En route dispatch updated us that the patient had a cardiac defibrillator and it had fired about ten times in the last fifteen minutes. Okay, so I was wrong...it's the latter. We arrived at the apartment and found a young woman lying in bed with her arms crossed around her chest and her eyes closed. She told me she was just trying to be still and relaxed so the defib wouldn't fire again. She said she has had an AICD (Automatic Implantable Cardiac Defibrillator) for thirteen years and has never had it fire. This was her second AICD (which she's had for the last five years) and as it turns out this particular model has a recall notice for some possibly faulty wiring. That had to be disconcerting.
I assessed vitals, ekg, and got some additional history from her. She was awoken from sleep by the fist shock but had no prior symptoms, stress, or unusual activity. Her ekg actually looked fine although we would have to wait for the ambulance to get a more definitive 12 lead ekg. This is a little frustrating because I am a 12 lead trained medic but we don't yet have the cables on our monitors to allow us to do them. My department is currently training all of our medics in 12 lead acquisition which is excellent. But, until that's done I have to wait to use my training. In any case, the scene was calm and my patient was cardiac symptom free: no pain other than residual pain from being repeatedly electrocuted, good BP, good pulse and rhythm. It was certainly looking like she got one of the defective defibrillators. Unfortunately there wasn't much I could do for her. Her chest pain was only a three out of ten and only caused by the shocks, she couldn't have morphine and my other pain management drug wouldn't do much in this situation.
The ambulance arrived and we were disconnecting our equipment from her when she suddenly screamed and sat bolt upright. The AICD had fired again. I was at her side and my firefighter had his back turned to her and was trying to coil up the long ekg wires when she screamed. In my peripheral vision on one side I saw my patient clutching her chest and rising up and on the other side I saw a tangle of wires flying into the air as my firefighter jumped like a startled cartoon cat.
It would have been funny except my patient was now crying and scared to move. This means she didn't want to get up and onto the waiting ambulance gurney. This means we have to pick her up and carry her to the gurney. Which means I have to get behind my patient and wrap my arms around her holding onto her wrists and pulling her arms into her chest while another firefighter holds her legs under the knees and we take her down the hall this way. She was young and light and I wasn't worried about the lift. I also wasn't too worried about the defib, it shouldn't really be strong enough to hurt me even if it fires while I'm carrying her (at least I hoped it wouldn't - I didn't really know how powerful the thing was). I just didn't want either of us to drop her if she suddenly screamed and jerked again with the sudden shock. Fortunately we made it to the gurney and the ambulance took off without any more shocks.
