En Route

February 10th, 2008

We were almost there - a patient with a painful hand. Did it warrant an emergency ambulance? I’ll never know.

Less than two hundred yards away from our destination, we were flagged down by three people at the side of the road. “Metro Control, Alpha Bravo 123, we have a passing call - car vs. lamppost. Will update you when we can.” I climbed out the passenger seat to greet the people milling around the car with no apparent sense of urgency.

“He’s still in there, but the doors are locked so we can’t talk to him” one of the bystanders informed me. I walked around to the driver’s side trying the back door on the way and peered through the window to see the driver.

“Dave,” I shouted to my ECA crew mate, “get on the radio and tell control it’s a cardiac arrest“. I’m not sure if it’s instinctive or not, but you can tell a dead body when you see one.

Just at that moment, a police car that we had passed on the way to the original painful hand stopped and asked us what was going on. I shouted something along the lines of “He’s dead; we need him out quick” and seconds later the police had produced a telescopic baton and were repeatedly striking the back windows of the car in an attempt to gain entry. I had no idea how much effort it takes to smash a car window!

I was surprised to find that the car doors would not open from the inside either, despite the fact that the car engine was still running. The impact against the lamppost was not significant enough to stop the doors opening, so all I could think was that he had a child lock on the back doors. Carefully leaning through, I tried to reach the front door to unlock the rest of the car; tiny pieces of shattered glass were everywhere, and I already had at least one cut finger. Somehow, I managed to find the right button and released the doors. I immediately opened the driver’s door and confirmed my feeling that this patient had no pulse.

Moments later, me and my crew mate dragged the patient unceremoniously out of the car, on to the neatly kept grass verge and started CPR. It didn’t look too good - we had probably spent two or three minutes before we managed to get CPR started, and from what we were hearing from bystanders, it had happened around three minutes before we got there. He was asystolic according to our ECG and looking a little bit blue, but after 2 minutes of resuscitation his appearance started to pick up a bit.

Around a minute later, his heart rhythm was no longer just a flat line, but erratically jumping around. As I was looking around the patient, carrying out my final safety checks before shocking him, I noticed out the corner of my eye someone walking up to a nearby police officer. “Excuse me, can someone move this ambulance - I need to get my car out“. I smiled as the policeman politely explained to the blocked in driver that now probably wasn’t the best time to be moving the ambulance.

Two more minutes of Nellie The Elephant and the inconvenienced driver had disappeared. The ECG still showed VF, so it was time for another shock. The monitor settled and showed a regular rhythm on the screen. I felt for a pulse and there was something there, but it didn’t last. Within 20 seconds it was gone, so it was back to the chest compressions. Help in the form of a second ambulance had arrived now and it was time to get the patient on his way to hospital. Another shock, another fleeting pulse, but within 40 seconds or so it was gone again.

Thankfully we were only minutes away from the nearest hospital, and it wasn’t long before we were sliding our patient over onto the hospital bed with a crash team ready to take over.

It turned out that no 999 call had been made for this incident, and that is more common than you might think. In all the confusion of the bystanders, everyone assumed that someone else had called. We just happened to be in the right place at the right time for this patient, but the outcome of the event was not so fortunate.

We tried our best.

Entry Filed under: Work