A race against time - The life of a paramedic
The emergency world is full of people who sacrifice everything to save others. Paramedics, in particular, must face a race against time to save some people’s life.
It happens that this race, many times, could be extremely critical, especially when is the case of a critical patient. This is one of the biggest problems in the life of a paramedic.
A race against time: a witness
As follows, the Guardian reports the experience of a paramedic in UK, who had to face a stabbed patient with respiratory distress.
We arrive. He’s lying on the footpath of a busy street. The police pull up. There’s a crowd around him. They’re distressed. I can see several stab wounds. Blood is pooling on the footpath. I look to Dom. He knows the score. We’ve done this before, once with multiple patients. Now is time for the critical decisions: do we stabilise on scene or do we scoop and run?
We opt for the latter. It’s his only chance at survival. He can’t walk or move but he’s too big for us to carry so Dom gets the trolley out. I plug holes, literally. His stab wounds are “sucking”, which means that with every breath, air enters the space between his chest and his lung, which collapses his lung and compresses the blood flow to his heart. He is dying.
We get him on to the trolley and into the ambulance. We were on the scene within six minutes of the stabbing, and are now leaving within four minutes of arriving. A paramedic from the fast response unit arrives and jumps into the ambulance to assist me.
I call the major trauma unit at the receiving hospital, telling them to prepare for a stabbing victim in severe respiratory distress. We estimate to arrive in 15 minutes but traffic is horrible.
I place a special trauma dressing on each side of the patient’s chest, but the rest of the holes also need to be plugged. The other paramedic cuts up a sticky defibrillator pad and covers the other holes. I must remember that trick for next time.
I reassess him. He’s paler and sweatier. His breathing is more rapid and shallow than when we arrived. His pulse is getting faster, but weaker. He’s lost blood, but not that much. I listen to his chest with my stethoscope. Neither lung is doing what lungs should do.
I need to stab him in the chest again, but this time to save him, by releasing the air. The other paramedic passes me two 14 gauge cannulas. They are more like knitting needles than normal medical needles. I ask Dom to keep the ambulance steady for 30 seconds while I try to decompress. He shifts from Stig mode to Sunday morning driver and the cars around us blare their horns.
My new colleague passes me each bit of equipment – just like in an operating theatre. I try to instruct the patient, just like we’re taught to do, but he’s almost unconscious. He might not make it to hospital alive. I insert both large cannulas. But it doesn’t work. The needles are too short for such a big man. Do I try another needle? We’re now only a few minutes out. We decide to prepare him to move into hospital.
Dom accelerates, overtaking all the cars that were beeping him a moment ago. At the trauma centre, Dom pulls into the blue call spot and we move fast to the trauma beds. As we enter, there’s a flurry of staff. The trauma consultants, residents, medical students and trauma nurses are standing by the bed, awaiting our arrival. I deliver a quick handover. The surgeon takes one look and says: “Call a code red, and get an operating room ready right now”.
We’re sweaty and exhausted, but our work is not done. I complete detailed paperwork, documenting our patient care which takes longer than our whole interaction with him. Over an hour is spent getting the blood out of every nook and cranny in the ambulance, our bags, our diagnostic equipment and the stretcher.
We then clean the blood off ourselves. It’s up to my elbows, and there’s some on my face. Finally, I get to pee. We pop our heads back in just before we clear for another job. The doctor tells us: “He just made it. Any longer and he would have died.”
This job makes me think of every hangover and every flu I’ve ever responded to. I think of every non-urgent job I’ve been to because someone is too lazy to go to their GP, hasn’t bothered to attend a walk in centre, or simply taken care of themselves. Every ambulance wasted – despatched to non-emergency calls – means there’s less chance we can reach patients like this.