“Just do your best. That’s all I can ask”. Mom said those words to me many times. It was an important life lesson.
Those Words Apply Even now, in Retirement
Of course, Mom referred to schoolwork when I was growing up, but I have found these words to follow me throughout life.
I became an EMT at 63 years of age. I wanted to do something to give back to the community and to “stay busy” (as if that’s a problem) in retirement. For 45 years, I have been busy working, often 6 days a week, 12 hours a day. Being an EMT has become my new work, even though I’m a volunteer. Some of the work is daunting, and on my clipboard, I have a sticker that says, “Even when I think I can’t, I have to”—Mom’s words, albeit a different phrase.
Notably, this was never more true than on Christmas Eve.
The worst kind of ambulance call
On Christmas Eve, my husband (who drives the ambulance) and I took a call about a “sick person.” I found a man lying in bed, in severe respiratory distress, who literally could not move. His arms and legs were stiff, and his respiratory wheezing could be heard from the doorway. His family said he’d gone downhill in the last 5-6 hours but had been sick for at least 5 days. He wasn’t eating. He’d been drinking only a little.
The patient was up a steep flight of stairs in a small bedroom at the top of the landing. After taking his history and a quick exam, we placed him onto a stairchair, which is a chair with two sets of handles and a mechanism for going down steps. As soon as we reached the top of the stairs, he went into respiratory failure, then cardiac failure, right in front of me. Furthermore, his family stood around us, waiting for me to do something.
CPR was started and continued for about 45 minutes. Other EMTs were called in to assist and quickly transferred into the ambulance. We then linked up with another ambulance service with two paramedics. The hospital was alerted 10 minutes out to have staff ready when we arrived. A group of 6 or 7 nurses and doctors greeted us to take over.
Mom’s Advise
Though I didn’t consciously think it, those sayings followed me. I had to do this. I had to kick into automatic mode from all my training, start CPR and put him on a monitor and defibrillator. Breathe for him. Monitor his carbon dioxide levels. It all happens very fast; a person’s life depends on having a team do these things. Suffice it to say it is incredibly stressful and not something one actively wishes to go through.
Only my best and all those other EMTs helping could keep him alive. Only my best would do.
Experience Helps
Previously, I went through something similar with another patient only a few days ago, but I was with a paramedic on that call. The paramedic was in charge and just called out what he wanted me to do. I learned a lot on that call.
And here we were, less than a week later, with the same thing happening on my watch. In as much as I had been walked through many of these steps, training kicked in, and movements became automatic, step by step. There are protocols to be followed. It’s all written in state codes with what to do and when. Defibrillators are automatic, which times the CPR cycles and tell us when to stop and stand clear while it reads any heart activity and decides if there is a shockable rhythm. By the way, you don’t shock a dead person, regardless of what is portrayed on TV. Shocking only works for a couple of abnormal heart rhythms, temporarily stopping the heart and letting the electrical impulses reorganize into normal activity.
Although I lacked much exposure to heart failure and cardiac arrest, I had all my training and last week’s experience to do this.
My Advice
Conclusion: Learn how to do CPR. Knowing could save a loved one. Here’s the Red Cross site. Take a local class. Red Cross and the American Heart Association offer them all the time. Your local fire department might even offer one. Likewise, many community groups and schools also offer courses.
Furthermore, if you or a family member has chronic diseases that could suddenly become life-threatening, make sure the paperwork is in order. Have a Do Not Resuscitate (DNR) order if you wish. Work with the patient’s physician for a MOLST (Medical Orders for Life-Sustaining Treatment), which will outline what medical procedures you wish to have implemented (or don’t want to be implemented).
Have a will and health care proxy forms. Give someone you trust authority to make decisions on your behalf for medical conditions when you can’t make them yourself. Let the family know your advance directives regarding medical procedures and where documents are located. These forms must be presented to the first responders or medical staff to ensure your wishes are followed. We must see the original signed forms. First responders and doctors can’t follow verbal statements or a faded copy. Paperwork really counts here.
I hope you never have to experience a scene like the one above. But the unexpected happens in the blink of an eye. It’s better to be prepared. Do your best. That’s all I can ask.
The Outcome
Equally important, my patient regained a heartbeat in the hospital before we departed. He may or may not live. But I did what I had to do, and hopefully, his family gets to see him on Christmas Day. Our team just did our best.
