How did you handle your first lost?

[Oilersfan1]

You will have patients who don't make it. As long as I know I did my very best It doesn't bother me.

Cheers

[Dustdevil]

That reminds me of a point that hasn't been covered yet. It makes a difference whether or not they were dead when you arrived. Full arrests that were already gone when you got there will usually affect you differently from those who are looking you straight in the eyes with their final desperation when they crash. Scenario one is pretty mechanical. You never established any relationship with those who were already gone when you arrived, so it is easy to walk away. But when you encounter those who are still alive and you watch them check out, it can hit you a completely different way.

There really is no "normal" way to react. Therefore, it is important that you do not try to react in a way you think others expect you to react. That means don't try to be strong like some guy you saw on "Turd Watch." Don't think you have to get all emotionall reflective like some loser on "ER" did. And don't think you must go to some retarded CISD because you heard others talking about it. You have to go with how YOU feel, because YOU are the only one feeling it.

[nsmedic393]

You are absolutely correct there dust... I find I could do a hundred arrests that were gone when I got there and it doesn't hit as hard as one that dies in front of you.

[rat115]

Dust, you are right that there are differences between if the pt is alive and talking or not. There is also a difference between if you know a person (or their family) or not.

My first loss was the husband of a friend of mine. He and his brother were finishing up a 26 mile bike ride that they had made in less than an hour and a half. His brother had been trying to get him to slow down. As they rounded one of the curves leading into town, the brother pulled around him to force him to slow down, looked over his shoulder, and watched the pt fall off his bike. A passing motorist stopped and called 911. We were toned and, since he had gone down less than 3 blocks from my house, I was on scene in less than 2 minutes. He was pulseless with aggonal respirations. We were never able to get a pulse back. When the autopsy came back, we found out that he had a blocked descending aorta (95% blocked). He never even bled from either the knee or head wound that he received when he went off his bike.

It was hard for me because it was a friend's husband, but I talked with my boss about it. I went back over what was done and what could have been done differently. Talked with some of the folks here in chat about it, too. That helped the most. Learning that there was basically nothing we could have done due to the blockage helped a lot, too.

BTW..... this patient's son has decided to do a bike ride in his name for an Eagle Scout project. The money raised by the bike ride is going to be used to purchase an AED for the new community/education building that has just been finished here in town.

[NREMT-Basic]

87 y/o female patient during my clinicals. She had fallen down 6 concrete steps and landed on her head and face. Posterior orbit frcture L side, broken jaw, shoulder..flail segments...pretty much everything on the involved side of the body. Not only was this my first loss, but my first patient as well. She developed intense icp and slipped into a fatal coma. This was so difficult because i had been with her from the time she was brought in. But it reminded me that we cant save them all, no matter how hard we try. I was not with her when she went, but was with her family as acting chaplain shortly after. That was the hardest part since I made the notification along with the doctor.

I came home cried, slept for a couple straight days, and got back on the horse with my ambulance rotations.

[CrazyNCute02]

I guess you can say I dealt with my first loss kinda callously, but I did still feel kinda bad. We got called out for 55 y/o female with back pain. She was an alcoholic, and she poo'ed all over our stairchair, so we were holding in our annoyance at first. We get her in the back of the rig & she starts gargling so me, who was only a CPR/1st aid, at the time & the new EMT roll her on her side to throw up & she codes. We get her to the hospital, complete asystole. We were doin' CPR for about 20-25 minutes until the family arrived. I was there when the doctor came over & told the family the deal & the family said to stop resus procedures. It was hard to swallow at the time cuz it's really sad to see the family go through that. However, I just said to myself, "Well, at least the familiy doesn't have to watch their mother/sister kill herself anymore. And, the family no longer has to be hurt by her mother/sister anymore." It's kinda a bad way to look at it, but it's the truth. Its kinda along the same line as rectifying a terminally ill patient dying by saying "At least she/he isn't sufferring anymore."

The kind of patient that still bothers me to see are the elder, child, and sexual abuse cases. I once saw an elderly lady that had decubitus ulcers on the back of her head & ears (yes...her ears even had decubiti!), straight down her back to her heels, and she hadn't been washed in at least 2 weeks, probably longer. :shock: ::shakes head:: Wat was worse was that the family came to see her, and didn't even ask why she wasn't washed or anything. They just took it as commonplace. People suck. Bleh. She ended up passing on soon after....think that was probably for the better for her. She didn't have to be neglected anymore.

[Medic_Kidd]

My first loss was a burn pt. in a suicide fire in 2003...... In fact, it was my very first clinical ride as an EMT-B, my first time EVER stepping foot into an ambulance, my first experience with EMS outside of the classroom setting, my very first call EVER..... I was 21 years old at the time, ready to fullfill a childhood dream..... My first day of riding, we are called to a fire...... We get there, are rehydrating some of the firefighters, etc, and then finally when it is all said and done, the firefighters find a pt inside the house..... the pt. had doused his house in gasoline, set it on fire, and shot himself in the head...... So, needless to say, my first call haunted me everytime I closed my eyes to go to sleep at night..... I had seriously considered dropping the class and quitting after that day, but I stuck with it, went to a CISD with some of the others, and just had to keep telling myself that they don't all end up that way..... 3 years later, I am so glad that I stuck with it..... I have seen some many more gruesome sights, had nights that everytime I closed my eyes I saw the faces of patients, but that's just part of the job, right? But there's also the "success" calls (someone that you picked up recognizes you and thanks you, with a hug to go with it) and many other reasons that make it worthwhile......... I know I would have regretted it today if I had quit after that first call......

[chicagoambo]

Talking with other medics is the best way to deal with what your going through, they've been there!Outsiders don't have a clue nor should they.

[AnthonyM83]

Last night: I thought I was going to have my first post-arrival patient death today, as the febrile actively seizing 13 month old in the ambulance slowly stopped twitching and then breathing... his eyes (seemingly) locked on me until they started rolling back. I squeezed him with my hands, gave a silent goodbye, and silently told us both (me and baby) that we (medic and I) did what we could. Then started bagging him.

That quick silent convo with myself and the baby allowed me to stay calm for the rest of the call and post-call, since I felt "at peace".

When I left ER, he was still seizing & being ventilated, but staff seemed calmer, so I hope he'll be okay. I know I won't be able to have that moment (out of a movie really) to say goodbye in future crashes, but I hope I can remember that at least I tried and not feel too much guilt.

As I told my friend, even if you didn't do everything you could for one person, your experiences will save another at some point. I hope I can remember that if things ever go wrong, as I've seen how my friend has suffered from his guilt from a call years ago, still.

Edit:

As far as them being dead when we get there, the only hard part is watching the family and seeing reflections of your family in them. Like when someone's mother dies with grieving children...cause I know I'll be in their place one day. Sigh.

[SSG G-man]

I have been an EMT for about a year now. I have only lost one pt that I know of. Mothers Day. Pager went off for Priority 1 Subject not breathing. I can be to the station in about a minute, so I headed out, figuring there would be few hanging out on Mothers Day. We were the second arriving unit. First unit was getting ready to move pt to their ambulance. Ask for set of extra hands, so I volunteered to go. I had noticed on the way in a stack of O2 bottles on the porch. Upon entering back of the box I noticed one leg amputated below the knee.

We worked the code all the way to the hospital, about a 20 minute ride. She was pronounced as soon as the hospital hooked up their monitors.

I never felt all that bad. I guess the clues to other problems made it not seem as bad.

I have had some calls where pt survived, but I was deeply affected. Several where I did right thing, but pt went south anyway. I have spent lots of time kicking myself over some of these!!