"89 year old male, collapse, irregular breathing, not responding"
I remember my first ever shift on an ambulance. I remember everything about it, every job, every patient, the two people I was with, where I was working, how I was feeling etc etc. There was a job that day which was given as 'COPD patient, difficulty breathing, not responding'. My mentor turned to me and said 'this guy could be very unwell, he may die on us'. I didn't understand how he could possibly know that! He told me it was just a feeling he sometimes got. Sure enough the patient was unwell. Very unwell indeed! On route to hospital he went into cardiac arrest and despite our best efforts he died. I remember feeling quite amazed that my mentor had predicted it from the minimal information we had. Well, years later, and I get those feelings, and today I had one!
I told the student with me to grab everything we would to take to a cardiac arrest. She looked at me like I was drunk, but I was insistent! We headed into the care home and were told the patient was on the second floor. My student pressed the button for the lift, I didn't wait and with surprising vigour, I bounded up the stairs. My student didn't follow, and waited for the lift with one of the carers. I was quickly located to the room and sure enough, lying on the floor was our patient, well and truly in cardiac arrest. I started CPR, got the oxygen on him and attached the defibrillator. The student was no where to be seen. It turns out they had to wait ages for the lift, then went to the wrong floor and then couldn't find the room. I later explained that no matter what floor the patient is on, as a first responder, if you suspect the patient could be very unwell, never take the lift!
As resus attempts go, this was quite long and drawn out. Once everyone had arrived, there were 5 of us in total sharing the workload. By sharing, I mean the two students were doing the lions share of the CPR, I was doing nothing but running the resus (perk of arriving first) and the other two were administering the drugs etc. We got his heart started at least 10 times but it was never sustained for longer than a minute or so. Each time it started beating it was slow and weak. We tried external pacing to no effect and it quickly became clear he was just reacting to the adrenaline we were pushing into him via the vein in his neck. After 90 minutes we stopped. We'd exhausted all of our options for the guy and after seeking advise from some grown ups we ended CPR, removed the oxygen and called a time of death.
It was quite sad. He hadn't been unwell, and only just moved into the home so wasn't known well by the staff. It was just his time. As is protocol, we requested police for the unexpected death and started our reams and reams of paperwork whilst the students started clearing up! A carer appeared in the doorway.
"Would anyone like some tea?" she said.
We all unanimously nodded away! How very British! There is nothing a good brew can't fix!
"How about toast? Would anyone like toast?"
Again, we all kind of looked at each other and started nodding away!
"Yes please, thank you!"
She disappeared off and we continued with the writing. Five minutes later she and another carer appeared with two large trays and set them down on the dressing table. There was pots of tea and coffee, sugars, milk, a selection of biscuits and about slices of toast with a pot of butter! Amazing! One of the students took up the role of 'chief butterer' and the other begun taking orders and pouring drinks. It was much needed and very appreciated. We sat around talking about the job, looking at the patients photos of himself and his family and talking about the life he had had whilst drinking tea and eating warm buttered toast.
The door then opened and two police officers entered the room. Take a freeze frame of what they saw:
5 members of the ambulance service, one sitting in an arm chair, one sitting on a bed, two sitting cross legged on the floor and one leaning against a chest of drawers, all with a cup and saucer of tea in one hand, toast in the other and a dead 89 year old man lying in the middle of them.
This sums up our job and a picture paints 1000 words. Some may think it's not appropriate, some may think it's extremely weird. To me, the last 5 people this man had contact with, who tried for 90 minutes to save his life, were sitting around toasting (excuse the pun) his life with tea. I like to think that he would have looked down and enjoyed his very British send off.
R.I.P
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