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Patient Care

Guest Editorial: A Battle Lost

“Ambulance 881, you’re requested to the home of a male subject, possible stroke.”

I roll over, roll out of bed, and acknowledge the page. My partner and I get our uniforms on—while most people are asleep, we are up and ready to help. I get in the mind-set of game time. I hop in the driver’s seat, start the rig up, and am joined by a partner with a tired look on his face.

We inform dispatch we are en route. I flip a switch, and red lights begin to flash around me. Then sirens. Our rig is lit up like Christmas running through the silent night, the sounds echoing off buildings.

Dispatch updates us that the patient has now taken a medication that is supposed be for heart issues. Then it’s a diabetic issue. I have no idea what we’re going into, but I’m not worried. We come through the small town and reach our destination.

A frantic woman waves us down, the look on her face saying something’s not right. I jump out, walk to the back of the rig, and grab my red bag that is heavier than me. I put my mask on and enter the home to find a male sitting in the bathroom. A first look tells me he’s hurting.

I begin my interview. What we’d thought was a stroke had turned into a higher blood sugar, then a chest pain scenario. The patient is sweaty and has a look of doom on his face. We figure it’s cardiac related, so we want to get him to the rig for evaluation. 

My partner leaves to get the cot ready. I continue talking and monitoring. My partner returns, and we assist the patient to a standing position. We take one step, and he flops to the ground like a fish. In the blink of an eye, he’s gone from full conversation to full cardiac arrest. My partner runs for the EKG, and we summon more help. 

Our patient is on the floor, teeth clenched, face purple. His wife is standing there, seeing everything. I ask her to back up and stay out of the way, as we’re about to work him, and it won’t be a pleasant sight.

The monitor arrives, and training takes over. I attach my 12-lead and place the pads. He isn’t breathing. His pulse is slowly going down. It confirms what we don’t want to be true: a heart attack. A complete blockage is working against our fight.

He begins to clench up again, and we start CPR. He comes to for the first time without any drugs. I’ll never forget the fear in his eyes. He reaches for my hand and holds it tightly. Then I feel his grip loosen and watch his eyes roll back. He cries out with the pain in his chest, and just like that, he’s gone again. 

We do CPR, establish an IV. Saline pumps through his veins like fire. We set up for intubation, bagging him. Intubation is successful, EtCO2 attached. The numbers aren’t good.

Rhythm check No. 2, we get him back. Unbelievable. Now he has a weak but steady pulse. His signs and vitals rebound. His EtCO2 is perfect, pressures nearly so. “Yes! What a save!”

Crew No. 2 arrives, and we start pacing him. We have a pulse. The patient fights the tube for a few short seconds—all good signs. But he fools us. We get him on a board and loaded, and then, suddenly, once in the rig, all life is lost. We start CPR again and run hot for the landing zone where we’ll meet the helicopter. We get ROSC twice—maybe he has a chance, we think. My arms are Jell-O, but we can’t give up. He’s fighting as hard as he can to stay on this earth. 

At the landing zone two amazing flight medics and a nurse arrive and take over CPR. But after rounds and rounds of medication to help restart his heart, we begin to think it’s over. Both crews agree it’s time to call it. It’s a harsh realization that there’s nothing more we can do. He’s gone, lifeless on the stretcher.

A life was lost in our arms tonight, and I will never forget this one. He looked at me and, without speaking, asked me to save him. I couldn’t. I felt for a few minutes as if I failed my job. God won the battle tonight and brought him home.

Life is full of battles, and some of them we have no control over.

Meena Thill is an EMT in Wisconsin and has worked in EMS for three years. She hopes to become a flight medic. 

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