How did you handle your first lost?

[Jeep_911]

I'm not sure I have actually yet dealt with my first loss yet. It was a code for which I have actually posted a scenario online. It was a good call at the time but have recently been really second guessing my treatment for my patient. I have talked to our medical director and was already told that with the amount of knowledge I have, at my level of training there is nothing that I could have done BUT now I've realised the true lack of control that we really have. You can't save them all, and even the ones that you sometimes can save still die because it was their time to go. It's tough

Healing is a slow process.

[bandaidpatrol]

Ambulance operating instructions:

Living: Get them to the hospital or doctors home as quickly as possible, worry about payment later.

Deceased: Carefully speak to the family, inquire as to the faith, if they would like the preacher notified, do they want an open or closed casket funeral (even if there was trauma disfiguration, my grandfather could take a photo and make that person look just as they did before the incident), and what cemetery they will be using. We gave them a small metal box that contained a silk hankerchief, that had our telephone number on it "Phone 3-71", names of our business partners, and related info. More for advertising than informative.

You have to understand what EMS began as, to not be offended by me. It was a christening to bring in a dead one. So after I brought in my first deceased victim, at the age of 14, my grandfather poured me a shot of sipping whiskey, and said that I was officially in 'the service'. I have never touched Tenn. Sipping Whiskey since then. It reminds me of the young man I brought in that morning. I suppose the haunting of seeing a good friend dead, and actually taking him to the parlor, then to his place of burial was only out weighed by the hundreds of deaths I witnessed at war.

That's how we made the money to afford to give a last ditch effort to save lives in rural america. Only to get told we were failing by the government, who was against ambulance services ran by funeral directors. They wanted paid and regulated volunteers, well, they didn't have either of those in 90% of the towns in the country. So we did what we could, stocking our rigs from a welding supply store (oxygen), Rexall Drugs (first aid), an army warehouse (blankets, folding cots, bandages) and Superior Funeral Supplies (everything else). We were lucky to rake in five bucks on an ambulance, call even though we had a set rate. Nobody could afford it in the places we went. So when we ran an automobile crash, a man having a heart attack, and a slew of resuscitator or oxygen tent calls every week, we may use 25 or 30.00 in first aid supplies, and 20.00 in oxygen and only make seven or ten bucks that week. It was a huge loss to the funeral industry. But when we brought in a DOA, we would get paid for sure. Either by the family, insurance estate, or by the county health board - because people had to be embalmed and buried. It cost us $15.00 to embalm someone, $25 to $200 for a casket, $5.00 in fuel for the hearse and limo for a funeral. We charged anywhere from $250.00 to $1,700.00 for a funeral. The prior being a "state funeral" in which someone had a large family, or wanted a nice casket, etc.

When we rolled on a known DOA, we would dress in our Sunday best suit and hat, cover the ambulance windows with conneau panels, and place a maroon velvet blanket on the gurney, the sheets had hospital corners, the siren was covered on the front by a bolt on cast iron panel that had funeral exgraved on it. We took the utmost care in removing the deceased, it was an honor to the person to be removed in such a fine way.

[Sassafras]

How do I handle the losses? By reminding myself that I (and my partner) did everything in our power to save them and that sometimes, all the skills, meds., and prayers in the world aren't going to stop the inevitable. You can't save them all. Many times, it's the elderly or chronically ill and I put it into perspective. Chances are they led a good, full life. Hopefully they have family that loved them beyond words and they passed knowing this. For those who are terminally/chronically ill, I just remember that they're no longer suffering. I usually have a feeling that I can't put into words that, out of all of the people that loved them, mine was the last face they saw, the last voice they heard. I consider it an absolute honor to be with these people at the end of their lives.

[HF-EMS]

Thankfully in the years i have been doing this i have been fortunate to have few losses. But no one can avoid them entirely.

For me, it doesnt seem to hit me as hard as it does others. But when it does i as others say remind myself i did everything i could. But i also remind myself of all the lives i have saved, and that is a comforting thought for any provider. To know that they DO make a difference.

[vs-eh?]

In less than 32 months working EMS in any capacity (though it has all been full time) I have seen oh I would say 30ish deaths (I will exclude trauma)....workable or non-workable...

EDIT - 32 months full time greater than 33% has been on a zoom car...Not anymore though...

I'm ball parking...But we will average a death a month (that may be high or low). Honestly I don't remember nor care...

I would wager 75% of them were when I worked on a zoom car (by myself). Follow my math kids....22.5 patients ish I would wager 75% of those I canceled off any other response (we'll say 17ish). Because I thought they were either recently (but beyond resus) or grossly dead (I don't need ALS to tell me this, nor do I attach leads) Because I can cancel people on any call who I believe are obvious deaths....which seems to fluctuate in reasoning here (on this site) for some reason. There is never any issue...If I call an obviously death (when I'm the only medical person on scene)...all other ambulances are canceled (I'm BLS) if they are still on route. No question.

Yes, I remember my first "code". Nothing I could have done. You try...

Considering, in the end, death is often an ACLS algorithm, you shouldn't take stuff personally unless you know them...

If you do know the patient take a day or several. If you don't, choose another profession...

[Ridryder 911]

Wow .. that makes me scared.. I see at least one or two a week.. sometimes s shift!. This is a small rural metro town as well. Of course we run on all "person down".calls..... First death exposure was hen I was 15 working in ER... didn't realize, the code had stopped..

Be safe,

R/R 911

[Asysin2leads]

I remember the name of my first cardiac arrest. The initials were H.P.F., I remember her full name but I won't post it. It was Saturday, September 14th, 2001 and having been through what I had been days earlier, it was shaping up to be just one heck of a bad week. I remember the specifics, and can remember that I took comfort in the fact the code went textbook, I was BLS at the time, Ventialtion, CPR, AED, ALS arrived in about 5 minutes, but she died anyway. People die. It's about the only certainty we have in life. We can give our best effort, we can train hard, work hard, play hard, but people will die. I remember a fellow paramedic student who mentioned that before beginning class he used to take cardiac arrests really hard, needed to go and get a beer, or what not, but after about hour 6,943,216 of ER rotation (or at least it felt that way), he said that when he saw a crew going all theatrical (pounding on the chest, saying the cliches) on an asystolic arrest, he would just shake his head and mutter something about rookies.

[Ace844]

I remember a fellow paramedic student who mentioned that before beginning class he used to take cardiac arrests really hard, needed to go and get a beer, or what not, but after about hour 6,943,216 of ER rotation (or at least it felt that way), he said that when he saw a crew going all theatrical (pounding on the chest, saying the cliches) on an asystolic arrest, he would just shake his head and mutter something about rookies.

Or even better, sitting at the "doc" station with a coffee and wondering aloud....What happened to all the savable people whom I can do some invasive skills on.. :wink: :shock: :wink: :roll: 8) .....Well they are soemtimes good for a central line or 2, depending on the attending...But I digress..

ACE

[EMS Guru]

How did you deal with your first lost

Called the code and went to lunch. :roll:

[Neb.EMT]

I know this sounds bad but, excited. Actually, it was Tuesday. Pt. had been down for awhile (exact time unknown) but we worked him for his wife.