First Cardiac Arrest

[PCP]

Thank you everyone for your kind words and thoughts. The fact that I was unable to bring this patient back from his arrest does suck, but what sucks evern more is, that I can't help to think if he had just gone to the hospital earlier in the day when he was complaining of indigestion to his wife. The fire captain was on scene as well and was feeling the radial pulse while I was doing chest compressions and he said I was doing good. So my only thought was I must be performing the compressions properly.

I am a BLS provider, so I don't have access to the tools that the ALS crews have, and as mentioned in other posts we do not have ALS in our community which would have been nice to have. It MAYBE could have made the difference in this call. I feel that for my first arrest that I did everything in my power to attempt to bring my patient back.

I feel for the family more than anything being so close to Christmas and also having another family member pass away just three weeks prior. I wanted to stay with the wife longer while they were working on her husband, but duty called. I attempted to get a line on the guy as well in the back of the ambulance while the fire guys where doing CPR, but was not able to start the line.

Not sure if that would have made a difference or not?

I guess there is not much more I can say, besides I did my best and unfortunatley it was this guy's time to go and hopefully next time there is a better outcome.

Thanks again everybody for your kind words, thoughts, and sharing your stories. It is nice to know that I can share my stories here on the City knowing I can get feed back and support.

MERRY CHRISTMAS TO EVERYBODY!!

Brian

[Siffaliss]

Well, I did my first cardiac arrest the other night and my patient did not make it.

They practically never do ...

After the call I had took some time to think about the call and I could not help, but to think if there was ANYTHING else I could have done that may have resulted in a better outcome?

First time on any new type of call it's normal to second guess yourself. The very first two trauma codes I ran I did the same thing, still do from time to time. I think everyone does. It’s a way of keeping yourself in check. Most of my codes now have been ALS and none have been actual saves, we just seem to prolong the inevitable.

She also said try not to think about the call too much and sometimes things just don't work out the way we think they should. She said it gets easier as you do more cardiac arrests. Does it?

She is right, don't think about the call too much and if you do perhaps look at chatting with some co-workers. That usually helps. Yes it does get easier because you learn different ways of dealing with calls, so you're not abnormal for thinking this way about your first code.

It has been two days since the call and I can still picture the wife performing CPR on the bed, as well as I keep picturing the guy's face as well. I am not sure if that is normal after doing a cardiac arrest, but I sure hope that I blank it out of my mind soon.

My first DOA was on EMT practicum. Some old man who died at home supine on his bedroom floor. I had looked at his face and it was creepy because it looked like he was smiling. It was just the way the cookie crumbled (for lack of a better term). Let's say it was a smile ... he died peacefully at home. You are thinking about this 24-7 as you said, so keep talking if you need. Just because it isn’t affecting your sleep (yet), doesn’t mean there isn’t something going on stress-wise. If it goes on much longer, consider accessing professional resources. By the way, that doesn’t mean you’re weak

It could be because it is so close to Christmas and that it was my first cardiac arrest. We had a hard time finding the house so I think what if we had gotten there sooner could we have saved him? Was I performing chest compressions well enough?

Sometimes they just die. I remember one of my EMR instructors giving that as an answer to one of my many questions in that class. My first code was December 24, 2006. 45 minutes to get to the scene, say 10 minutes on scene and another 45 minutes back to hospital with only BLS. Even with ALS the lady probably wouldn't have made it anyhow. Her husband came into the ER later that night suffering from anxiety for two reasons. The first is obvious, and the second was that she was supposed to make xmas dinner for the family on xmas day. He didn’t know who would cook now. I'm sure you and your partners did everything you could, so don't beat yourself up about not being able to find the house.

Well that was my first experience attending a cardiac arrest and I have to say it is alot different then how they make it out to be in the class room.

It always is different than the classroom. I would say I'm still fairly new with only 4 years on the road, last 3 with full time ALS. My more experienced friends and foes out there would probably agree that we all just find ways to deal with abnormalities (which is all the freaking time), and improvise. Everything comes with experience, and that's gained every time you go out on a call as long as you can learn a little something from it. It sounds like you’re just going through the normal motions of your first serious call. Again, don’t beat yourself up about it and eventually you’ll move on. This might sound shitty to you at this point, but eventually you find something amusing about nearly every code you go on. Could be a partner, patient’s family member, family pet, whatever. I’m sure most of us could post a few good stories and you’ll have your own down the line.

Edited December 23, 2010 by Siffaliss

[DwayneEMTP]

...I also think that we are jumping way ahead of things when we start telling the OP that they need help when in fact they might not need it. We are also jumping the gun by saying that this call seriously messed with their head as we do not know that for sure.

Let's not get this poster too out of whack until they get a chance to talk to someone about the call.

At least let's give them the benefit of the doubt before we call them nuts!!!

I'm not sure where this came from. Where in this thread did any of this happen?

Dwayne

Edited to add this note! Mobey! Hello!! As it appears that you never empty your PM box, so I can't send you private messages....Can you resend the email you sent me a few weeks back? I've somehow misplaced it but would really like to see it, even if it's too late to offer an opinion. Thanks!

Edited December 23, 2010 by DwayneEMTP

[Just Plain Ruff]

There was a poster earlier who from what little was posted said that the call had seriously messed with the OPs head. I will have to go back and point it out.

Sent from my SPH-D700 using Tapatalk

[Mateo_1387]

I also think that we are jumping way ahead of things when we start telling the OP that they need help when in fact they might not need it. We are also jumping the gun by saying that this call seriously messed with their head as we do not know that for sure.

Let's not get this poster too out of whack until they get a chance to talk to someone about the call.

Man, I think anyone could use the resources of professionals, weather they are pathologic or not. Just being able to explore our minds with the guidance of a professional that can be trusted is not a bad thing. The same also holds true to talking about what is going on in our minds with our friends, family, and community.

To PCP, I have entered this discussion a little late, but how are you holding up?

It is not uncommon to be stressed by calls where the adrenaline is running rampant. This was a new experience for you, so questioning the experience is not a bad thing. On a personal level, professional level, and even as a society, a lot of weight is placed on running this call just right. The truth of the matter is that the call can always be better, but I do not think it can be perfect.

Also, I can completely understand questioning the call since you have not seen it done in the past. There is nothing really for you to go on about how the call went compared to another cardiac arrest. But now you have that experience. Use it to make the next one go even better.

I do not find myself plagued by mental images of calls weeks after they happen. I do take some time after all calls to review what could have made it run smoother and then I let it go. At the same time though, I would never want to memories to disappear. The emotions that surround such events make us who we are. For example, you remembering the wife performing CPR on her husband, realizing the emotional impact that such an event would have on the wife, really shows how in tune you are to not only the medical needs of the patient, but the mental needs of the family. Us remembering is the drive that makes us strive to be better.

They key to situation though is acceptance. Once you are able to accept the whole situation, the good and bad notwithstanding, only then does it become easier, IMO. As many times as you have replayed the call in your head, I have no doubts you have identified things that should have gone better. Just realize that what happened is done with. Now you get to focus on the now and the future to make sure it goes even better. And it will, with your new experience to help guide you. Also, make sure you identify the things that rocked during the call too, those are just as important.

Thanks for feeling comfortable enough to share your experience with us, I for one always learn from these discussions.

Matty

[NYCEMS9115]

That is why you became a Paramedic; all the money and time spent to learn all the didactic knowledge to be a Prehospital Care Practictioner. Its one of the few jobs where it can be pressured pack; adrenalin running through the vessels; a sense of euphoria; a difference can be mde with a split decision. Awesome feeling huh? At least you got through your first arrest and regardless of the outcome; you and your partner did all you could. If that's the case, you should be proud. Its when you don't do everything; then you should question your worth. Keep up the enthusiasm and persistance; these qualities with help you through the rough times.

I remembered working NYC 911; 4 months out of school at a Hospital Based EMS (Victory Memorial); I did 7 cardiac arrests and ET intubated 10x in my first week. It was ridonculous. It was great to have already done most of the ALS skills in my first week minus the needle cric and decompression. I did that my first month there. Brooklyn is crazy...