# First paediatric arrest



## AusMed (Jun 27, 2009)

Well the one thing I have dreaded the most happened in the early hours of this morning at work. the phone rang at station and I was told we were responding to a cardiac arrest. I got to the car to check the MDT and the job description was _4 month old male, ? cardiac arrest_. My heart sunk. I called out to my partner and told her we are going to a kiddie code 2 (our code for cardiac arrest). She didn't believe me until I said a second time and then she just looked at me.
We started responding and asked radio where our IC back-up was coming from....10 mintues away.... we are only 5 minutes from the job. My partner looked at me and said... " S*^!, we are going to be first on scene ". Neither of us had done a paed arrest yet and we are both 'new' in the job (both within 2.5yrs service). We decided enroute that we would start working on the bub, seeing as though neither of us was comfortable with calling a child deceased, decided that we would wait for IC to arrive and let them make the call.
So we get to the address, go inside and find dad doing fairly effective CPR on the child (with instructions being given over the phone by the calltaker). The bub looked pale and was cold to touch. No output was present and was monitored in asystole. 
I was on the airway and when putting in an OP airway, the jaw was tight but able to be moved a bit to allow the OP in.
After what felt like an eternity (only 5 minutes) the IC arrived on scene. During this time Police had also arrived and we had given them a quick heads up of what was going on. Once IC was on scene, we all agreed that the bub was deceased and had been for some time. We continued working for another couple of minutes while the IC spoke with the parents and explained what was going on and that we were about to stop resuscitation. The scream from the mother is something that I will not quickly forget.

We stopped resus and I took the gear outside to the truck, which also gave me some time to compose myself before heding back into the house.
After about 10 minutes, we left the scene with Police to handle the job.

Now this bit gets me annoyed......We were sent back to station to clean up and debrief yet 5 minutes after clearing from this job, radio put us on another code 2 in the area. WTF!
Thankfully the duty inspector was listening and over-ruled this decision and sent us back to station to meet him and de-brief. I don't know how I would have gone having to do another code 2 in such a short time frame.


Sorry if this has brought any gremlins back for anyone, just wanted to get it out there.


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## PapaBear434 (Jun 27, 2009)

My very first call after being released was an 8 month old cardiac arrest.  Hadn't been down as long as yours, because he was still warm.  It was two days after my own second born daughter turned 8 months old.

I've mentioned that a few times on these forums, and I've also mentioned this:  That kid was going to die whether you there or not.  That second code was going to happen whether you were there or not.  The calls after that would have had the car accident, swallowed too many pills, and had a stroke, all without you being there.

At least with you there, you gave them a better chance than had you not been there.  

Keep that in mind, and don't try to take it on yourself.  Putting yourself in their place and carrying that baggage won't do you or any of your future patients any damn good.


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## Melclin (Jun 27, 2009)

+1 on the ^. Keep talking about it too. Tell anyone who'll listen. Don't make it all your problem.


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## downunderwunda (Jun 27, 2009)

Mate,

seek out peer support.

If you dont feel comfortable with anyone there, send me a PM. I am peer support & I will contact you.

Wunda


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## willbeflight (Jun 27, 2009)

I know that must have been incredibly tough.  I am so sorry!  You did all you could do and now, you have to give it to someone else.  Let your peers help you through this!!  That is what this forum and people on here are for.  

Also, How is your partner doing?  Is she handling it ok?


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## JonTullos (Jun 27, 2009)

This is what I dread the most about being in EMS.  I'll be fine during the call but it may take a bit afterward to get back in my right zone.  I'm sorry you had to go through that.

When my dad was on the fire department he responded to an apartment building on fire.  The paper snapped a picture of him carrying out a dead baby he found in there.  He said there's still not a day that goes by that he doesn't think about it, but he knows that he did his job and that he saved a lot more than he lost.  He takes a lot of comfort in that.


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## FF-EMT Diver (Jun 27, 2009)

Well it sounds like you stayed calm even though you both were nervous being your 1st Ped arrest.

My 1st was with a partner who can get overly excited and he did so on this call it totally throws the situation out of control and also causes you to doubt yourself in the end if you're spazzed about it.

My 2nd was in my county where I volunteer and I heard 911 give the call it was 6 miles from my house and some people I knew from cutting their grass ( l do lawn care as well) our ambulance was tied up on a call 12-15 miles away, I responded POV to find a cold cyanotic 3 mo old with grandmother doing ineffective CPR so I resumed it and decided to let On-Duty Ems make the call. It took about 10 min for them to get there and it felt like an eternity.

As has been said if you need to talk....I'm a few keystrokes away.


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## Tincanfireman (Jun 27, 2009)

AusMed said:


> Thankfully the duty inspector was listening and over-ruled this decision and sent us back to station to meet him and de-brief. I don't know how I would have gone having to do another code 2 in such a short time frame.


 
First of all, kudos to your supervisor for having the presence of mind to take you OOS until you had a chance to unwind.  Secondly, while I'm sure you are aware your treatment options were nil on this obviously deceased child, you did what you could for the parent's sake until it was time to call it.  While you couldn't do anything for the child, the parents will remember your efforts and kindness for a long time.  We can't win them all, but we can always go the extra step to make it easier for the loved ones of the deceased.


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## AusMed (Jun 27, 2009)

Wunda,
Thanks for the offer mate. I have a few people that I am currently talking with. Will keep you in mind if needed.

Everyone else,
Thanks for the support and offers to talk. First night sleeping post incident and I tossed and turned for a little bit but once off to sleep, no nasty awakenings.
We both kinda knew the baby would probably be deceased but didn't want to be the crew to call it, especially when the father was already doing CPR when we got there.

Willbeflight,
My partner seems to be doing ok also. She is only 12 months older then me and we got along really well. We have been keeping in touch via email and phone over the last day (as we are now on days off).

Again, thanks all for your support. It's great having a place like this to be able to 'spill your guts' to others in the same type of work.


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## willbeflight (Jun 27, 2009)

That is what we are here for!!!


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## atropine (Jun 28, 2009)

AusMed said:


> Well the one thing I have dreaded the most happened in the early hours of this morning at work. the phone rang at station and I was told we were responding to a cardiac arrest. I got to the car to check the MDT and the job description was _4 month old male, ? cardiac arrest_. My heart sunk. I called out to my partner and told her we are going to a kiddie code 2 (our code for cardiac arrest). She didn't believe me until I said a second time and then she just looked at me.
> We started responding and asked radio where our IC back-up was coming from....10 mintues away.... we are only 5 minutes from the job. My partner looked at me and said... " S*^!, we are going to be first on scene ". Neither of us had done a paed arrest yet and we are both 'new' in the job (both within 2.5yrs service). We decided enroute that we would start working on the bub, seeing as though neither of us was comfortable with calling a child deceased, decided that we would wait for IC to arrive and let them make the call.
> So we get to the address, go inside and find dad doing fairly effective CPR on the child (with instructions being given over the phone by the calltaker). The bub looked pale and was cold to touch. No output was present and was monitored in asystole.
> I was on the airway and when putting in an OP airway, the jaw was tight but able to be moved a bit to allow the OP in.
> ...



That's your job, to run calls, not whine about them.


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## AusMed (Jun 28, 2009)

atropine said:


> That's your job, to run calls, not whine about them.



If your going to be an arse I'd prefer that you keep your comments to yourself.

My issue with this was that there was a crew who had both just attended their first paediatric arrest. There were other cars in the area who were able to do the second arrest, but because we were 1 minute closer we were put on it. We were not even technically restocked to do the job.

I'm sure jobs don't effect you at all. Apologies for not being as hard as the awesome FF/Medic that you are.

This site is supposed to be to support one another, not knock them down when they have done a difficult job.


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## atropine (Jun 28, 2009)

AusMed said:


> If your going to be an arse I'd prefer that you keep your comments to yourself.
> 
> My issue with this was that there was a crew who had both just attended their first paediatric arrest. There were other cars in the area who were able to do the second arrest, but because we were 1 minute closer we were put on it. We were not even technically restocked to do the job.
> 
> ...



So what, if you wern't restocked why did you take the call?, who says I don't support one another, but this is you chosen job, until something else comes along at least.
We run calls all the time 16  calls out of a 24 hour shift, so no sympathy from buddy.


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## AusMed (Jun 28, 2009)

atropine said:


> So what, if you wern't restocked why did you take the call?, who says I don't support one another, but this is you chosen job, until something else comes along at least.
> We run calls all the time 16  calls out of a 24 hour shift, so no sympathy from buddy.



We didn't take the call. The way our service is run, co-ord simply tell you where your next job is. Before we could say anything, the DI got on the radio and stated that we were to return to station for debrief and co-ord was to find another car.
In my area we generally do 10-14 jobs in a 12 hr shift mate.

I was simply trying to vent a little after a big shift. I wasn't looking for people to tell me to stop whining and just get on with my job.
Seems as though we may have differing opinions on how to look after staff that have been through a stressful job. Looking after your staff is one way to help keep them in the job.
This is something that I want to do for a long time, so I feel that adequate debriefing after certain jobs is necessary and important. 

As always, things are done differently in different parts of the world.


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## CAOX3 (Jun 28, 2009)

atropine said:


> So what, if you wern't restocked why did you take the call?, who says I don't support one another, but this is you chosen job, until something else comes along at least.
> We run calls all the time 16  calls out of a 24 hour shift, so no sympathy from buddy.



That was supportive.  

Yes we all choose this job so we should never complain, ask for help, support or advice?  :wacko:


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## downunderwunda (Jun 28, 2009)

atropine said:


> So what, if you wern't restocked why did you take the call?, who says I don't support one another, but this is you chosen job, until something else comes along at least.
> We run calls all the time 16  calls out of a 24 hour shift, so no sympathy from buddy.



It is amazing how ignorance abounds.

Yes it is our job, but it is not a normal situation to be confroneted with. Everyone reacts differently. We need to be mindful of this or we will burn out.

I would rather see a crew off the road, given time to make sure they are OK & get on with it. We are talking 2 junior inexperienced officers here, a bit of support now will see them through for the long haul.

Grow up


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## medic417 (Jun 28, 2009)

AusMed said:


> .We were sent back to station to clean up and debrief yet 5 minutes after clearing from this job, radio put us on another code 2 in the area. WTF!
> Thankfully the duty inspector was listening and over-ruled this decision and sent us back to station to meet him and de-brief. I don't know how I would have gone having to do another code 2 in such a short time frame.
> .



That is life in the medical profession.  Some doctors and nurses code multiple babys in a day.  So how do you do it?  You think of the body as a machine.  When broke you try and fix it.  When unfixable you kindly explain that to the patient or family.  You are compassionate but allowed to keep your distance thus you can move forward.  Often going right back to work is better than stopping to debrief as you don't dwell on the call that way.


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## AusMed (Jun 28, 2009)

medic417 said:


> That is life in the medical profession.  Some doctors and nurses code multiple babys in a day.  So how do you do it?  You think of the body as a machine.  When broke you try and fix it.  When unfixable you kindly explain that to the patient or family.  You are compassionate but allowed to keep your distance thus you can move forward.  Often going right back to work is better than stopping to debrief as you don't dwell on the call that way.


Yes but we are not doctors and nurses doing this in the 'safety and familiarity' of a hopsital setting. We are doing this in other peoples homes or out in the street. We are turning up and seeing a parent crying whilst doing CPR on their child. By the time a pt gets to hospital they have generally been 'packaged' by us and are ready for the doctors/nurses. 

I do understand that you have to distance yourself from what is happening to the patient and I have been to other jobs whereby the pt was pronounced deceased on scene. I just think that different emotions happen when it is a child, especially such young ones.

My main point to this was that it was two reasonably new and inexperienced officers attending their FIRST paediatric arrest, who were then expected to attend another arrest without first being checked to make sure that they were coping with the last job they had just done.
I'm sure that of those that have experienced this type of job, no one can say that their first one did not have some type of emotional effect on them (even if it was only a minor one).

Thanks to all those that have shown support, it is appreciated.


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