NS Medic
I am nsmedic. I have been a paramedic for going on 7 years. I got my Advanced Care (ALS) tag about three years ago. I work rural ground ambulance in Nova Scotia, Canada and Air Ambulance in Nunavut, Canada.
Heading Home
- By NS Medic
- Published 05/16/2008
I have been in the arctic for just under two weeks now and I am finally heading home. We have been busy as sin, which is typical and i have had yet another set of awesome experiences. The idea of starting this blog was to share some of those experiences with people...or maybe at least to just lay out my thoughts on what happens here.
I have sat down at the computer many times, even started writing on my palm pilot about different calls i have had, people i have met. In the end I decided every time not to post them. I didn't want to be someone who just whines about bad calls i did or how something screwed up or pissed me off. I just wanted to write about something happy or positive.
In the last two weeks I have not transported a single adult patient. Sick babies and sick children. Pneumonia, bronchiloitis, sepsis, fractures, kids run over by ATVs and kids run over by vehicles. Last night was the worst.
I was visiting the pilots at their crew house, we had made a big dinner since it was to be my last night in the north of this rotation. Everyone sitting around the dinner table having a great time when Dave, my first officer, got the call on his cell phone. He looked at me laughing "I guess you are gonna get one last call in" he said. "and its a long one". The patient was in one of the most northern communities in the country, a three hour flight one way if there wasn't a head wind.
We finished dinner and i made my way to the hospital. Looking at the run sheet in the nursing station it looked like a pretty straight forward peds call. A 14 month female, febrile, nausea and vomiting since the day before. There was a note on the bottom that the patient might have some odd neural like symptoms on the right side of her body, but if the nurses in the clinic say "might" it usually means "not" and it caused me no real alarm.
After singing out my drugs I sat to chat with the nurses for a minute while i waited to talk to the doctor on call to get his take on the situation and found out that the pediatrics resident would be coming with me. It seemed kind of odd since on paper this looked like a routine medevac but in a minute everything became clear. The peds resident came into the room, a cell phone to his ear. He was talking to the nurses in the clinic about our baby. Catching only bits and pieces of the conversation it became apparent that this baby was sicker than I had thought. Talk of valium, seizures, decreased LOC and intubation was the subject of the conversation.
In the end though, there is a point when you have to stop talking about it and start doing it. We could talk about treating this baby all night, but if we didn't get in the plane and start moving in their direction we wouldn't get a chance to start doing any of the things they were talking about so animatedly on the phone.
A quick drive to the airport and we loaded all our gear onto the plane; airway kit, drug box, peds kit, lifepack, IV pumps, ventilator and extra bottles of oxygen and medical air.
The flight was just over three hours long, i spent the time trying to read, sleep and wound up going over drug dosages, concentrations and generally trying to plan the unplanable.
When we arrived at the airport we were met by the village taxi/ambulance/whatever...a white panel van that we could fit all our gear, stretcher and crew in the back. Normally the clinics are located close to the airport, but in this particular community there is a half hour drive to get from the airport to town. The driver didn't know much about the situation, he was just able to tell us that the baby was sick and there were allot of people at the clinic.
Walking through the doors of the clinic, it looked like the whole town was there. Every seat in the waiting room was occupied, children were playing on the floor. If i didn't know why they were gathered, i might have thought it was a community event or something.
I barely got in the door when one of the nurses grabbed me by the arm and pulled me into the treatment room. On the stretcher in the middle of the room was our sixteen month old patient. Things had obviously gotten worse while we were in the air. The child was posturing, her little arms drawn up tight to her face. She grey and the nurses were trying to ventilate her with a bag valve mask. Her respiration's were obviously insufficient, her heart rate had dropped from 200 to 80 in the last half hour and her BP according to the machine was 50 systolic.
I got one of the nurses to call the ICU at Ottawa Children's and got to work. Fluid boluses, Lido, atropine, fentanyl, versed and succs and we had the tube in a few minutes. With ventilations, the baby's colour started to improve, we still didn't have the pressure under control but i was hoping that we would have someone on the phone in a minute to give me some advice. We got the kid onto our pediatric ventilator and started getting her packaged on our stretcher.
She crashed...heart rate dropped to a PEA in the thirties. We worked on her for a half hour and then called it.
On my best day I hate being the one who has to tell the family that a loved one has died. In a northern community, when literally there are dozens of family members present and they speak English very little it seemed like a nightmare. I sat in the room with the nurses for a couple minutes to try and prepare myself for it.
The head nurse brought me out into the waiting room and beckoned the mother and father over. They actually spoke reasonable English. I told them that the girls condition had seriously deteriorated and that despite our best efforts she had died. The whole room went off. It was probably harder for me to stand there and try and console the family members than it was to actually work the arrest.
I don't think anybody spoke more than 10 words the whole flight home. I know my pilots had never seen anything like what happened in the waiting room. For that matter, i hadn't seen anything like it before. Dozens of people grieving over the loss of a 14 month old little girl.
