Richard B the EMT Posted May 11, 2009 Posted May 11, 2009 Years ago, when the "In" things were the pet rocks and mood rings, I was one of many at my VAC wearing one of the mood rings (I had to give up the pet rock, it never came when I called it). We noted that, even when a CPR run was unsuccessful, and the ER/ED pronounced, the mood rings showed the wearers, myself included, to be quite happy. Was something wrong with us, to get that reading? Prior to State DoH certification for Certified First Responder, my VAC had an "in house" CFR training level for riding members. My "Lady J" was so "certified", when she rode. Another member, who was also an "in house" CFR, and in an EMT course, kind of upset Lady J, who was dispatching the call in question. The call was a DOA (Dead On Arrival), and this other personnel, at the time about 21 years old, was jumping up and down, being so happy that she had been on a DOA call. I was told that she didn't put on any such display in front of family members/friends/bystanders on scene, at least, but saved it until inside the VAC headquarters. If I have a DOA call, I usually am somewhat somber, whether the patient was "worked up" or in obvious signs and indicators of death. Taking into account that I've been doing this from 1973, is there any proper way to handle one's self following DOA calls?
Dustdevil Posted May 11, 2009 Posted May 11, 2009 Taking into account that I've been doing this from 1973, is there any proper way to handle one's self following DOA calls? Whatever works constructively for you personally to move on without second thought is the "proper" thing to do. Of course, that will vary from person to person. There is no one right way to do it. But most commonly I would suspect that simply getting on with your day and moving on to the next run is going to be the most constructive method. Anything more is dwelling. Back in the 1980s, the David Clark Company -- makers of MAST pants and communications headsets -- gave out little plastic cards at the trade shows (JEMS, NAEMT) that had a "mood" circle on them. Basically, it was the same colour-changing crystal that is in mood rings, on a credit card sized card, and it had a colour scale printed on it for interpretation. You were supposed to hold it between your thumb and forefinger for a given amount of time, then look at the colour to interpret your mood or stress level. It was labelled as a stress monitor or something like that. My partner and I had a lot of fun with those things, checking our levels before and after every run, and anytime someone pissed us off. I finally burned it out by leaving it under a halogen map light for too long, lol. Who knows if those things really have any validity to them. But anything to get you thinking about your stress level, and means of reducing it, is a good thing.
Just Plain Ruff Posted May 12, 2009 Posted May 12, 2009 I agree with Dust, move on and continue working. Death is a part of life and if we dwell on death then we become depressed. Remember, this person had the emergency not you. Unless you know the person who died, it shouldn't affect you much. But that being said, It's ok to feel sad but to dwell on it too much can bring you down.
Richard B the EMT Posted May 12, 2009 Author Posted May 12, 2009 Actually, this was to assist me in telling Lady J if this other person was reacting "strangely" (my choice of word) to having had a DOA call. The actual call happened over 15 years ago, but Lady J brings it up every now and then as if it happened yesterday, as she was (and is) upset with that other VAC member for what she regards as a bad reaction. Lady J was not on the ambulance that day, but was dispatching, just as an "FYI". Actually, this was to assist me in telling Lady J if this other person was reacting "strangely" (my choice of word) to having had her FIRST DOA call. The actual call happened over 15 years ago, but Lady J brings it up every now and then as if it happened yesterday, as she was (and is) upset with that other VAC member for what she regards as a bad reaction. Lady J was not on the ambulance that day, but was dispatching, just as an "FYI".
Katiebug Posted May 13, 2009 Posted May 13, 2009 I remember my first DOA. It was a grandmother that had laid (or collapsed) sideways across her bed and died. Not sure what the cause of death was, but she had dependent lividity and we got asytole in two leads, so the medic (who was my preceptor) called it. The family was outside the house holding each other and sobbing. I am normally a very empathetic person, but oddly I was completely unphased. I remember having absolutely no emotion about it at all. I've always thought that was odd, given my nature. A few months after that, I had my first code. I was eerily calm for that too. I even knew the old lady that coded in my ambulance, but I seem to go into autopilot when confronted with these scenarios. When we got her to the hospital, she was in PEA. They got a shockable rhythm and she saw a sinus rhythm for about fifteen seconds before going into permanent asystole. To this day neither one of those experiences bother me one bit. It's like I completely detach. As far as getting excited about a DOA, that seems a little off to me. Somebody just died. Yes, it's part of the "circle of life", but I don't get the excitement of your acquantance bearing witness to that. That's just weird. In my mind, the hope is that we arrive in time to prevent death. If not, either we weren't called in time, or that person was just DTJ and we weren't meant to be there. I at least try to let the person leave this life with dignity. But like Dust said, whatever gets you through the call.
Richard B the EMT Posted May 13, 2009 Author Posted May 13, 2009 (edited) As far as getting excited about a DOA, that seems a little off to me. Somebody just died. Yes, it's part of the "circle of life", but I don't get the excitement of your acquantance bearing witness to that. That's just weird. In my mind, the hope is that we arrive in time to prevent death. If not, either we weren't called in time, or that person was just DTJ and we weren't meant to be there. I at least try to let the person leave this life with dignity. Thanks, Katiebug, your response (at least the part I quoted) is what Lady J feels. As for any call pronounced after being "worked up", my personal take is, I review what I did. If I feel that I missed something, I use it as a learing experience, if nothing appears "off", then I let it go. By the way, what is DTJ? It is an abbreviation I dont know, which might be a local one for you, but not used in my area. Edited May 13, 2009 by Richard B the EMT
AnthonyM83 Posted May 14, 2009 Posted May 14, 2009 Was your partner a medic or EMT? I will say that there was much less of a personal investment in the patient as a basic, since you could potentially do everything close to perfect. And it's almost the same every time (relative to ACLS codes). As an EMT, I was completely detached from my patient. I mean 100%. But when I ran my first code during clinicals, I found myself very committed to the patient. He lost and regained a pulse several times, often not noticed by nurses. I stayed at his side monitoring all the way to ICU...I guess so my "work" wouldn't be "undone"? But who knows, maybe that was just because it was my first ACLS code. I might go to not caring once in the field.* *And to clarify, the reason I completely detach is because they're unconscious. During critical calls, I do a much better job, trying to do a good job for myself, rather than for the patient. It eliminates most of the anxiety factor. BUT if it's a non-critical patient, I'm very touchy feely with them. As far as DOA's, my partners and I have had both kinds. If person is with family, it creates a very sad situation. We just quietly put our equipment away and usually go a few blocks before saying something. If they're by themselves, I don't really feel to sad, since the patient can't be sad.
Kiwiology Posted May 15, 2009 Posted May 15, 2009 Back in the 1980s, the David Clark Company -- makers of MAST pants and communications headsets -- gave out little plastic cards at the trade shows (JEMS, NAEMT) that had a "mood" circle on them. Basically, it was the same colour-changing crystal that is in mood rings, on a credit card sized card, and it had a colour scale printed on it for interpretation. You were supposed to hold it between your thumb and forefinger for a given amount of time, then look at the colour to interpret your mood or stress level. It was labelled as a stress monitor or something like that. My partner and I had a lot of fun with those things, checking our levels before and after every run, and anytime someone pissed us off. I finally burned it out by leaving it under a halogen map light for too long, lol. Who knows if those things really have any validity to them. But anything to get you thinking about your stress level, and means of reducing it, is a good thing. Can they be used instead of the Wong Baker faces? (I really like the Wong Baker faces.....)
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