I did an amazing thing, apparently.
Duty Night. Chillin' in the lounge chairs, watching a movie I've seen before and don't mind seeing again. Earlier that day, I had played in a kickball game with some other folks from the Firehouse. Good times. No beer for me as I was heading directly to the Firehouse afterwards.
Roswell pops his head into the lounge, "Hey, maddog, can I see you?" He tilts his head in a way that tells me he need to talk to me RIGHT NOW.
"Sure!" Off I go. He leads me back to one of the dorm rooms where his girlfriend, JLB, who's also a firefighter/EMT, is lying on the bed. They've been drinking steadily for the previous 7 hours (they started at the kickball game). She's lying on her side, breathing at a rate of 60 breaths per minute.
OoooooooKay! Pulse is 92, BP is 130/82 and her blood is 99% saturated with oxygen (SpO2=99). These are all good. Oh, yeah. She also smells boozy to the max!!! The thing is, I can't rouse her at all. I do exceedingly painful things to her but she doesn't respond. That is bad. However, considering her blood pressure and pulse are reasonably OK, I'm willing to adopt a "wait and see" attitude and see how long it takes her to sleep off her drunk. Roswell and I roll her onto her left side and make sure she's got a clear "vomit path" in case she barfs. We're trying to ensure she doesn't breathe in, or aspirate, anything she pukes up.
I'm standing next to the bed, discussing with Roswell what we should do. We were just deciding to check on her ever hour when her noisy breathing stops.
We look at each other.
We look at her.
We look at each other again.
This is the first time I've ever seen Roswell scared. Strangely enough, and totally out of context, I realize that, despite the ups and downs of their relationship over the past 2 years, Roswell really loves JLB!!
I roll JLB on her back. I move her head back to ensure her airway is open.
She's still not breathing.
I check her pulses on her neck (carotid) and her arm (radial). What had earlier been a steady "THUMPTHUMPTHUMP" is now a, "THumpthumpth...tu..th.......th......t...t....p....p................"
Everything is now bad.
"Hey, Roswell?" I say in my calmest voice, "I think we need to start a medic unit, OK?"
In a flash, he's gone.
I try again to get JLB's airway open and, again, try to rouse her with painful stimulus.
Still no breathing.
Check the pulse again. I can barely feel it. It's beginning to dawn on me that I may have to do CPR on a woman who I consider a family member. I guess I better get her off the bed and onto the floor!
I cradle her like a child and move her to the floor. She's as limp as a rag doll (or the newly dead). By this time RockSteady has shown up. He was a Paramedic back in "Joisey" before he came down here to be a financial planner. He runs at the Firehouse because, deep down inside, he misses it.
"What do you need?" he asks me. As calm as could be.
"AED, O2, BVM, a medic unit and wake everyone up." I reply in a tone that I hope sounds as calm as RockSteady.
Brooklyn shows up with the "Go" bag and the O2 Kit. This kid has learned much from the maddog. I drop a 22fr Nasopharengeal airway in JLB. Her jaw's pretty tightly clenched so I know I'm not getting anything in her mouth. At least I can help a bit with a flexible tube down her nose to help get oxygen into her lungs. I get out the Bag-Valve-Mask (BVM). This is a device that allows me to put a mask over your nose and mouth and squeeze air, via a specially built bag, into your lungs. I'm trying to breathe for JLB. By this time, Brooklyn has left to go get the stretcher. I check JLB's pulse again.
Nothing.
I check it AGAIN!
No, Really, I mean NOTHING!
"Crapcrapcrapcrapcrapcrap!" I'm saying to myself.
Weed has slid into the room at this time. She's still half asleep. I've never worked a bad patient with her but she and I work together as one.
"I got nothing" She says to me. She's feeling for a pulse too.
"Right!" I say. Weed hands me the scissors and In about 1 second, I've got JLB's shirt and bra cut off. Weed takes over the ventilations.
At this point, part of my mind is remembering how many times JLB and I have joked about getting "Trauma Naked" by cutting someone's clothes off. We say that this is a real possibility when someone dates a paramedic. Now, here she is, "trauma naked."
I start shoving on her chest with all my weight. I'm forcibly and mechanically taking over for her heart. I'm slamming it flat to force the blood in it to go out to her body and lungs and then springing up suddenly to allow it to fill up with blood to, again, be forced out to her body by the next compression of my body weight on her chest. It's not elegant but it IS effective.
I do about 2 rounds of 30 compressions when the AED arrives with Brooklyn, Ninja and RockSteady. We slap the pads on her and stop CPR long enough to have the machine tell me that no shock is advised. I go right back to CPR.
Here's the freaky bit:
I finish my 3rd or 4th cycle of chest compressions when JLB's eyes snap open and she takes a deep, ragged breath.
Woah!
Did I just do that?
"Hey, darlin'! Glad you've decided to come back and join us!" I say in a voice I hope sounds lighthearted and calm. Her eyes orient towards me and she makes eye contact. Well! This is Very Good!!!
She fades in and out. Her respiratory rate never gets above about 6-8 per minute so, I keep assisting her ventilations with the BVM and a full dose of Oxygen.
Brooklyn, Ninja, Weed, RockSteady and I get JLB moved out on a Reeves stretcher. This is a nice tool for getting people out of tight spots without jerking them around too much. As we load her onto the stretcher/cot in the engine bay, we hear the Medic unit pulling up out front.
Smooth and easy we move her into the medic unit. Weed and I stay in the back to help out and Ninja jumps in the driver's seat. Off we go. The medics hook JLB up to the EKG, check her Carbon Dioxide output (Capnography), her blood pressure and other vitals as well as starting an IV in her left arm (after an attempt in her right arm and her external jugular vein with no success). All the while, JLB is alternating between lucid periods where she's looking at me and asking where Roswell is and complete unconsciousness with a respiratory rate of around 4-6 breaths per minute.
The two medics, Weed and I work together like we were cogs made for the same machine. Medic #1 calls the hospital on her cellpone and gives them a good, solid report so they know exactly what's coming in the door when we arrive. It pays off too. We roll right into a critical care resuscitation room and are swamped by nurses, techs and doctors.
As soon as we arrive at the hospital, we're swarmed by other firefighters, JLB's family and a few cops too. It's a circus. I hand off ventilations to a tech and clear out of there. I wash my hands and find a spot out of the way to wait and see what happens.
20 minutes and 2 liters of intravenous fluid later, JLB is answering questions and completely alert. 1 Hour later, all of the people involved are having a CISM debrief in a conference room in the hospital. 2 hours later, JLB is going through a battery of tests, EKG, 12 lead, Blood work, etc., etc.. I'm back at the station, filling out my reports and restocking my gear.
They keep JLB at the hospital for a while to do a full workup. By the time she slides into CAT scan, I'm dead to the world asleep.
I did everything as I should and made no mistakes. Clinically, I'm pleased and satisfied. 14 hours later, telling the story to someone who's not a firefighter, I can't stop myself from crying. No sobbing of loss of control. I simply cannot stop the tears from flowing out of my eyes.
She woke up. Her eyes opened and she looked right at me. I'm beating on her little body hoping to push enough blood around to keep her brain from dying and she opens her eyes and looks AT ME.
Somehow, this is the part the overwhelms me.
-'Medic
