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Sunday, January 3, 2010

3 Year Old Full Arrest

About 2200 we were toned out for a 75 year old woman that fell down the stairs and possibly fractured her hip. The call was on the far West side of our district, close to station one. As we were leaving the apparatus bay we heard station one get toned out for a possible full arrest in the far East end of our district. We all realized that to give the dying person the best chance of survival we should turn around and respond to that call. We were closer, already dressed, and rolling. We could get there several minutes before station one and that could make all the difference. So we turned around within earshot of the address of the first call.

As we informed dispatch that we were re-routing the confusion began. With all the chaos on the phone the dispatcher missed our radio call informing her that we were now responding the the full arrest. She continued to advise station one units that they were responding to a 3 year old full arrest and that PD was responding as well.



Now we were really glad that we decided to respond. We finally cleared things up with dispatch just before we arrived on scene. Luckily station one was on the ball and headed to the old lady that fell. As we approached we could see that two PD units were already on scene. The officers were kneeling over the patient who was laying in the grass right next to the curb. There were about 15 friends, family and neighbors outside watching things unfold. My immediate thought was this one looks real. It must be, the family ran the kid out to the first arriving unit. Before the engine came to a complete stop I was out of the rig grabbing equipment. My engineer, another medic, was thinking the same thing as me, "God help this little kid." We both have kids that are three.
http://circ.ahajournals.org/content/vol112/24_suppl/images/large/24FF1.jpeg
























This is the treatment plan that was going through my head.

As I approached the kid I noticed that the cops weren't doing CPR but were acting flustered. I knelt next to my patient and moved one of the cops out of the way. I did a quick check on the important stuff. The kid was breathing, although not well, he had a pulse and he was 11 months old, not 3 years old. We quickly started assessing the child. While he was breathing and had clear lung sounds, he was clearly struggling and had a strange almost clapping sound when his epiglottis closed. It was audible even without the stethoscope. The mom, understandably on the verge of panic, asked us to do CPR. Without missing a beat I let her know that her son was breathing and his heart was pumping. The best thing for us to do was to finish checking him out and get him to the hospital. I reassured her that if he needed CPR I would begin without hesitation. I then asked her to go get a blanket to cover up her son to protect him from the cold. This gave her something to do and some semblance of control over the outcome of her son.

The parents said that their son was standing and fell face forward onto the tile floor. He acted as if the wind had been knocked out of him. While we were assessing the patient we were able to watch the goose egg form on the right side of his forehead. The patient had periods of crying (seen by medics as a great thing) but mostly he was sedate. The little boy let us manipulate his arms and legs without fuss in order to get his clothes off. He didn't resist when we placed him on the pediboard. He even tolerated the oxygen mask.

http://www.dvrescue.com/pediboard.jpg
Once AMR arrived on scene we finished strapping him in and sent him off to Children's Hospital. My engineer and I were both a little shocked when the AMR medic decided he didn't want a "rider" (a firefighter to go along with them just in case the kids started to circle the drain).

I have no idea what was wrong with the child. Everything that we could check was normal (with the exception of the labored breathing). All I do know is I can tell the difference between big sick and little sick. This kid was big sick. We've asked our EMS chief to follow up on this patient for us.

The 75 year old woman, for whom we were originally dispatched did have a fractured hip but thankfully was not in too much pain.

4 comments:

maxwelton's braes are bonny said...

Can you keep us updated if you find out? I have a 13mo and that hits just a liitle too close to home. Thanks. Hope he was okay. Oh, I would've jumped in with the medic anyways-just because.
Wow, hope he's okay.

Firefighter/Paramedic said...

I'll post an update as soon as I find out more.

Firefighter/Paramedic said...

Update: The child was admitted to the hospital and scheduled for a "foreign body object removal." So evidently he swallow something and that is what was making the strange sound. He was discharged in less than 2 days. I wish I was able to get a little more information but its good to know the kid is OK.

Anonymous said...

I was going to suggest epiglottitis, but foreign body it is. Praise God the kid is OK!

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