Yesterday afternoon I was awoken from my daily nap by the pager tones. Yup. I’m old and take daily naps… or that might be from the boredom. Anyways… The tones went off… then again, then the dispatcher comes on with “Medic 3, Medic 2: Cardiac Arrest, CPR in progress, 8yo female. yada yada location, 8 miles away”
Being woken up by the pager is never pleasant. It is worse than any alarm clock. The feeling of abrupt end to a peaceful nap with what is usually a nonsense call is less than ideal. It leaves you half awake trying to collect your thoughts for what could lie ahead…
Back to the call. I fumble to get my boots back on–I’d like to meet the man who invented zippered boots–and rush out the door. I am in my car and my partner calls asking where I am–apparently my radio is on the fritz and they didn’t hear me copy the call. By the time I’ve hung up I am in the parking lot(I live about 300 yds away from the station) and rushing towards the truck. The lights are already on and one of our volunteers is in the passenger seat. I hop in back and buckle in to buckle down.
We don’t have anyone on scene yet and dispatch cannot get through to the Colony. They only have one phone and left it almost immediately after placing the call. The tension in the truck is more than just uneasy. It feels like we’re walking out of an arrest–not walking in.
We continue Code 3 to what every person in healthcare hates: A Pediatric Code. Death is a fact of LIFE. Cardiac arrests are part of our job. People die–more often than not. Peds Codes still suck. Instead of looking at a spouse or their Adult children, you’re faced with Parents and siblings. You never know what you’re going into and while sometimes that is what makes this so addicting–it can be what makes this line of work so stressful and heartbreaking too.
We are just pulling onto the gravel road that is the last 1 mile of our journey as the local PD comes on the line and gives us direction as to where to park. No status update yet. We are going to a larger colony and he hasn’t made contact yet–in fact he doesn’t until we are walking in the door behind him.
As we pull in I stand up and begin pulling out the airway bag, the first in bag with our ACLS meds, and the monitor. I have them set out, gloves on, and my glasses on–I’ve learned a thing or two–I wear safety glasses(or as I call them “oh SHIT glasses”) to anything that can get messy. Anyone who has worked an arrest knows things can get messy quick. The stomach does NOT like CPR.
We come to a stop after what seems like 40 minutes(but I see later on my time sheet was only 7) and I slide the side door open, making sure to turn the lights in the box on before I step out. I walk briskly into what appears to be a large industrial type kitchen. As I walk up the first step I notice a crowd has gathered. 20-30 women all standing there. They all have an uncertain look on their faces, but there is no histeria. There is no panic. There is a calm uncertainty in the air. I walk around the corner and see a young girl, just laying there. No one is touching her. She has a blanket on her. No CPR in progress, no anything. No comfort from family, nothing. I have to double take. My first instinct was that it was going to be DOA. Then I look back and she is smiling.
My “dead” patient is smiling. She is far from dead–and always has been. In fact she seems fine. And then the story begins.
Because of the quantity that this kitchen cooks for they have a service elevator to bring supplies up from the supply room in the basement. This elevator has a standard wooden door into it and has a gate that comes up to my thighs. This is an older elevator and will work with the doors open.
Apparently my patient was hanging over the railing when someone downstairs called for the elevator. Despite the grinding noise it makes she does not move and the elevator comes down on her, trapping her in place–right across the top of her chest/collar bone. They are unsure of how long she was there before being noticed, or how long it took to get her out. They say a minute–which in some emergencies could mean 5 seconds or the opposite–5 minutes. My guess is not very long based on the appearance of my patient. The bystanders state that she was blue and unresponsive when they pulled her out.
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I immediately get to assessing my smiley patient. She states it kinda hurts on her chest, but has no other complaints. She is breathing normal, adequately, and without pain. Her lung sounds are present, equal, and clear. Her O2 sats are 99% on room air and all other vitals are within normal limits. She is literally in great condition.
I decide that because of the nature of the incident(and a little CYA medicine) that spinal immobilization is necessary. We quickly package the patient and get on the road. She never once complains, never once cries. She actually smiles a lot. I got her laughing and promised her a day off from school–though I’m not sure her community will follow through.
By the time we get to the ED she is chatty and still happy. She has no complaints other than a little bit of tenderness. Breathe Sounds are still normal and her vitals still stable. After explaining everything to the receiving RN/Doc/Trauma team that they called despite my insistence that it was not necessary, I wish my young patient well and lead her mother to the registration desk.
I walked out of the hospital, my free soda and cookies in hand, in a bit of a blur. I’m convinced that my ride TO the scene was more stressful and exhausting than the call itself. I wish all of my patients handled stress this well!
As we round the corner inside the door, the scene is as expected–practically empty. One staff member sits with our wheelchair bound patient, everyone else seems to be missing, despite it being meal time. A quick once over leads me to believe there is no amputation, the annoyance sets in.
