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Tuesday, September 29, 2009

Running Firefighter

In general, firefighters are supposed to be the guys that nothing phases, and when they show up, everything is under control. Think about the times that you have seen a firefighter responding to a call. How often is he running? He may be moving quickly and with purpose but usually not running. This post is about one of the exceptions to this.

Our tones went off about 1100 in the morning. We stopped working out and jumped into our turnout pants. As we started responding we were informed that we were responding for a premature baby not breathing. At that point my pulse quickened. Not only is there now a life on the line but it's a kid, a young kid. This is both good and bad from a medical standpoint. Kids don't die (usually) unless there is something stopping them from breathing and if you can correct that problem, they bounce back. The down sides are that it's a much more stressful situation (you can have hysterical family there adding to the stress you're already feeling) and you don't run that many pediatric calls so everything may not be quite second nature.

As we pulled up to the scene my Captain said go get the kid and he'd grab the equipment. As I exited the rig I saw a woman (who turned out to be grandma) standing in the door way bordering on the hysterical. On a call you never know if dispatch got things right until you get there. Grandma being outside was not a good sign. I ran up to the house and inside I found mom holding her infant in her arms by the kitchen counter. The baby was very cyanotic, limp but breathing. The poor baby was using all of her muscles that she could to breathand she had retractions.
http://newborns.stanford.edu/images/retractions1.jpg
The mom said that she was born 3 month premature and was originally due to be born the following week. The baby had only been out of the hospital for a few days. She also said that she was burping the baby when she choked and stopped breathing. She did back blows to try and clear her airway and it worked. As I held the baby I stripped of the onesie. The baby did not look good. We placed her on some high flow oxygen and started getting some vitals. By the time that the next responding unit showed up I thought she was looking great. The paramedic walkinginto the scene thought she looked horrible until I explained how bad she was and that she was on the up swing. The AMR medic showed up next and we had to repeat the process. We quickly loaded her up and I jumped into the back of the ambulance, just in case things went south. We checked her capnography, pulse ox, and heart rhythm. Everything seemed to be checking out good. She started to really pink up (return to normal skin coloration) too. By the time that we got to the ER she was still having some respiratory distress but she was no where near the critical patient that I first saw.
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