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Thursday, May 15, 2014

Going, Going......Gone

We got dispatched for a medical aid just after lunch. We were told that we were responding for a 95 year old male who was ill and unresponsive.

We arrived and were met at the front door by the family. The house was a mess. It was another hoarder house. Trails leading throughout the house. The family had slid their father/grandfather to the front door on a chair. As I walked up I asked what was going on while in my head I did a quick visual assessment of my patient. I could tell just by looking that this wasn't going to go well.

The family told me that the man had been unresponsive since the night before. His mouth was filled with crumbs because someone had decided to "feed" him while he was unconscious. He was breathing, but just barely. I reached out and checked for a radial pulse and found nothing. I did find a carotid pulse but it was slow and weak at about 45 beats a minute.

Something didn't seem right with the story so I asked again how long the patient had been down. I was told this time that their father had stopped responding to them this morning.

I little later on I asked a third time and was told that the old guy had only been unresponsive since lunch time.

I love it when stories change.

AMR showed up and started getting their gurney ready. I checked a BP (105/52) and a sugar (182). I also through the patient on the heart monitor (sinus bradycardia, no ectopy).

At this point, rather than staying on scene and pretending to be a doctor we scooped and ran. At the back of the ambulance I asked the medic if he wanted me to come along.....just in case.

He declined (you got to love young inexperienced medics that think they can handle everything by themselves).

I looked at the patient again and told the young medic that I was coming along for the ride.

As I walked around to the side of the ambulance the little voice in the back of my head told me to grab our Autopulse. I told the ambulance crew to wait for just a couple of seconds as I went to the truck to get the equipment. As I returned to the ambulance I could hear the medic remark that he hadn't seen the old man take a breath in a while.

Great. Just great.

I checked for a carotid pulse. Nothing. The old guy had coded.

I had the young medic help me get the patient onto the CPR device and told the driver to go. While en-route to the hospital the two of us would do everything we could to get the patient back. I was at the head of the patient so I took over on airway. I sank in an OPA and had good compliance with the BVM. In between breaths I flooded the IV line, grabbed the medications, put the patient on the StatPadz and checked the patients underlying heart rhythm.

The young medic attempted an IO but his drill died. He then got an IV established and administered the medications.

We rolled into the ER with the now dead patient. The ER quickly went to work continuing our resuscitation attempt. After 20 more minutes of CPR the MD finally called it.

Time of death 1406 hours.
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