First Call by Myself

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NetMatrix

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Well Sunday night Monday morning at 00:10 the pager for the fire department I'm with toned for a 56 year old female that had a seizure and was not breathing. Now I'm not done with the EMT class yet and have not gotten my EMT license yet through the state. The final exam is tomorrow night in class. Well I had called the fire chief and asked him if he wanted me to go straight to the scene to assess the PT and start CPR if needed and he told me to hear over there asap. I only lived a 30 second walk from the PT's house. I got my truck grabbed a few of my medical supplies that I have and went to the house to assess the PT and start CPR on her. I got there knocked on the door the PT's boyfriend told me to come in and I introduced myself to him and told him I was with the fire department. I was EXTREMELY nervous cause I was there by myself with no assistance from anyone else. I asked him what had happened and he told me as I was walking over to the PT. I started to do a very rapid assessment of the PT checked her breathing which she was not breathing, check to see if she had a pulse which was absent. Her skin was very cool to the touch and pail in color. I cut her upper garments off and started to administer CPR to her. I knew right from the get go that she was to far gone and there was maybe a 5% chance of bring her back. There was about a 10 minute response time for the rescue unit at the fire department and a 20 minute response time for the ambulance due to their locations and road conditions. When the rescue unit arrived on scene one of our fire fighters/EMT jumped over me and applied the pads to the PT's check for the diffubilater. Another one of our fire fighters/EMT had the suction machine to suction the PT's mouth. We continued to perform CPR on the PT and was able to get 1 shock. The ambulance arrived at the scene so we got her on the long board strapped her down, and got her to the ambulance. We kept doing CPR the whole time we just had to change persons doing compressions due to the terrain. Anyhow the ambulance took her to the hospital and at the hospital she was pronounced dead.

It was rather nerve racking for this being my first time out on my own assisting a PT waiting for the rescue unit and the ambulance to arrive. After the call when the 2 EMT's that are also our fire fighters got back the the department (they rode with the ambulance to assist them) they told me I did a great job and stated that the PT was to far gone to really do anything for her. I feel good that I was able to do what I could do and what I have been trained to do. I'm really enjoying taking the class to become a EMT and I do look forward to working with more PT's in the future. It really sucks that she died, and sadly this PT won't be the last one.
 
NetMatrix said:
Well Sunday night Monday morning at 00:10 the pager for the fire department I'm with toned for a 56 year old female that had a seizure and was not breathing. Now I'm not done with the EMT class yet and have not gotten my EMT license yet through the state. The final exam is tomorrow night in class. Well I had called the fire chief and asked him if he wanted me to go straight to the scene to assess the PT and start CPR if needed and he told me to hear over there asap. I only lived a 30 second walk from the PT's house. I got my truck grabbed a few of my medical supplies that I have and went to the house to assess the PT and start CPR on her. I got there knocked on the door the PT's boyfriend told me to come in and I introduced myself to him and told him I was with the fire department. I was EXTREMELY nervous cause I was there by myself with no assistance from anyone else. I asked him what had happened and he told me as I was walking over to the PT. I started to do a very rapid assessment of the PT checked her breathing which she was not breathing, check to see if she had a pulse which was absent. Her skin was very cool to the touch and pail in color. I cut her upper garments off and started to administer CPR to her. I knew right from the get go that she was to far gone and there was maybe a 5% chance of bring her back. There was about a 10 minute response time for the rescue unit at the fire department and a 20 minute response time for the ambulance due to their locations and road conditions. When the rescue unit arrived on scene one of our fire fighters/EMT jumped over me and applied the pads to the PT's check for the diffubilater. Another one of our fire fighters/EMT had the suction machine to suction the PT's mouth. We continued to perform CPR on the PT and was able to get 1 shock. The ambulance arrived at the scene so we got her on the long board strapped her down, and got her to the ambulance. We kept doing CPR the whole time we just had to change persons doing compressions due to the terrain. Anyhow the ambulance took her to the hospital and at the hospital she was pronounced dead.

It was rather nerve racking for this being my first time out on my own assisting a PT waiting for the rescue unit and the ambulance to arrive. After the call when the 2 EMT's that are also our fire fighters got back the the department (they rode with the ambulance to assist them) they told me I did a great job and stated that the PT was to far gone to really do anything for her. I feel good that I was able to do what I could do and what I have been trained to do. I'm really enjoying taking the class to become a EMT and I do look forward to working with more PT's in the future. It really sucks that she died, and sadly this PT won't be the last one.
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That's great experience. Good job. But one question... You have no cert/license depending on your state. Granted, you did nothing past first aid.. Anyone can do CPR, but why were you on call and with a pager If you have no cert? Are you a FF? Departments I know would not have their personal respond without a cert or at least a preceptor at scene or on route with them.
 
I would assume the op has at least his CPR cert. I passed a scene before I was an EMT, was actually getting ready to go in the pizza place when a code was dispatched for that location. Of course I went in and started to work, ad let my ems chief know I was there.
 
The pager is what we have for both the fire department and ambulance service. Not everyone has a actual radio issued to them. The chief wanted me to respond to the call cause I'm certified to perform CPR, and it would take them a while to get to the scene cause of the distance and weather. The whole CPR deal is why he had me go there and with only being a few seconds away from the house. Also with the ride along time I had to do for the EMT class all of the EMT's we have with the fire department rode with me and was able to see how I act and manage PT's on the scene. Yes it was kind of one of those calls that can be questioned on them having me go, but with general first aid with cuts, burns, and other things I have been trained on with the fire department and CPR is one of them.
 
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I guess we start here...

Essentially, your Dept. Head dispatched you to a scene. If you had done something fatal and you weren't "quite" covered by your training then his butt would be in a sling.

Given that you didn't arrive in an "Official" capacity, accompanied by real Fire Trucks and Ambulances and the like, I question the sanity of choosing to cut the woman's clothes off before CPR, like, "WHO THE HELL ARE YOU???" might come up and slow your delivery of care.

(Unless, of course you're a whacker and showed up in turnouts!)
 
firetender said:
Essentially, your Dept. Head dispatched you to a scene. If you had done something fatal and you weren't "quite" covered by your training then his butt would be in a sling.

Given that you didn't arrive in an "Official" capacity, accompanied by real Fire Trucks and Ambulances and the like, I question the sanity of choosing to cut the woman's clothes off before CPR, like, "WHO THE HELL ARE YOU???" might come up and slow your delivery of care.

(Unless, of course you're a whacker and showed up in turnouts!)
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i'd prob shear em off.. better landmarks and its gunna hafta come off sometime in the future for the defib.. than again, landmarks can be established with clothes on. just a matter of preference
 
When I arrived at the PT's house I told the boyfriend who I was and let him know that I was with the fire department. Also he knows who I am and he knows I'm with the fire department. He sees me all the time responding to calls. But I still did the proper introduction when I arrived at the house. Before I cut the upper garments off his girlfriend I did tell him that I was cutting them off to expose the chest for compressions that it helps to keep from other injuries caused by garments. Then went to do CPR. Everything was explained to the gentlemen as I was doing it. On a legal stand point I'm certified to do CPR,a nd there is documents of other rescue calls that I was in the rescue unit and had to perform CPR, and those PT's did live, and them and their spouse sent me thank you cards for saving the life. The big part of it isn't because I haven't taken my state test yet. It's I'm certified to perform CPR which is all I did. Nothing else happened till rescue/ambulance arrived on scene.

rwik with our protocol shearing of upper garments are required due to a female that CPR was done on that had a push up bra with the under wire and that wire went into her chest as the compressions were being done.
Look at it this way your walking down the street you are certified to do CPR, but not a first responder or EMT (and never had training in those 2 areas.) Would you stop and do the CPR and tell someone to call 911 or what would you do. I didn't realize doing this post would cause a debate like this. I'm trained in some first aid situations, but I'm done posting on this thread.
 
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NetMatrix said:
When I arrived at the PT's house I told the boyfriend who I was and let him know that I was with the fire department. Also he knows who I am and he knows I'm with the fire department. He sees me all the time responding to calls. But I still did the proper introduction when I arrived at the house. Before I cut the upper garments off his girlfriend I did tell him that I was cutting them off to expose the chest for compressions that it helps to keep from other injuries caused by garments. Then went to do CPR. Everything was explained to the gentlemen as I was doing it. On a legal stand point I'm certified to do CPR,a nd there is documents of other rescue calls that I was in the rescue unit and had to perform CPR, and those PT's did live, and them and their spouse sent me thank you cards for saving the life. The big part of it isn't because I haven't taken my state test yet. It's I'm certified to perform CPR which is all I did. Nothing else happened till rescue/ambulance arrived on scene.

rwik with our protocol shearing of upper garments are required due to a female that CPR was done on that had a push up bra with the under wire and that wire went into her chest as the compressions were being done.
Look at it this way your walking down the street you are certified to do CPR, but not a first responder or EMT (and never had training in those 2 areas.) Would you stop and do the CPR and tell someone to call 911 or what would you do. I didn't realize doing this post would cause a debate like this. I'm trained in some first aid situations, but I'm done posting on this thread.
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I'm not chastising you in anyway or criticizing you for responding. You've got to understand that debates like this happen all the time in this forum, and you shouldn't take any criticisms personally. Around me its different than say where you live. I think people could see what you do in many different ways; a) you do have a cpr cert and the experience helped you gain more confidence, and its the judgment of the chief, whoever to decide wether or not to have you respond. B.) some people on this forum will see what you did as irresponsible on the side of the chief and being you had no EMT certification, had no right to respond to a call without a supervising individual

although having a CPR card and running into a cardiac incident at the mall and doing compression until ems arrives is much different than responding on behalf of an agency with a CPR card.. not the best analogy. Im not aware of the Good Samaritan law in your state, and whatever it covers... much in the situation where you did compressions, say broke a rib and punctured a lung, you could be able to get in trouble. Yes, she is pretty much dead whatever, coding, but a lawyer could see fault in a non-certified person responding to a call.
 
NetMatrix said:
...When the rescue unit arrived on scene one of our fire fighters/EMT jumped over me and applied the pads to the PT's check for the diffubilater. Another one of our fire fighters/EMT had the suction machine to suction the PT's mouth. We continued to perform CPR on the PT and was able to get 1 shock. The ambulance arrived at the scene so we got her on the long board strapped her down, and got her to the ambulance...
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I have two comments, both based on the parts of your quote that I highlighted.

1. "diffubilater" This has got to be the bestest misspelling of defibrillator that I've ever seen. :D

2. Why was the patient put on a long board? Doesn't seem indicated to me.
 
The long board is for movement and so you are doing compressions against something hard.
 
JJR512 said:
I have two comments, both based on the parts of your quote that I highlighted.

1. "diffubilater" This has got to be the bestest misspelling of defibrillator that I've ever seen. :D

2. Why was the patient put on a long board? Doesn't seem indicated to me.
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I have a hard time spelling that word. She was put on the long board to get her on the cot and to continue CPR. The pad on the cot is really thick and soft. Thick meaning it has a lot of padding in it. Also with where the patient was located at the the structure of the house. It was impossible to get the cot in there, and the paramedic wanted her on a cot. Plus with being on the back board (long board) able to do the compressions without the body being pushed down into the padding on the pad on the cot. That's also more protocol for our region. If they are trauma they go on the back board and she was trauma.

One of these days I'll learn how to spell defibrillator correctly. Our abbreviation for that in which we can put on the report is defib.
 
Ok I found my mistake. I forgot to put in that she was put on the cot then loaded into the ambulance. Well at least I didn't make that mistake on the report for the fire department. Sorry about that one was in a little hurry when I was typing the starting post.
 
What made the patient a trauma? I understand the board for movement and compressions but how was the sz a trauma?
 
1. What would have changed, for us, if the OP was a representative of the volunteer Fire Department, responding as a First Responder (which does not require state certification, only the completion of a class)? He was dispatched as a fire person, arrived (and identified) himself as a fire person, and acted well within the SOP of an FR. Let's forget the (absent) EMT credential...

2. OP, Can I teach you the Enter and Tab buttons, please... to create paragraph breaks, or even indent?

3. If you were putting the patient on a board for trauma (which I think we disagree with), did you apply a collar and blocks? Strap the patient down?
 
emt.dan said:
1. What would have changed, for us, if the OP was a representative of the volunteer Fire Department, responding as a First Responder (which does not require state certification, only the completion of a class)? He was dispatched as a fire person, arrived (and identified) himself as a fire person, and acted well within the SOP of an FR. Let's forget the (absent) EMT credential...

2. OP, Can I teach you the Enter and Tab buttons, please... to create paragraph breaks, or even indent?

3. If you were putting the patient on a board for trauma (which I think we disagree with), did you apply a collar and blocks? Strap the patient down?
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Ok I'm seriously starting to get tired. Don't ask about the trauma part. I've been studying that part of the EMT book all night, and trauma is really stuck in my head right now.
 
emt.dan said:
3. If you were putting the patient on a board for trauma (which I think we disagree with), did you apply a collar and blocks? Strap the patient down?
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I can sort of understand using the long board to move an unresponsive patient out of an area if you can't get the stretcher into that area. In this situation, I don't think the collar and blocks would really be necessary.

I can sort of understand using the long board to be a hard surface for CPR, but I have to wonder what kind of stretcher mattresses they're using that are so different from standard stretcher mattresses, which in my admittedly limited experience (and always seeing, never doing), have always seemed fine for CPR. In this situation, just as the previous one, I don't see that the collar and blocks would really be necessary.

What I don't understand at all is the new claim that the patient was a trauma. I can understand that a patient, during seizures, might physically injure herself, whether from falling down or from striking something while seizing. But I don't think that kind of injury would be a significant enough mechanism to warrant a long board. Of course, I wasn't there, and perhaps there are additional details of which we have not yet been made aware.
 
The long board does make a difference with CPR. As someone who has done compressions with and without the LSB on the gurney, you can feel the difference, mainly in smaller patients IMO.

I have a feeling this is a trauma per protocol situation. You would be amazed how many simple fall-from-standing patients get back boarded because they are a "trauma".

By simple I mean people who just fell down. No boucing off of dressers or concrete steps or whatever.
 
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Aidey said:
The long board does make a difference with CPR. As someone who has done compressions with and without the LSB on the gurney, you can feel the difference, mainly in smaller patients IMO.

I have a feeling this is a trauma per protocol situation. You would be amazed how many simple fall-from-standing patients get back boarded because they are a "trauma".

By simple I mean people who just fell down. No boucing off of dressers or concrete steps or whatever.
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With the different protocols not all trauma requires a c-collar. On a technicality with some protocols just a simple abrasion to the knee just from falling off a bicycle. That type of injury is considered to be soft tissue trauma. With this lady yes there could have been trauma caused when she fell.

With our protocols when a patient is unresponsive with no pulse and no breathing that patient is considered to be a trauma patient, because there is a life threatening situation.

With our stretchers we have the automatic style (I don't remember exactly what they are called) they have a up and a down button on them. It's all electric. It does have a thicker pad on it than standard cots have that I have personally seen, but they are also brand new. The brand new pad since there has not been enough patients to wear it down yet is 3 inches thick.

With the first responder there is a certificate that you do receive once you complete the class for it. I'm not a first responder, but I am a medical technician. I went to college for that 3 years ago; I just never got a job at a hospital for that training. So I do have the basic first aid training. Plus all the training we are required to have with the fire department in regards to first aid.

Yes some people will question the chief sending me over there to assess the patient and perform CPR. I called and asked because of the ice on the roads I knew for a fact the response time for them to arrive was doubled because of the snow and ice that was on the roads. The area that me and the patient live at is a little village out in the country. Roads aren't taken care of very well. To me making that phone call and the chief telling me to go over there with the short amount of time I got there I was hoping would save her life. Sadly her life was not able to be saved...
 
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