The radio crackled loudly at 0100 hours, “37, 37, possible.” Half asleep I picked up the radio and responded “Gerber 37, go.” The radio crackled again, “37, respond to an emergency with fire engine 1 at Driftwood nursing home, room 5A, for an 82 year old female with difficulty breathing.” Thinking that it was another patient that was placed on 2 liters per minute of oxygen via mask rather than the usual 10-15, I replied slightly annoyed “10-4, give us 4 minutes.” When we arrived on scene my partner reminded me to bring my personal protective equipment because this could be a potential full arrest. I never had a full arrest patient before and I immediately started to recite, “Airway, breathing, circulation, look, listen, feel, head-tilt chin lift, modified jaw thrust, compressions 15 to 2, rescue breaths 1 every 5 seconds.” As we wheeled the gurney into the building I could see the caretakers and nurses rushing around frantically in and out of room 5A. When we reached the doorway I could already see one firefighter performing CPR and another medic intubating the patient, while two others were trying to set up an IV and obtain a blood sugar. The monitor was hooked up to the patient and the firefighter performing CPR momentarily stopped to check for a carotid pulse, “no pulse.” Being an EMT my scope of practice is very limited and out of all the things the firefighters were doing I could only perform CPR. Hesitant at first, I relieved the firefighter from CPR.
With hands interlocked and back straight I used the body’s landmarks to position my hands at the intersection of the nipple line and the sternum. The patient’s rib cage had already been cracked by the firefighter performing CPR before me, so there was little resistance upon compression; it was a unique and surreal feeling. Pumping deep and fast, I maintained adequate perfusion throughout the body in hopes of saving my first patient in full arrest. “Clear!” yelled the paramedic. I stopped CPR and watched the patient’s body jerk violently like a fish out of water. “Check for a pulse,” demanded the paramedic. I felt around the carotid artery expecting nothing due to the low success rate of CPR. There was a faint but distinguishable pulse at the tips of my fingers. I held my fingers there for a couple seconds in disbelief. The pulse was not coming from my own fingers, it was genuine. “I got a pulse, it’s weak but regular.” Upon answering the paramedic, I was filled with hope and excitement. The patient had a chance of surviving and I was able to contribute to her survival.
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