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Respiratory distress = emotional distress

Stabilizing a patient in despair suffering from tracheostomy bleeding



The emergency lights send splashes of color into the night, lighting up the soggy world like a disco ball. The headlights shine through the rain, illuminating a narrow driveway. As the ambulance bumps toward the house, the roof antenna makes twangy vibrating sounds as it hits low-hanging limbs. An old, cracked sidewalk leads to a dark entryway.

Inside the house, there is a man in severe respiratory distress. He is having complications with a recent tracheotomy. The incision where his tracheostomy tube enters his trachea is packed with bloody gauze, but there is still blood oozing out. As he attempts to breathe, blood gurgles in the tube. As he coughs to try to clear his airway, a clumpy stream of partially clotted blood spurts out of the tube. He is unable to speak but wears a look of fear. He motions wildly toward the tube and points toward the bag he has already half-filled with blood and paper towels.

No time is wasted in loading him onto the cot and getting him to the ambulance. Several first responders help get the cot over the rough places on the sidewalk. Inside the ambulance, while I work quickly to patch him up to the cardiac monitor and take his vital signs, the paramedic hooks up a suction catheter. As she suctions the tube, the patient coughs to help get as much fluid out of his airway as possible.

Within only a minute or two of receiving suction, the patient improves dramatically. The vital signs on the monitor stabilize. The patient’s skin color returns to normal. But best of all, the fear disappears from his face. The patient would be taken to the hospital for definitive treatment and would require suction several more times while en route.

And once again, I was filled with a sense of awe at the miracle of someone’s crisis being averted. Within a few seconds of treatment from a person with the training and equipment to provide life-saving care, a person’s worst day was made better. Much sleep was missed that night. Other patients who really did not need an ambulance would call 911. However, during that early morning ambulance run, I was filled with a sense of gratitude to be part of a team with the ability to save a person’s life.

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Chris Nace took his EMT class when he was 17 and took the NREMT test 6 days after his 18th birthday. He has worked for two rural ambulance services in Kansas and Oklahoma, and serves on his town’s volunteer fire department. He is currently in nursing school with the goal of being a flight nurse when he gains enough experience.