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I don’t believe in providing false hope. But I do believe that as a paramedic I am often a person’s last best hope at life. I know that in a cardiac arrest situation there are many protocols regarding treatment and transport. I also know that personal biases come into play when life and death situations come in to play. But it’s not about me or my protocols. It’s about my patient and their second chance at life.
Recently, I worked a cardiac arrest on a woman. The arrest was witnessed by her mother. My partner and I arrived on scene and immediately began CPR. I don’t know for sure how long she had been down but I know that it was long enough for her to go into asystole. While my partner performed compressions I established an intraosseous infusion route in her proximal tibia. 30:2. Ventilate. Resume compressions. Epi 1:10,000.
This is a routine I’ve been through dozens, if not hundreds of times in my career. What many people consider to be the absolute worst day of their life, for most a once in a lifetime experience, is part of what I do on a very regular basis at work. On this particular occasion, it was looking as though we were fighting a losing battle. We had already been working our patient for 15 minutes or so.
I went to prepare the mother for the worst. Her daughter was about to be pronounced on her kitchen floor. We know how this scene plays out. Law enforcement comes out to secure the scene. EMS returns to service, then the coroner comes out and the body heads to the morgue.
“Ma’am, we’re doing everything we can for your daughter but it’s not looking good. At this point in time, she is dead. I don’t believe that we’re going to get her back. I’m sorry.”
“Please! You can’t let my daughter die! Please don’t give up yet!”
“Yes ma’am. Guys, get another Epi out.”
We administered that one last epinephrine. Suddenly, what had looked like a very bleak situation turned around in instant. She now had an organized rhythm. She had a pulse. She had a blood pressure. She was back! We got her back! This truly isn’t something that happens very often. In fact, more often than not, we wind up hugging family members. Wishing we could have done more but knowing we could not. We pack our bags and return to service feeling defeated. This isn’t why we entered the profession. We entered it to save lives, to help others. Sadly, that’s often not the case.
But this time, we had a rhythm. “Get her on the backboard! Move the stretcher around back! Let’s go! Let’s go! We won this time. She had a pulse. She made it to the hospital. She was stabilized and moved to the floor. That’s a win in my book. We were her last best chance tonight and my partner and I successfully stood in the gap between life and death. We did our job and we did it well. I’ll be back next shift for that rare chance to make a difference. The wins make it all worthwhile.
– Story written by an anonymous paramedic
