Ambulance

I’m riding in the “box” of the ambulance. There’s a call for a 80 year old African American woman with "seizures." Doesn't sound too serious. Besides, an ALS (advanced life support) fire engine is on the way, well before we will get there.

Mid-way there, the driver yells back into the box "they're doing CPR." The driving gets noticeably more serious. We're running red lights like crazy now. Oh boy.

I rehearse what I learned over a year ago in my head. 30 compressions and 2 breaths. Or is it 30 and 4?

We arrive at the scene. The patient is lying on the floor, with a tube into her lungs. Someone is performing chest compressions. A woman cries in the corner. Another man looks forward, blankly, as if nothing is registering at all.

I see a big bottle of oxygen in the corner of the room, as well as a peak flow meter. She must have lung problems.

The paramedics flop her onto the blue backboard. They struggle to keep her lifeless hands from flopping to the side. Someone instructs me to turn the stretcher around, which I do. They place her onto the stretcher. The paramedic I'm with points to me and says "Start chest compressions!" I do. They load her into the ambulance with me compressing away. "Use the heel of your hand! Harder!" I continue compressions for about five minutes until someone else takes over. I’m exhausted. I could feel that some of her ribs had broken (not unusual). And there's no discernable heartbeat pattern on the monitor.

I hand someone a stethoscope. No left lung sounds. Must be a right mainstem intubation. They pull out the tube a bit, and it sounds better. They give her epinepherine and atropine through a needle in her neck. Someone asks me "Do you feel a femoral pulse?" I reach down there. "Um, maybe, yeah, I think so." Indeed, she now had a (slow) palpable pulse. God Damn, I was sure she was going to die. Wow. We saved her!

We arrive at the ER. The doctor looks none too pleased. He asks "how long has she been down?" "About 10 or 15 minutes, but she has a pulse." "Damnit! Well, resume chest compressions, then. We have no critical care beds!"

In any event, she will probably never leave the hospital.