First 36 Hour Shift - and a Cardiac Arrest

Trip Start Sep 14, 2008
Trip End Nov 01, 2008

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Flag of United States  , Texas
Thursday, October 2, 2008

Well, I just completed my first 36 hour shift. I came in at 7pm Tuesday night expecting an easy shift. Yeah... right.

We had about four runs and a cardiac arrest. It toned out as respiratory difficulty at a nursing home and when we got there she was sitting upright in bed with her head flopped forward. There were a buttload of nurses surrounding her all freaking out. The patient had a pulse when we got to her, but after we did a quick check after we got her loaded into the ambulance we saw that she was in a PEA rhythm.... that's basically where the electrical system of the heart is working fine, thus showing a rhythm on an EKG, but there is a mechanical problem and the heart isn't pumping. We started CPR and got some vasopressin in her (though my first instinct was to reach for the epinephrine, which is not MCHD's front-line medication). I told the EMT to intubate her. The other Paramedic did compressions and I did the IO so we could get a line quick (it went in a lot easier than the trainers we had in class). We got a round of vaso in her and two rounds of atropine by the time we arrived at the hospital (we had a supervisor drive us). She was still in PEA when we transferred her to the ED. Unfortunately by then her pupils were fixed and dilated. Given that and her age, they decided to call it.

Unfortunately you lose more than you win. I'll probably never know exactly what was wrong with her, but there you have it. My first run as team lead for a cardiac arrest. It was eventful, but slow moving. Definitely not like ER where everyone is scrambling around and shouting orders.

THe next 24 hours were pretty uneventful... I ran a few calls later. My preceptor is letting me take complete control over scenes now, which is nice. Hopefully I can squeeze a few more shifts between here and the 28th and get the hell out of dodge early!

Thanks for the comments, guys. It's nice to know you guys care! I miss all of you! :)
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