Thursday 12 July 2012

Cold and Clinical

"86 year old male, cardiac arrest, CPR in progress"

There it is again. That itch of excitement. The sense of urgency that has been dissipated through every time-waster I have seen, yet bursts back to life when the words 'cardiac arrest' appear on the screen. The term cardiac arrest for all intent and purposes means dead. The heart isn't beating in any discernible rhythm; breathing has stopped and the brain is being starved of oxygen. Without intervention that is how it will stay. With intervention, that is probably how it will stay, but there is hope, hence us! We sped out of the garage and started the daily battle with rush hour traffic. Only 3 miles to go but on a bumper-to-bumper dual-carriageway that takes some negotiating. We pulled into the road and at the end was another ambulance. That would make things easier! We parked up, grabbed suction, some spare oxygen and a few other bits that the second crew traditionally bring in and headed over to the house.

In the hallway there were a number of people, most of whom were in tears. The emotion at a resus when the family are present is something I often find hard to deal with. The patient's wife was standing in the doorway to the bedroom, tears running down her cheek; there were a few neighbours there for support and one of their children had arrived. It was a sombre feeling walking past them; I could feel the all too familiar eyes of expectation bearing down on us. I was first through the bedroom door, lying on the bed was the patient, he was lifeless, eyes open and fixed on the ceiling, hands in a half closed position and a pale purple tone to his skin. I looked at the crew who were standing beside him and one of them just shook their head. It was a telling a shake. There would be no resus, this patient would remain dead. 

"You can leave it with us if you like"

We exchanged call signs, picked up our stuff and left. On the way out I exchanged sympathetic smiles with the relatives; the fact we were leaving told them all they needed to know. Our colleagues explained what had happened, why we were not bouncing up and down on their loved one's chest and what would happen next. We got in the cab and filled out our paperwork.
'On arrival crew on scene, pt. laying prone on bed. 0 heart sounds, 0 resp. effort, heavily cyanosed, postmortem staining present, asystole, crew left on scene dealing, see their PRF for full pt. details'
Seems a bit clinical doesn't it? I wrote it and read it back and realised that we had just walked in on a dead person, looked at him, spoken to the crew and left. Seeing a dead person is a huge thing for most people; I suppose we take it for granted. I hope the family didn't think it was insensitive that we just walked in and out. There was nothing for us to do, a recognition of life extinct form would be filled out by the other crew and police would arrive as it was an unexpected death. I think where possible we distance ourselves from all emotion, it's what enables us to go off and carry on our shift. It maybe seemed as cold and clinical but sometimes it has to be. I just sat here thinking about all the cardiac arrests I have done since I started this job. I can only remember one name; most of you will know the job that was from. As for the rest of them, I haven't got a clue. As for this guy I'm writing about, I couldn't begin to tell you. Is that bad?! 


  1. No- not bad. You all do your best, when its time to go, its time to go.
    At least the old guy you're writing about had dignety. No point doing ALS when there is levidity present!
    You can't carry them all with you, it would kill you. The fact you carry 1- with understandable reason- is enough.

  2. Do you have a blog in relation to the resus you said you remember the name to?

    1. It was the post call a Tragedy Laid Bare

  3. You need to compartmentalise - put it in a box, shut it, store it never to be opened. It's the only way you keep your sanity *speaking from experience*

    1. God, can you imagine if the box was opened!! That would mean time to leave!

  4. We have all done it, stops u going mad. My crew mate phone went off durin telling now widow her hubby of 55 yrs has gone, his ring tone??? Always look on bright side if life'!!!

  5. People die. People deal with it. I don't want the ambulance service sobbing on my shoulder. You've a job to do. I have no problem with that. Your time was clearly better spent elsewhere.

    You did the right thing.


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