Ok. Every person in the medical field has looked back on their career and thought of a patient that, if they didn't kill, they at least did not help. Not on purpose of course. Well this patient is a little different. I know now that there was no way to save him. But I digress.
Busy days are the worst. Nothing is as exciting as crawling into your lumpy bed and pulling your blanket/sleeping bag/sweater or whatever you have with you over your shoulders and closing your eyes. BEEP BEEP BEEP! Dammit! The stupid radio! "MVA in the middle of Frickin Nowhere!" I honest to goodness slept my way out to the call while my partner drove like a bat outta hell, lights and siren on. We pull up to the scene. A battered and bloody man is sitting on the bumper of the fire truck.
"Can you wake up my buddy so we can go home?" he asks me, his drunken slur unmistakable. I scramble down to where the action is. Four firefighters are piled inside a single cab truck around my patient who is barely breathing. Before I get to the truck, one firefighter is yelling to me, "I'm going with you to the hospital"!! I shrug. I don't give a crap who comes with me. Maybe no one will come with me depending on the patient. This particular firefighter annoys me anyways. When I fail to answer her and begin assessing my patient she taps her bloody fingers on my shoulder and repeats herself.
"Fine!" I answer just to get her to shut up. She drops the c-collar she was putting on the patient and runs to yell at her captain I said she could come with me. The patients head bobbles. Three of us gasp and grab his head. I yell for someone to put the c-collar on and ask the guy breathing for the patient if there is an airway adjunct in (something that keeps the airway open). A quick shake of his head tells me airway is priority. I set my EMT to get an IV and I attempt my first (and so far, last) NASCAR style intubation. I am lying on the hood of the pickup my head and shoulders through the broken windshield attempting to stick a tube down this guys throat. Needless to say, it fails. We forget the airway and haul his but onto a backboard and trek him up the embankment to the ambulance. The one overeager firefighter is waiting in the back of the ambulance. I take one look at her and one look at the patient and ask for another firefighter too. We are at least twenty minutes to town so I tell my partner to go and I will do everything else enroute. Jumpy firefighter is helping the patient breath and competent firefighter is helping me set up medication and equipment to try to intubate again.
I push Jumpy out of my way and attempt another intubation. One breath in and the tube fills with blood. I pull the tube out and bloody vomit follows immediately. All over the patient. All over the ambulance. All over me. Now I am annoyed. I ask Jumpy to suction his airway while I get a new tube. The task seems to be too much for her so Competent jumps in and helps. I kneel in the pool of bloody vomit, cringing as I do so. I attempt an airway again with the same result. I am truly annoyed now. I have failed to get an airway, my #1 priority, and I am covered in nastiness. We are about 10 minutes from the hospital and I pick up the radio to let them know where we are. Just them Competent says, "Hey! look at the monitor. How long has he been dead?" In silence we all three stare at the flatline on the heart monitor. "Shit!"
We start CPR and medications to start the heart with no real gusto. We all know the facts. Trauma codes don't come back. We arrive at the hospital and the doctor calls him dead before we finish transferring him over. Now that we are in a big trauma room with bright lights and no rain I can clearly see a large split down the side of his head. Yeah, he never had a chance. Still, I never want to hear my firefighter say to me again "how long has he been dead?"
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