One that went well

It was dispatched as an unconscious patient. They almost always regain consciousness while we are on the way. The common phrase is "syncopal episode" - a fainting spell. So when the notes on the MDT were updated while in route with "PATIENT STILL UNCONSCIOUS," we knew it was probably serious.

We were on our way to sit point for area coverage, so our response time was faster than normal. As we pulled up, a sheriff's deputy car was outside the house, with the sheriff inside. We grabbed all our gear and loaded up the cot.

The sheriff met us at the door and said, "He's in the bathroom. He's still breathing."

My partner led the way and took one look at him - an elderly man on the floor, leaning against the tub. He was gray and dusty in color. "He's not breathing right. He's breathing like a fish out of water. Let's get him out of the bathroom."

We dragged him out and, suddenly, the training kicked in, and it was all asses and elbows, equipment flying everywhere.

While my partner prepared to intubate, I started pulling out everything we needed from the Lifepak monitor: blood pressure cuff, oxygen/pulse fingertip clip, heart monitor leads, etc.

While I was getting him hooked up, my partner successfully tubed him and started bagging him with the bag-valve mask (BVM). At this point, the fire fighters arrived and since the call was in my fire department's area, I knew them both.

"What do you need?" they asked. I tossed Jim the BP cuff and told Cupcake (Dave) to go get the backboard and straps from our ambulance.

By now, the patient had regained some consciousness and was looking at us, obviously unhappy about the tube down the throat.

"Sir! Don't fight the tube. It's helping you breath. I had to put a tube in your throat to help you breathe," my partner loudly told the patient, and surprisingly, he understood her and stopped fighting. She said to me, "I'm gonna give him some medication to help him tolerate the tube."

Once we got him stabilized, we slipped the backboard underneath, strapped him down, and lifted him to the cot. We found out from his girlfriend that he had COPD (chronic obstructive pulmonary disorder) and had not taken his breathing treatment that day.

In the ambulance, my partner asked fire to drive as she wanted me to help on the way. With lights flashing and sirens blaring, we took off down the road, things looking good.

Suddenly, he made a noise. We looked at each other, and it happened. He vomited. What looked like recently eaten chicken noodle soup came welling up, past the tube, running down his face, into his nose and eyes. I grabbed towels and started wiping, while my partner grabbed the suction and started suctioning. The guy was understandably freaking out and reaching for the tube.

"Sir! Sir! It's OK! You can breathe through the tube. Don't worry about vomiting!" Again, surprisingly, he understood us and stopped reaching for the tube. He crossed his hands on his chest and just looked at us.

At the hospital, we hustled the patient into the ER, and the staff burst into action. We quickly transferred him to the hospital bed and thankfully handed him off to the nurses and doctor.

It took us quite awhile to clean up the cot and the back of the ambulance, reviewing the call and what went right and wrong. While it had been stressful and physically demanding, it had gone well, and we felt we had been able to use our skills to truly help someone.

This was the type of call that make up for all the ones that are less than satisfying...