) and some things even the best medical professionals who are the right people for the job can't fix. People are going to die no matter what sometimes and that's ok, it is not a bad reflection on us or ability.

Too illustrate that point, we had a similar case to the one I described earlier. This time it was a 13 year old girl whose family car had had a roll over. (No details on the accident). She had been patched up in Mexico and was intubated already. We called for a flight as soon as we saw the patient. Flight couldn't make it to our area because of weather, but could make it to the town the hospital is in.

The paramedic I was driving for did what I consider miracles to keep that poor kid alive until we made the hospital. Shortly after we arrived at the hospital the local IFT unit arrived to transport her to the aircraft. They ended up leaving without the patient because the hospital was working hard on her. She passed away the next day, still at the hospital. Even with all their tools and abilities they couldn't fix her.

 

[Carlos Danger]

I have never lost a patient. They are always in front of me or next to me until I hand care over at the hospital or leave them on the scene. I always know where they are.

Me too. I've found that by simply making sure the patient is always in my line of sight, that I never have to remember where it put them.

 

[mgr22]

DowntownMedic, what happened?

 

[NysEms2117]

just to re-iterate what everybody else said, it's just a way of life. YOU didn't lose a patient, their life had taken its course and it was their time. As long as you can honestly say to yourself "i did everything i could for that patient" you should be perfectly fine sleeping at night. Nobody will fault you for trying your best, family may be caught up, but it's happened to me, they acknowledge they were caught up in the moment and realized you were trying.

 

[Bullets]

I tell our new cadets this when they always ask this eventual question

The outcome of 99% of the calls you will respond to are decided before anyone calls 911.

In that 1% of the calls, did you do everything you could have to help the patient? I would only stress if i felt i did something (or did not) that negatively impacted my patients morbidity or mortality.

 

[SpecialK]

I've never found it a problem; I don't know these people and am completely emotionally divorced from the situation. Honestly. I can only tell you the name of ONE of the patients I have had who has died, the rest, hell, I can't even remember who they are or why they died they just sort of all blend together.

 

[GMCmedic]

It doesnt bother me. I had my first Pedi code a couple weeks ago and I honestly have to think really hard to remember the kids name. Eventually Ill forget it like all the rest.

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[VentMonkey]

It doesnt bother me. I had my first Pedi code a couple weeks ago and I honestly have to think really hard to remember the kids name. Eventually Ill forget it like all the rest.

When I hear this kind of stuff it's usually from someone who A) doesn't have kids, and/ or B) is so detached that they're unaffected. I could be completely off base because I don't know you personally, though.

Pedi-codes genuinely suck, but like everyone else has hinted you find your own ways to cope and you move on. Or you don't, and you resign. And you know what? That's ok, too.

The best advice has already been given OP, and like @mgr22 eluded to something either happened, which you're more than welcomed to discuss, or you're just genuinely curious. Either way, what they all said.

 

[GMCmedic]

When I hear this kind of stuff it's usually from someone who A) doesn't have kids, and/ or B) is so detached that they're unaffected. I could be completely off base because I don't know you personally, though.

Pedi-codes genuinely suck, but like everyone else has hinted you find your own ways to cope and you move on. Or you don't, and you resign. And you know what? That's ok, too.

The best advice has already been given OP, and like @mgr22 eluded to something either happened, which you're more than welcomed to discuss, or you're just genuinely curious. Either way, what they all said.

I have a 3 year old and one on the way. In between we lost one at 8.5 weeks. I guess I am just that detached. The run sucked, it really did. It hit me a little watching the Doctor tell the parents they were ceasing efforts. Then I went back to work and went to my next patient and moved on.

I dont know if that is a good thing or not. Ive been in EMS for 7 years and Ive always been that way. Its not something I ever tried to do, it just naturally happened.

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[E tank]

As far as peds go, the death of a child is always rotten, but more than anything else, it's the parents reactions that are the most brutal to take in. Found that to be the case even before I had kids.

 

[VentMonkey]

@GMCmedic I think we all cope differently. I'm not judging you, brother. I would just prefer a regular plain ole' 80 year old who'd seen the world and back arrest than the unpredictability, and stress of a pedi-code.

 

[DrParasite]

whiskey is my preferred drink of choice, followed by vodka.

The outcome of 99% of the calls you will respond to are decided before anyone calls 911.

This is very true. the 90 year old grandmother wasn't going to make it, regardless of what you did. the 400 lb diabetic is in the same position. Even the 7 year old who got hit by a car going 60 mph... does it suck? yeah, but you didn't cause the issue, and sometimes you are so far behind the 8 ball that there is nothing you could do about it.

I didn't cause the issue, so I don't stress it. And like special K said, I've ran so many calls in my career that they all blend together. I can't remember names. I do have some calls that I do carry with me. But I think this is a good image to remember: http://www.dansunphotos.com/Emergency-Response-Portraits/i-F2W2KRf

You can't save everyone, and even doctors carry their mistakes with the. the best thing you can do is not repeat them.

And yes, even the dispatchers hate losing a patient: http://www.dansunphotos.com/Emergency-Response-Portraits/i-NPHTRD6/A

 

[NomadicMedic]

I tell our new cadets this when they always ask this eventual question

The outcome of 99% of the calls you will respond to are decided before anyone calls 911.

In that 1% of the calls, did you do everything you could have to help the patient? I would only stress if i felt i did something (or did not) that negatively impacted my patients morbidity or mortality.

I think that number is a little skewed. I would say maybe 5% of the calls that I respond to are decided before anyone called 911.

There are a lot of calls where EMS makes a huge difference.