*Fast forward a minute or two. We're back the our medic unit at the other medic unit begins to leave the scene.*
Maybe we should have been a little quicker, the BLS patient is beating us off scene. While we did a lot of work on scene, perhaps we could have done more en route. On the other hand, I can't think of anything that we did that COULD have waited. They had a simple patient, so I guess it's no surprise.
*I help Breslin hook the stretcher onto the latch at the back of the ambulance. Breslin confirms that the stretcher is attached to the ambulance by giving the stretcher a tug. The safety latch is engaged. As she lifts the stretcher up and retracts the hydraulic legs, I climb into the back and start pulling out IV equipment. He's lost a lot of blood. I pull out two IV kits and two one liter saline bags. As Breslin secures the stretcher into the back of the ambulance, I toss her a tubing kit and liter bag of saline. Her and I bother strip and spike the liter bag. She leaves her completed IV set at the feet of the gurney.*
'I need you to call the trauma alert on this. I'm going to have my hands tied.' I tell Breslin. She acknowledges and quickly closes the doors as I hastily prep his first arm for a 16G IV start.
Before I know it we're moving. Lights & Siren blaring.
I hear the monitor hiss and know that it just cycled a BP. I take a quick look. 61/45 with a heart rate of 142.
Holy Crap. This dude's going to die back here.
I regain my focus and start my first IV on the first attempt, not an easy task, especially since this guy's got such a low blood pressure.
Once the first IV is flowing wide open, I begin working on the second IV. Unfortunately, this one is proving more difficult to get. My first attempt misses.
'Damn.' I say out loud in frustration.
'How are you doing partner? You still with me?' I ask as I look at him. I thought it wasn't possible, but he actually looked more pale now than he did when I first encountered him.
'I'm gunna.......die.....oh my god...I'm gunna to die.' he lets out weakly over the hiss of the non-rebreather O2 mask.
'No you're not. I've got you man. Just hang on for me.' I say as I concentrate on getting the second IV.
'Tell....call....please....tell my mom.....I love her...' he lets out weakly.
'You can tell he yourself after all this. You're going to be fine.' I say reassuringly as I make my second IV attempt.
My second IV attempt is successful. I open the IV wide open and secure it. Once done, I cycle another Blood pressure. I sit back as I wait for the blood pressure to come back. I have a quick peak out of the rear windows. I see that shady fried chicken joint I swear I got food poisoning from last month. I know that we're just mere seconds from pulling into the ER.
I look at the patient again. His eyes are closed.
'Hey buddy, you there?' I ask as I tap him firmly on the shoulder. No response. I jolt up from my seat a bit as we pull into the ER bay with a little too much speed.
'Hey! Ethan. Open your eyes for me.' I say loudly as I start to shake and pinch his shoulder vigorously. 'Shit' I say to myself softly as I reach for his carotid pulse.
The Monitor beeps. It threw an error saying that it couldn't measure a blood pressure. My heart sinks. I can't feel a pulse.
'God damn it! Breslin! He just coded, lets get the hell inside like right now!' I yell towards the front. She replies to me and says that we're backing in right now.
I start doing chest compressions. '1...2...3...4...5...6...7...' I count to myself with each compression. '28...29...30...1...2...' The vehicle stops back up and I hear Breslin barreling out of the cab and towards the back doors. She rips open the back doors and climbs up and tries to unhook all the saline bags from the roof of the ambulance. She gets one down and struggles with the other. I stop compressions long enough to the the saline bag down. Breslin hastily unlocks the stretcher and pulls it out of the back as I hop out. With the wheels on the ground I unlatch the back of the stretcher, freeing it from the ambulance. I start doing one handed compressions as I stand at the patient's side. Breslin then starts pushing and steering the stretcher as I walk along side doing one handed compressions. As we walk in, I am directed straight to Trauma Bay 1 where a sea of hospital staff are waiting. I start giving my report as we enter the bay.
'We have here an 18 year old male, stabbed twice with a knife of unknown length during an altercation, once in the lower chest and once in the abdomen. The patient coded as we pulled in. PEA on the monitor. No drugs given.'
As we maneuver the stretcher next to the Trauma Bay bed, a tech takes over compressions. 'I got it bud.' He says to me as we switch positions. Breslin and I hastily unbelt the patient and slide him over to the trauma bed. I continue my report:
'On scene he had severe dyspnea and absent breath sounds on the left. We performed a needle decompression which was successful and restored lung sounds and resolved the dyspnea. I got the 2 16G saline IVs in and wide open. He's got no medical history....' I get cut off by the trauma team that swarms in and is obviously no longer listening.
*Breslin pulls the stretcher out of the way and back out into the hall.*
*The nurse serving as the scribe approaches me and gets all the identifying information I have about the patient.*
*I stand for a moment watching. It's organized chaos. at least 7 people, doctors, nurses, techs, all doing their assigned task. If this kid has any chance, he has the best one here.
After about 30 seconds of watching, I walk out.
I hope this kid doesn't die. Please don't let this kid die. Is it my fault? Could I have done something different? Did we spend too much time on scene? Shit. Is this my fault?*
*I wash my hands and arms in the near by sink.*
'I have a hell of a report to write on this' I say to myself, feeling defeated.