really difficult patient

[emtcutie]

Ever had a patient(s) that was so disturbing, tragic, memorable... ect. That you can't forget. I've been plagued with the memory of a women 8 months pregnant and lifeless in the e.r as an emergency c section was performed in attempt to save the baby. I remember every detail of trying to bring mother and baby back with no sucsess. How do you forget something like that. Or recover from it. It's been the hardest thing i have ever seen as an emt. I cant get it out of my he

*head*

[Kaisu]

I honestly can't say that any patient "haunts" me. I feel for some of them for a time, and there are those that I will never forget, however, feelings like you describe seem beyond the norm. It certainly strikes me that this is not healthy or beneficial to you or your patients.

Is there something about this patient that you identify with? Was she your age?

If something like this ever happens to me, I will find someone to talk with.. a professional mental health provider.

Good luck to you.

[DFIB]

Ever had a patient(s) that was so disturbing, tragic, memorable... ect. That you can't forget. I've been plagued with the memory of a women 8 months pregnant and lifeless in the e.r as an emergency c section was performed in attempt to save the baby. I remember every detail of trying to bring mother and baby back with no sucsess. How do you forget something like that. Or recover from it. It's been the hardest thing i have ever seen as an emt. I cant get it out of my he

*head*

There are a couple of patients I remember more than others, and some that are difficult to get over. One of the things that helps me first and foremost is a good operational debriefing. It seems to me that it has been some time since this incident. You might want to get a chance to talk to one of your partners that were there or one of the attending at the hospital. Recounting all the things we did right helps me.

Cesarean childbirth is an impressive surgery in the best of situations. There is a lot of fluid and blood. It seems very unnatural for all of that liquid to be flowing from an abdomen. I have seen many c-sections and still cannot get used to them. I can only imagine how impressive and appalling it must have seemed outside of the controlled environment of an operating room. Despite how appalling it may seem, you have to know that by that time the results were not in anyone’s hands but Gods. If you believe that God exist then know that many of the things we cannot understand He keeps in control.

In a case such as this any effort to save life is an act of desperation more than skill and the results most definitely do not depend on us. So many times the trauma or illness surpasses the bodies ability to compensate or absorb the energy.

If none of the old crew is around, talk to your friends at the station, your family if you think they will support you, the chaplain, your pastor or priest can listen and help. Any of your partners or chaplains will recognize if you need a more professional help.

You are doing the right thing by reaching out but you will benefit much more if you talk to someone close to you and more professional.

Edited November 29, 2011 by DFIB

[Just Plain Ruff]

To the OP - get some help and a debrief. Your vivid memory of this call will only fester in your mind and one day you will not understand why you are messed up. Not saying you are but by the tone of your post I can only imagine that you are having a very hard time with this situation. GET HELP from either a friend or a professional or you are going to wind up like some of my burned out colleagues who had no coping mechanisms or people they could go to.

Get help now to save you later.

Was on a call a number of years where a woman pregnant was thrown from a vehicle. She was in arrest on our arrival. She was 8 months pregnant.

We had a faint ECG heartbeat that we thought might be the babies. We coded her, transported her to the ER and requested Surgeons and OB nurses in the ER when we arrived. They were all there on our arrival.

Within minutes of arrival (more like 30 seconds) the baby was out and coding as well. 1 hour later we called it. I remember it like yesterday but I don't remember mom though. I do remember the father who arrived at the ER about an hour after the baby was pronounced. He said that he was very grateful that we tried to do everything we could. The baby would have been his and his wifes first. I still keep in touch with him off and on over the last 10 years.

Nothing we could have done would have affected the outcome of the call but the father was what made the call bearable.

I also have a very good medic friend who performed an infield c-section of a woman who's head was crushed by the bar of the t-tops on her camaro roof. He delivered a full term baby boy who is alive due to his actions.

[hatelilpeepees]

Why didnt you do an emergency c-section ruff ?  To the OP, your memory is a good sign that you care, when stuff like that does not bother you anymore it is time to get out of the job.  Kind of reminds me of a famous Alan Alda quote from MASH:Rule #1 in war: Young men die. Rule #2 in war: Doctors can not change rule # 1.Remember that you did not cause her to die, you did your best to reverse a bad situation, and many times you can't.

Edited November 29, 2011 by hatelilpeepees

[paramedicmike]

Those M*A*S*H rules were spoken by the actor playing Henry Blake. Not by Alan Alda.

To the OP:

I agree with what the others have said. It sounds like this is something for which you need professional help. Please seek out a reputable, licensed health care provider to help guide you through dealing with your thoughts. If it's possible, someone who has experience dealing with EMS providers would be a bonus.

Good luck.

[Kaisu]

Why didnt you do an emergency c-section ruff ? To the OP, your memory is a good sign that you care, when stuff like that does not bother you anymore it is time to get out of the job. Kind of reminds me of a famous Alan Alda quote from MASH:Rule #1 in war: Young men die. Rule #2 in war: Doctors can not change rule # 1.Remember that you did not cause her to die, you did your best to reverse a bad situation, and many times you can't.

So, in your TV educated common sense science hating point of view, because I am extremely responsible regarding my fitness to do my job and thus handle situations like the one described by the OP, I should get out of the job?

Is that what you are barfing out now?

[HERBIE1]

Ever had a patient(s) that was so disturbing, tragic, memorable... ect. That you can't forget. I've been plagued with the memory of a women 8 months pregnant and lifeless in the e.r as an emergency c section was performed in attempt to save the baby. I remember every detail of trying to bring mother and baby back with no sucsess. How do you forget something like that. Or recover from it. It's been the hardest thing i have ever seen as an emt. I cant get it out of my he

*head*

Talk to someone and seek professional help- doctor, clergy, PTSD, counselor- whomever is available. Things happen, and we all have calls we remember, but if they haunt you to the point where it affects you and are unsure you can get past it, you are in trouble, Sadly I have witnesses some incredibly horrible things in my career. Some I vividly recall, others are a bit more suppressed. Point is, you need to figure out a healthy coping mechanism and develop empathy, but maintain a detachment, especially if your personality tends to be one that gets more emotionally involved/attached to people.

I am going to say some fairly harsh things here, so beware..

I am inferring that this was something you saw in an ER clinical time, and not a patient you responded to, That concerns me, since simply watching this should not be so traumatizing to you without even the connection of talking with the patient, responding to a scene, their family, bystanders, friends, etc . Sad- sure. Tragic- no question. Maybe even shed a tear for the family at the time. To the point of worrying about getting it out of your head? No way- that's a pretty extreme response.

Bottom line- unless you are doing IFTs for your whole career, you WILL see things like this and a whole lot worse. Child abuse, elder abuse, nasty accidents, suicides, senseless brutality, children all but incinerated in a fire. Some may cause you a few restless nights. That's OK- it comes with the territory, but you need to figure out now how much you can tolerate.

One coping mechanism I would suggest( it worked for me, but everyone is different) is this. If I witnessed a horrible situation doing clinicals very early in my career as a student, I recall feeling overwhelmed, watching a nasty trauma, or a chaotic cardiac arrest- I focused on watching the various players in the room. What was the attending MD doing? How did the patient's vitals respond to interventions? What about the nurse doing charting? How about the Respiratory Tech? The ER techs? The residents? What medications/procedures were being performed and why? Think about your protocols and how you would handle such a patient if they were presented to you? LEARN from such things, so when you are faced with a similar situation, you can be better prepared to handle it, and your response to it.

Maybe this explains what I mean. Over 30 years ago, shortly after I became an EMT-A(now called a B,} I was in college and volunteered to staff a senior Olympic event. Pretty cool, and it was one of my first "official" duties as a newly minted EMT. Of course, a 70 year old man who was competing collapsed after a run and arrested- the first time I ever witnessed one- even during clinicals. There were lots of trainers, docs, etc, on scene, and I did some compressions until the paramedics showed up and relieved us. I remember stepping back watching them work this guy, and feeling very helpless and lost- I realized that after CPR, there was little I could do for this guy- which motivated me to continue on with my education in EMS. Was I sad? Sure- it was the first time I saw someone who had just died, but I was frustrated that I could not do more.

Challenge yourself. Take each situation and see how it can make you a better provider. What can you learn? What tips, tricks, information can you gather that you were not aware of?

You'll be OK- just keep your focus- the tragedy is NOT yours, it's someone else's.

Edited November 29, 2011 by HERBIE1

[DFIB]

Why didnt you do an emergency c-section ruff ? To the OP, your memory is a good sign that you care, when stuff like that does not bother you anymore it is time to get out of the job. Kind of reminds me of a famous Alan Alda quote from MASH:Rule #1 in war: Young men die. Rule #2 in war: Doctors can not change rule # 1.Remember that you did not cause her to die, you did your best to reverse a bad situation, and many times you can't.

This is a horrible thing to say in a thread where a fellow EMS person is reaching out for help and advice. Definitely not in the spirit of helping.

I think you might be the better candidate for therapy.

Edited November 29, 2011 by DFIB

[Just Plain Ruff]

Why would I do a emergency c-section on a patien, way beyond my level of comfort. I don't remember being trained to do that. I would actually have no clue how to do it. Are you advocating that you would do it?

There is a whole story to the on scene c-section that I have shared here in the past but to suffice it to say, my friend had a physician on scence guiding him through the procedure. The physician just couldn't get into the car to do it himself. The car was upside down in a ditch with about a 2 foot area for one person to crawl into the car. The car was basically wedged between the sides of the ditch. So there was no more than 1 person getting into the car at one time.

Now if I had guidance via a physician outside the car telling me how to do it I would do it though.