This Stuff Really Works

“She’s not breathing!” screamed the skinny teenage girl, on the edge of hysteria as we came to a stop in front of the apartment building. “Hurry, please, it’s my mother!” Tears streamed down her face.

My partner, Dick, and I were grabbing gear off the ambulance as Engine 7 pulled up behind us. “What do you need, Mike?” the shift captain asked.

“Set up the stretcher at the base of the stairs and bring up a backboard,” I called as I ran around the police cruiser, heading to the back of the building. As I ran up the outside stairs, I thought to myself that nothing ever happens on the first floor, and I’m getting too old to be running up three flights with 60 pounds of gear hanging off my shoulder.

At the top a man with long hair and a bushy mustache was pointing the way. The husband, I suspected. “Through there—the room on the right,” he said. “She’s not breathing—hurry!” We eased our way down the narrow, cluttered hallway to the back of the apartment.

I turned into the room; it looked like it was ready to explode—small, but full of a lifetime of belongings. The bed filled most of it, the patient lying on the only space on the floor. She was wedged between the bed and the dresser. Two police officers who had arrived first had the AED attached to the patient and were performing CPR.

“What do you have, guys?” I asked, kneeling in the doorway by the patient’s head, checking for a pulse.

“She was down on the floor with no pulse,” answered the sergeant. “The AED advised a shock, so we shocked her just before you got here.”

With compressions, she had a good pulse. If they were interrupted, she lost it. I told the cops to continue. Then, “Dick, I need the BVM, then set up for an IV line.” I turned to our paramedic student for the day. “Melanie, what do you want to do?”

“Let’s get our cardiac monitor on her and see what we have for a rhythm,” she answered.

I turned to the police. “Good job, guys, keep doing compressions.” With the ResQPOD in place, I started to assist ventilations with the BVM.

From down the hallway one of the firefighters called out: “We’ve got the stretcher set up at the base of the stairs, and the backboard is in the hallway, Mike.”

“OK. Melanie, what do you have for a rhythm on the monitor?”

“V-fib.”

“OK, what do you want to do for it?”

“Shock it. I need to charge the monitor, 200 joules. Charging, everybody—clear, clear, clear—shocking.” Verumph, the deliberator went off, the patient jerking with the electrical charge as it shot through her body.

“OK, start compressions again, hard, deep and fast. Let’s go, let’s go.”

Out of the corner of my eye, I caught the sergeant grabbing Dick by his jacket. He lifted all five feet of him over the patient and placed him at the foot of the bed.

“Dick, how’s that IV coming?” I asked.

“Jesus, Mikey, I can’t get to her. There’s no room, and we need to get her out of here.”

“All right, get the backboard in here, place the foot of it at her head, and we’ll slide her onto it.”

The crew was getting tense—I needed to calm them down. Beth, one of the firefighters, was struggling to get the backboard placed. She was working in close proximity to my backside. We have worked many tense calls together and have a good relationship and respect for each other.

“Beth,” I told her, “I’m a little gassy today. I don’t think you want to get too close down there.” Silence, then chuckling from the crew. It worked—the tension started to resolve, and people worked harder and faster.

“Geez, Mike, you didn’t have to say that,” said Beth, smiling but understanding what just took place.

The backboard was set. “On my count. Ready, 1-2-3—pull!” Onto the board she went. We now had her in the hallway, with a little more room to work.

“Anyone have any information or history on this lady?”

“IV is in,” reported Dick.

“Give an amp of epi,” I told him, “then get the amiodarone ready.”