The call comes in.
Our truck lurches forward, the lights bouncing and the siren echoing off of the houses we fly past.
“Priority one,” Dispatch says flatly. “MVA, pedestrian struck.”
The driver steps on the gas pedal, diesel surges through the truck. I’m just the student in back. Adrenaline surges through me.
What will we need?
Did we pick up that backboard after we dropped the last patient off?
Where’s the tape? I know I picked it up, where did I put it?
Collars. Towel rolls. Suction supplies.
Where the hell is that backboard tape?
IV supplies. I’m probably going to need those.
I can feel the truck slowing down. We’re nearing the scene. I look through the front window in an attempt to grasp what we’re rolling up on. I can see a younger female bagging what looks like a child on the street.
Fuck.
Not a kid. Not again. Not twice in one week.
I toss the airway bag onto the stretcher along with the rest of what I thought we might need.
He’s laying in the street in a pool of blood. Laying there, with his blond mohawk and dirty fingernails and Batman tshirt. With his long eyelashes and chubby cheeks.
My heart breaks.
His lips were already swollen. Blood was running freely from a large lac on his head that extended down the side of his face.
A crowd is forming. People are crying.
My hand are shaking. The boy reminds me of my Son.
I have what we need at my side. I just pray that this time I’m not called on.
“Epi…”
“EPI.”
“EPI!!! You have this.” He hands me the tube and laryngoscope.
I instantly felt my stomach turn.
Focus, girl, focus.
It hits me. His belly is huge and the BVM is making an awful squaking noise.
“Jeff, take the bag from her.” He does.
I check my equipment. Everything is as it should be.
“Stop bagging.”
I hold my breath and open his airway.
Fuck.
That is a lot of blood.
“Suction!” I yell, louder than I mean to.
Sean, a classmate and the partner of my preceptor, does his best to clean out his airway so that I can see something. Anything.
I take another look. I see chords, but they’re quickly submerged.
I start cussing.
“Suction him again.”
Fuck.
The patient’s Mother just pulled up. She’s being restrained by a friend or family member and a police officer.
She’s screaming.
Oh Jesus, please let me get this tube. Please.
I go in one more time. I see white chords and I stick the tube in, inflate it, and have Sean listen over the boy’s stomach and chest.
“It’s good, Epi. Good tube”
Jeff keeps bagging.
I finally exhale. For the first time in four minutes, I’m able to breathe.
Oh thank God.
“Let’s get the hell out of here, please?”
We load and go.
ETA: 6 minutes. Level 1 trauma center.
“Epi?”
“Yeah Jeff?”
“You rocked that, girl.”
Thanks, Doc.
**********
“We did everything we could.”
“His injuries were…”
“We’re so sorry.”
“I’m sorry.”
I doubt that his Mom and Sister heard anything that was said by anyone. Not the ER nurses, not the Docs, and certainly not us.
Know this, Mom.
I’m sorry.
I did everything that I could.
We all did.
And I wont forget him.
Oh, Epi. Tough day. :-(
Glad you were cool in a pinch. And you know that those opportunities for a tube are always a bad situation, often getting worse.
Hang in there. Let it make you stronger.
It has been a tough week here, too.
Oh man, can’t you catch a break?
Hugs, sister. :(
Jesus Epi!
I hope you are okay. Trial by fire, most definately, but you did good.
I feel so lucky that I have missed a job like that so far for the last 9 years!
You had my heart in my mouth reading that one.
You did all you could, and you got a very tough tube.
Rule 1: People, including kids, die.
Rule 2: You can’t always change Rule 1.
You’ll make a fine medic, Epi.
My heart breaks just reading that, thinking of my own six year old son and hoping I never had to roll up on what you did. You were right – you did all you could do, and you did it with passion and caring. Are you doing OK ?
Been there. Well done, despite the outcome. It never gets any easier. And I remember most of them, too.
One. big. Hug.
Wow, Epi.
I can’t add much to the above, but hang in there. Calls like this never get better, but they don’t come every week.
Nice job. But also remember that the tube is not everything, especially with pediatric patients. Some studies suggest not to tube them. If you become fixated on that as a new student you may forget to maintain c-spine, ventilate the patient with a good old fashioned BVM, stop life threatenting bleeding, etc. Don’t get stuck on your “tube, tube, Tube, TUBE!” chant. Keep breathing yourself and get the kid to the hospital. That having been said, blood filling the airway is a good reason to tube, but the outcome you got was inevitable. Learn from the stressful experience, go home see your own kids, come back to work, rinse and repeat. Good job.
Wow. I know that it is hard to do but good job on getting the tube. Trial by fire is hard as it, but good job. Also as always very well written.
You did everything you could to give the docs a chance to save the kid. Sometimes all we can do is not enough, but we have to know that we at least fought the good fight and got them to the hospital as quick as we could. Despite what Buckman said, the tube here was definitely necessary, cause it sounds like the airway was comprimised and needed to be secured. Great job on the tube, pediatric intubation is the toughest skill to master.
Honey, don’t ever forget that you did the very best you could under what sounded like really shitty circumstances. And when that was done you took care of your secondary patient’s – that boy’s family.
Sometimes this is more important. But you already know that.
And I’ll echo what some others have said: when the rubber meets the road, you will become a damn fine medic – I have no doubt about that.
Sorry you are having a rough time….*hugs*
Pedi calls are tough, no one enjoys them even a little bit. Still, you kept your composure and did a good job, including the tube. We can’t always make a difference, but we can always try.
What you did on scene may not have stopped that poor boy from dying, but what it did do was show the family that all that could have been done was done, so that they never have that doubt, that their son might have lived if… It’s not much, but it’s sometimes all we can give.
Ans, as for what Buckman said, if the bvm is ineffectual, tube, tube, TUBE!!!
aw, epi, that’s a rough one. Damn. You kept it together long enough to protect that airway and get him packaged, though. Good work, even though it has a sad ending.