three years later

[emtb.ashleyw]

When I was 16 fresh out of emtb class I did an internship with the paid companies to get my high school credit. We picked up a 3 year old in full cardiac arrest, his pupils were fixed and dilalted the paramedic warned me he might not make it. I had no idea that there had been trauma involved the mom wasnt telling us what happened so I opened his airway with the head tilt chin lift maneuver. Next thing I know we are cutting off his clothes and see multiple bruises and are boarding and putting a collar on him. The mom threw him down the stairs twice. He also did not make it. I cant help but shake the feeling that I had something to do with it by opening his airway wrong. Three years later and I STILL have dreams about that day atleast three times a month. Sometimes hes alive when we get there, sometime hes already dead he never makes it through. My dh doesnt think me going to visit the child's grave will give me any closure but should I atleast try it anyway? It was my first loss and I took it hard. I honestly have no clue what to do to stop it it seems like no one understand they are like it wasnt your fault now get over it. Anyway any ideas anyone?

[AnthonyM83]

I can't say if it was the head tilt / chin lift, since I don't know how he was acting before and immediately after or even what the doctors said caused his death (something that could be caused by moving neck on a trauma?) or if there's other unspoken issues about why you think you might have been at fault.....

BUT when it comes down to it, the mom was responsible for the baby's death. She committed the brutal crime and you came upon a situation that was realistically too far gone to fix no matter what you had done. That's the kind of situations you get with EMS. Don't displace that blame from her onto yourself and carry a burden you don't need to carry.

ALSO, be aware that the episode probably affected/imprinted on you more because of your young age and being right out of EMT school, and while you've grown older with more experience, it still "got in" and is affecting you like it did back then.

And yeah, visiting the grave might help...but probably once you're ready for closure...not sure if you are yet.

PS, what's a "dh"?

[Michael]

"dh"?

Usually = dear/darling husband.

[mobey]

A study was performed on 166 pediatric patients mixed post-arrest and closed head trauma. All 166 had fixed and dilated pupils.

Of the 166, only 13 were discharged from the hospital and a mere 8 of them had "productive" neurological function.(Sorry I cannot post my source I pulled those facts from a presentation I have).

Anyway the point is, no one here can tell you if you did any further damage than the mother did, but I can tell you this patient had a VERY slim, almost nill chance.

What you need to decide is if you did what is RIGHT. If you walked into a house with an unCx patient that is not breathing, and no obvious trauma you did what anyone else would do...Opened the patients airway.

I just finished a code where the wife stated "he just collapsed", we found him lying supine on the carpeted floor, first thing i did was a head tilt chin lift.

So if the story I am given afterwards by police is that the wife hit him with a frying pan and pushed him down the stairs, only to drag him back up and call us, did I do the wrong thing?

Of course not. So if I switch my adult patient for a child does that change your answer?

Perhaps you need some professional help to teach you how to deal with these feelings. We all could use some help sometimes.

[Just Plain Ruff]

My friend, you need some help. Not saying that in a bad way but you really do.

After 3 years and you are still dreaming about it 3 times a month.

Your dh bless his heart has done all he can and now it's time to bite the bullet and get some professional help.

This will never go away but this is beyond the scope of both this forum and your husband.

There is nothing wrong with seeking professional help. I've been there, I've been in counselling. It works.

This brings me to another point, this is a reason why I advocate that someone 16 years old or so should not be doing this job. This is a prime example of what we see on a regular basis and should we be letting kids see this kind of stuff? I don't think we should.

But that's for another topic.

Go to a trusted physician and ask who they recommend for this. Once you get the help you will get back on track and the memories will be just that memories and not nightmares 3 times a month or more.

[firedoc5]

I don't feel that you did anything wrong. You did what you are trained to do. You can only go by what information you have. If you were not given the information or the information was wrong, it's out of your hands. I'm sure that if you knew there was the possibility of head/neck trauma you would have done it differently. I know it's easier said than done, but don't beat yourself up over it. You're young and have many years ahead in EMS, you can't let the one incident effect you for the rest of your career. You learn from the experience. Perhaps next time you may do things a little different. Hopefully there won't be a next time, but unfortunately if you stay in EMS it will happen again.

I agree you need to talk with someone, a professional. Check with your service. They may have a program or someone to refer you to. If anything else, PM someone here and perhaps offer you support and just listen.

[Asysin2leads]

Get help, then find a new line of work. If one arrest is going to affect you as much as this one has, I would really suggest that health care in general is not for you.

[EMS49393]

I have to agree with ruff about starting in EMS so young. I started EMS as a (gasp) volunteer when I was a teenager. The state certified at 16, however we could only ride as a third until 18, otherwise known as the legal age of adulthood. I wish I would have stuck with my other hobbies in school instead.

Now, I've been in EMS for 17 years, and about six months ago I had a bad two weeks. Every single call was bad. A two year old struck by a car and unresponsive; an emaciated man found dead in his apartment; an 81 year old vet having a STEMI telling me he knew he was having his last heart attack; a man in his 40's that removed his head from his torso with a 12-gauge shotgun shell; an 8 year old terminally ill child having new onset seizures that I couldn't stop. There were plenty more bad ones in that stretch, that's just the high-lights.

I was the angel of death. You would have thought the grim reaper was paying me off. I had run plenty of nasty, awful calls in my career, but the one constant in all those calls was a break. I averaged two or three really bad runs a year, not 20 really bad runs in two weeks. I could handle this at a slower rate, but when it sped up, I lost it.

I started dreaming about all the dead kids, headless men, and rigored elderly I'd run on in the past 17 years. I'd wake up screaming, sweaty, crying. I'd scare my partner. I had an anxiety attack nearly every time I was dispatched out because I knew it would be bad, and it would be my fault. I knew I had to get help or get out. I sought out EAP services, and now I'm a happily counselled and medicated paramedic. I'm not ashamed of needing help. I was even less ashamed when I found out nearly all of my coworkers are living better through pharmacology.

Unfortunately, as women, we are inherently more empathetic and sympathetic than men. It can often hurt us, but it's also the most wonderful quality we possess when taking care of someone. We often listen harder, explain more, and treat kinder because we are female. We don't have to be macho. Of course the flip of that is someone telling you to find a new career because things are bothering you. Take it like a man! Well, we're not hardwired like the menfolk. It doesn't mean we should all just become schoolmarms. It only means that we have to remember to take care of ourselves, while we're busy taking care of the rest of the world.

Get help, get better, get back to work. If you need anything, PM me.

[CBEMT]

Get help, then find a new line of work. If one arrest is going to affect you as much as this one has, I would really suggest that health care in general is not for you.

I think expecting a teenager to NOT be affected by an effing pediatric trauma arrest is a little cold. You must have a fantastic bedside manner. :roll:

Like some of the others here, I implore you to seek professional help in dealing with this issue. There is no shame in it.

[KSEMT122]

I would agree with Ruff 100% in reference to the age of the tech. That was my first thought when reading this. And not that it changes much, other than you would have been a little older and more ready to deal with feelings such as that. Ped Codes are always the worst. Don't be embarrassed by the fact that it's causing you issues so far down the road. For that to be your first Code and to have it be a Ped is the worst. This is not your fault. No situation we come upon is our fault. And as long as we all give the best care possible and follow our protocols, the outcome of any situation is not our fault. God is God, Medics are Medics. Sometimes people get confused and intertwine the two. Professional help would probably be beneficial to you at this point. Once you get it, you might be ready to return to the field.