TouchMeI'mJeffrey

Code Blue

In my EMT-Basic class, they drill us on our Cardiopulmonary Resuscitation skills. The instructors pull out the CPR dummies and we put our backs into our compressions. If you’re doing it right, they say you’ll break ribs. Effective CPR puts a pause on the clock of death, and when done with timely defibrillations, the patient comes back, avoiding death in that moment.
 
0700: I sat on the couch in the nurses’ lounge, listening to the charge nurse give the ER assignments to her staff. I felt a bit out of place, being a student among all the techs and RNs, but there was another student there with me, and my preceptor was a tech certified as a Basic as well. 
 
I had been in an ER many times before. I used to volunteer at Seton Main, which had a quaint little ER. We never got that many interesting cases there and I never got to do much patient interaction just as a volunteer with no credentials. This particular hospital was fancy with an extensive (and expensive) ER. So I had a bit of a misconceived notion of what my day would entail.
 
0800: After touring the ER with my preceptor, I took a seat at the nurses’ station. It was slow so far, and I liked observing the ER doctors and nursing staff interact. My preceptor said that there was an incoming patient who had respiratory distress. The paramedics already started bagging him (giving him breaths) in the field, so this was a high priority.
 
When doing ambulance ride outs we get to be the first point of contact between the patient and healthcare. As thrilling as it was responding to emergencies, it was extremely dissatisfying not to follow through with my patients, dropping them off at the hospitals for the nurses to take over. I was excited to finally see what all that happened on the other side of the veil.
 
0845: 72 year old male presents with obvious respiratory distress. Unconscious on arrival with a Bag-Valve-Mask (BVM) providing breaths. Patient has a history of kidney cancer metastatic to right lung and lymph node. The nurses take over and begin attaching leads to gain vitals from the patient. The readings do not look good…
 
In all of medicine, there are three main tasks that are crucial for every level of health care providers to assess in order to make sure the patient stays alive: Airway, Breathing, and Circulation (ABC). If any of these are compromised, then the patient is in danger of not perfusing necessary nutrients to the body and eventually lead to death.
 
0900: The patient has become hypoxic with low O2 saturation. Blood pressure dives down and the heart is tachycardic. The nurses try desperately to find vessels to start IVs. The body is in shock and the monitor sets off alarm after alarm. They hung fluids and started pushing drugs…etomidate and succinylcholine help the doctor intubate so a direct flow of oxygen can be made to the lungs. And then suddenly…v-fib.
 
Ventricular fibrillation occurs when the heart is unable to maintain coordinated contractions. Pulses are no longer present in the carotid or femoral arteries. To the health care providers, this is DANGER. I had never seen a person go into cardiac arrest before; I had never seen a person this close to death in my life. I calmly observed, but my heart raced as adrenaline ran through my body. My only thought: Holy Shit!
 
0920: “STARTING COMPRESSIONS!” The charge nurse was short, and the bed of the patient was too high for her to give good compressions. “Bring in the LUCAS!” As they brought in the automatic chest compressions machine, another tech suggested, “Let the students do the compressions! Come on kid, get in there!” Damn I didn’t think I would do anything but observe the code! I felt like an idiot not having my gloves on yet, wasting time…but holy shit this was my chance to do REAL medicine!! I got in there and pumped. The rule is fast and hard: 100 times per minute and at least 2 inches deep in order to maintain circulation to the body. It is recommended to switch partners after 2 minutes due to exhaustion. I stood over the patient, throwing my body into my compressions, glasses flying back and forth on my face. I could see why it was tiring, but adrenaline kept my energy going. 
0930: The nurses ran this code, logging the times, reading the cardiac waves, managing the airway, pushing drugs in his IV: LR, amiodarone, epinephrine, dopamine…The doctor tried to insert a femoral central line, staying nearly silent the whole time. Meanwhile, my peer and I took turns, pumping away at the patient’s chest. Pump pump pump pump. Every few minutes they would recheck a pulse and shock the heart. In this generation, they use the sticker pads to give the shocks, not the metal paddles that are so common in movies and TV. In that short moment where they yell CLEAR, there is a small silence that captures the room. Are the rhythms back? Is he alive?? The daughter of the patient sat by his head, whispering “come one, you can do this. keep fighting!” No pulses…resume compressions…pump pump pump pump.
0940: As I pumped his chest, in my head I was praying “God, please bring him back! Don’t let him die under my arms!” As soon as I finished my turn of compressions, they checked for pulses. FINALLY, his rhythms were back. Patient’s vitals were stabilizing. The code was nearly over. I looked down at my hands, and they were shaking. Although I was still in my adrenaline high, I could tell that my body was exhausted. But that was nothing compared the the exertion that the patient just went through. But I was done. That patient was alive, and I helped. I saved a life.
You can imagine how I felt about the code being such a avid pre-med student. There was excitement, and there was fear. There was joy, and there was sympathy. I cannot believe that I performed CPR on a patient and he survived! Statistically speaking, about 70% of patients who undergo CPR don’t make it back. I was so thankful that my first time was successful. 
1100: The patient’s wife had come to the hospital. At the sight of her husband hooked to machines, tubes down his throat, pale as a sheet, she immediately began sobbing. Ultimately, she decided to withdraw care. I watched as the nurse extubated the patient, but I left to give the family some privacy. They had been through a terrible ordeal and felt so sorry for them.

Even though I helped save the man, I understood completely why she decided to take him off the machines. It is totally the prerogative of the patient and patient’s family (if he didn’t have an advanced directive). I’m glad I did my part and I’m happy the man could end his suffering. 
I’m so thankful that I had this opportunity to use my skills in an actual clinical environment. I felt like this experience told me that I can deal with the high-stress environment of medicine. I can cope with the rush of a code and the loss of a patient. I’m so ready to get into med school and continue what I hope to be a successful rest of my career.

suspend:

i want kids but im scared they’ll blame me if theyre ugly

hotboysofficial:

image

heard you’ve been talking shit

1021girl:

snickerdoodlesandsausages:

enjolrasactual:

in-love-with-my-bed:

the-winchesters-creed:

ayellowstateofmind:

Imagine stabbing someone with this knife. 

It would instantly cauterize the wound, so the person wouldn’t bleed, so it’s not very useful.

if you want information it is

and above, in order, we see a gryffindor, a ravenclaw, and a slytherin

why would you stab a PERSON when you can have TOAST?

There’s the hufflepuff

1021girl:

snickerdoodlesandsausages:

enjolrasactual:

in-love-with-my-bed:

the-winchesters-creed:

ayellowstateofmind:

Imagine stabbing someone with this knife. 

It would instantly cauterize the wound, so the person wouldn’t bleed, so it’s not very useful.

if you want information it is

and above, in order, we see a gryffindor, a ravenclaw, and a slytherin

why would you stab a PERSON when you can have TOAST?

There’s the hufflepuff

(Source: picapixels)