Saving lives is anything but a game, but sometimes it’s tempting to consider the work we do from a sporting perspective. Baseball offers one of the purest comparisons — a heady game of technical precision, where numbers and probabilities reign. Sound familiar?
So I applied the baseball analogy to a particularly memorable recent shift. Here’s how my game played out (it’s better if you imagine Vin Scully’s voice when you read):
It’s the top of the second, and I’m hitting cleanup. Three up and three down in the first. The patient is a tough kid — 19-years-old and having an allergic reaction to peanuts. She’s struggling, panicking and her throat is about to close. The pitch comes in, I take a big swing and hit her with .3 mg of Epi. A minute later, the crisis is over and she’s breathing easier. An IV and some oxygen and we’re on our way.
Single.
Fourth inning. We’re down a run. I step up to the plate, the pitch comes in. A diabetic this time, blood glucose 22. He’s out cold, lying on the floor of his bedroom, his wife looking on concerned. We start an IV, administer 25 grams of D-50 and he’s back in the game a few minutes later.
Double.
I’m up again, seventh inning, still down by a run. A heroin addict overdid it; he’s in the driver’s seat of an old Chevy Impala, barely breathing and ready to code. The next pitch is right down the middle — 2 mg of narcan, IM in the triceps. He’s up and at ‘em in less than a minute.
Triple.
Ninth inning, tie game, two outs, nobody’s on. This time it’s a 45-year-oldwhose heart is beating at 220 beats a minute. I tap the bat, take a few practice swings, get the Adenosine ready, then the 20 ml saline flush. It’s a curve, I take a mighty swing, push the 6 mg quicker than the eye can see, then follow through with the flush. The ball takes off, the rhythm on the monitor staggers, slows and goes flat. A few moments later, it starts again and resumes a normal sinus rhythm.
Home run!
Epi, D-50, Narcan and Adenosine, all in a nine-hour shift. In all the years I’ve been doing this, it’s the first time I’ve ever hit for the cycle. It may not make SportsCenter, but it will go in my highlight reel.
What’s your EMS ‘cycle’? Drop a note in the comments below.
