I could see from the bottom of the stairs that he didn't look right. When babies don’t look right, something is definitely wrong.
His mother cradled his limp form in her arms and tried to explain what happened as I scanned the apartment, quickly assessing the situation as I approached them. She flinched when I reached for her child, pulled back and cradled him closer.
"We heard a crash from the bedroom, he was under the dresser," she explained, frantically.
I looked into the bedroom in question. A full-sized dresser leaned against a wall; its drawers open and a big, heavy TV smashed on the floor in front of it. The baby’s eyes rolled in his head; he was breathing normally but remained unresponsive.
"Did he cry when it happened?" I reached again for the child; again she pulled back.
"He didn’t make a sound."
We were on the third floor.
"Get the papoose ready, we're coming down," I relayed to the crew from Engine Co. 14.The baby’s mom held on tight, unable to let go. The story of King Solomon came to mind, and rather than getting involved in a tug-of-war I let her carry her child to the ambulance. She knelt next to the stretcher while we worked around her; it wasn't that hard and well worth the trouble. The baby cried a little while we restrained him, and struggled with the restraints, but remained unconscious with a grayish-blue tint to his skin.
"Let's roll," I said as soon as we had him secured on the stretcher and his mom on the bench seat, close but unable to touch him. It must have been unbearable. A firefighter joined us in back, while another drove the ambulance.
Jermaine hit the gas and we were on our way to the trauma room at Hasbro.
"Do something! Hurry up!" said the boy's mom from the bench seat, frantic as she watched her son lying motionless.
"We all have kids of our own, we're doing everything we can," said Ariel, my partner for the overtime shift. He said it gently, looking the mother in the eye. It worked, and she relaxed.
The baby needed an IV. Ariel is not normally assigned to EMS; his usual spot is as a firefighter on Engine 11. I didn’t think he had started many IV’s on adults, let alone a baby. I've worked with him a few times; he's calm, competent and more than willing to do the job. Asking somebody to start an IV on an unresponsive infant in a moving truck in front of a panicked mother is not something I do lightly. Alas, we all have a job to do, and I couldn’t do mine if I were doing his.
"I need an IV."
"I got this,” said Ariel.
I moved from the infant's side, sat on the Captain's chair and called the ER at Hasbro.
"Providence Rescue 6, we have an eighteen month-old male, semi-conscious, responds to painful stimuli, no obvious deformities with a heart rate of 140 and 128/96, respiration's 40 and shallow, pulsox 98% with blow by 02."
From my seat behind the patient I watched as Ariel and Hans, another firefighter from Engine 14 who had joined us, established the IV better than I could have—and I’ve established more than I can remember. Early in my career I would have grabbed the baby from his mother, wasted time doing the hands-on things myself and thought I had done my job. But to do my job, I needed to give up control of all the little things that need doing, let capable people do their jobs and let the big picture come into focus, much like a director on a movie set.
"IV established, he's restrained, BG of 184, ETA four minutes."
"See you in four."
The baby stopped breathing. I stopped breathing.
"Is he alright?" asked the mom.
For what seemed an eternity the little guy lay on the stretcher, motionless. Ariel gently shook him, I squeezed his little hands, pulled back his eyelids—nothing. As I reached for the pedi bag-valve mask and got ready to have my crew start CPR, the most beautiful sound filled the back of the rescue; a baby crying. Not loud, not in earnest, but crying nonetheless.
"He's okay," I told the mom. "He is injured, but things are under control. We'll be at the hospital in a minute."
A minute later we backed into the bay at Hasbro. The trauma team was ready, I gave my report and they took over.
Then I started to breathe.
One of the hardest, but most important lessons I’ve had to learn is that the best way to keep things under control is by giving some of it away.
Michael Morse, EMT-C, is a rescue captain with the Providence (RI) Fire Department. Follow Michael on Facebook and e-mail him at firstname.lastname@example.org.