Saturday 31 December 2011

That day

Its a day I'll never forget. A call I'll never forget. Unfortunately.

Sat in my car and the computer starts ringing. I look down and in the details said "Not Breathing". Lights on, foot down I start "making progress" aka driving rather fast. Whilst traveling the computer bleeps again. I glance. I double take. I bury my foot that much harder into the floor.

The details had been updated and now the age was there. 16/12. This, in medical terms, means 16 months.

The rest of the journey is mostly a blur. I do remember the computer bleeping again telling me another crew were on scene. It was a crew I knew and I have never been so glad to know they were on a job with me. After burning a huge amount of diesel and probably taking a good few millimeters of break disk off, I arrived as one of the crew come running out of the house with this tiny thing in their arms. Limp. Lifeless.

Another car turns up (We tend to throw every resource we can at a job like this). The driver says "I'll get the parents", leaving me and the crew free to deal with our patient. On board of the ambulance the defibrillator pads were on and the patient was were being ventilated (we were breathing for them). The heart tracing was not what you'd want to see. We all knew this would probably be a hopeless case but we persisted.

"Shall I do an IO?" I said. An IO, which stands for Inter-ossious, means forcing a large needle into a bone. Sounds gruesome but is quite a good route for getting drugs and fluids into a patient and, allegedly, not that painful (being less than needle friendly I don't want to test this allegation!) Tiny babies have tiny veins so our normal route of a small needle in a vein was not likely to work, hence the less subtle approach. It was agreed that I'd do an IO and so I set up the kit (not easy in a moving ambulance), cradled this tiny, limp leg in my hand and did it.

I cant describe the feeling, or the sound of forcing a large needle through something so delicate. However much i want to, I'll never forget it. I am told I went quite pale. I know it was necessary to ensure we try everything for this little one, but that doesn't make it easier. Now we have special drills that work a lot better and are much easier than the manual method i used for this patient, so I should never have to do this again, and for this I am quite glad.

Unfortunately, despite our best efforts, the baby died at hospital. We gave it every chance we could, but in vain. We did out paperwork, went back to a local station where the manager supplied us with tea and biscuits, had a chance to sit and chat, and then back on the road.

One thing with ambulance work is the need to be able to move on from job to job. You rarely get down time these days and, while we had some time after this job to chill, relax, debrief and get it out of our system, we still had to put it all behind us and deal with whatever else could be thrown with us. This can be a blessing, keeping busy stops you from dwelling, but also a curse as you don't get chance to get things out of your system so they can build up.

Sometimes though, and this was one of those times, moving on doesn't bring the distraction you'd like. I did another job, nothing of note, then another "Cardiac Arrest". The age? 3 years old. It was quite some drive away and again I administered significant quantities of diesel. Before I get there I get cancelled. I have no idea if the child was in cardiac arrest or not. I have no idea if they survived or not. I do know all my thought of the previous job came flooding back. This was not good.

Another couple of nothing jobs and I had settled back down but fate, it would seem, had other ideas and sent me a 6 year old, not breathing. To say my nerves were shot to pieces is an understatement as I again did my best to destroy the ozone layer and burn as much diesel as I could. I turned up finding another car on scene who greeted me with the blissful words "not as given". A bit of a language barrier and misunderstanding had led to the impression of not breathing.

I left the first car to it as the child was fine. I, however, wasn't. I only had about 45 min left of shift so I called control, explained that after the initial dead child and two further jobs given as not so alive children that I needed to go back and sit down. They agreed.

This shift, those jobs, that child, I'll never forget. It was the day from hell and one I wouldn't wish on my worst enemies.


Some may ask why I post this now, on new years eve when everyone is so merry and looking forward to the new year. I don't want to bring people down, but for some 2011 wasn't so great. Some have experienced loss and pain, others far worse. It is, however, worth reflecting on the bad to try and move forward, to make the most of every moment, and to try and improve yourself and help those around you.

I will admit that one reason to post now is entirely selfish. I've been struggling with this post for quite some time. Its been painful and quite a block to my blogging, so i wanted to get it out there and leave it in 2011, leaving 2012 to be much more positive (although I know I have a couple more tough posts to write).

But most of all, I think its a reminder. A reminder that sometimes life sucks, but it still goes on. Those of us in the EMS, and indeed other medical fields really do witness some of the darker sides to life, and it can eat you up inside. However, life does go on, years keep coming (not quite as fast as jobs!) and we do have to make the most of it, but also know when to stop, to say "wait a minute, i need a breather".

2012 is going to be an amazing year. There are wonderful things in my personal life, the Olympics are coming to London (Good luck to all you London EMS types, you're gonna need it!) long with many other festivities etc throughout the UK. Just remember, take care of yourselves, take care of those around you. Make time for friends and family, and make 2012 the best you can.

Happy New Year,

NM.