Sayings

There's a saying in the fire service that goes "Something will always go wrong. It's all about the recovery." This proved very true today.

We were having a badge pinning/promotion celebration for one of our departments newest engineers and had about 50 people at the station. It was just winding down when the tones went off. The crew from the neighboring district was at our station meeting with the Battalion Chief so the call was given to us. I didn't hear the nature of the call until we were on our way and the captain told me it was a 41 year old female unconscious, not breathing. We had a little bit longer of a drive than usual and a piece of equipment (the AutoPulse, automatic CPR device) that was being temperamental lately, so my captain called for another engine to respond with us.


We got an update en route that the police department was on scene and had CPR in progress. We arrived a minute later and brought all our gear in, the captain bringing the auto pulse. My firefighter took over CPR, I got out the BVM and dropped an OPA in the patient (is that enough acronyms for ya?). We got the patient put on the auto pulse and immediately had a battery failure. OK, recovery, switch batteries and turn the machine on again. This time it ran fine but the captain radioed the second crew to bring in extra batteries just in case. The second crew and the ambulance arrived, just as the auto pulse died again. We swapped batteries out again and it ran fine. I assigned one of the ambulance medics to the airway while I looked for IV access. The ambulance medic got the tube and although it was virtually a blind stick, I got a flash in my IV catheter that meant I was in. I turned to get the IV tubing and hook it into place and somehow bent the IV catheter in the process. It's flexible so I hoped it would still work. It didn't, I had no flow from the IV bag. The medic from the other crew was setting up for an IO or intra-osseous IV, that is, one that is drilled into the bone of the tibia (literally with a small drill).


I found the landmark for him and he went ahead and drilled. This woman was pretty large and the drill isn't the best for large people but he got in, bone marrow was aspirated, the IV was flowing, and we started pushing medications. Recovery.

We hooked up the CO2 monitor to the tube the ambulance medic had put in and got no reading. All other signs that the tube was good were present but we decided to pull it and put in a different kind of tube. This one got a reading and we went with it. Recovery.

It was at this time that I glanced at the IO and noticed a lot of swelling at the site meaning the needle was dislodged from the bone and the fluid and meds we were giving were not getting into the patients circulation.

At this time we decided to get moving and loaded the patient into the ambulance. My firefighter and I jumped aboard and rode along to the hospital. On the way, the ambulance medic got a new IV in the patients other arm (recovery) and after one more round of drugs we got the patient's pulse back. We still couldn't get a blood pressure and the patient wasn't breathing on her own, but we were able to stop CPR. We also checked her blood sugar level and it was high at 343. The heart rate was fast but looked good. I don't believe this was actually cardiac related and am quite curious as to the cause of this woman's arrest.

By the time we brought her into the hospital she had palpable pulses all the way down to her wrist, a heart rate of 120-150, and perfect CO2 numbers.

Now she too has at least a fighting chance at recovery.