Your first code

My first code wasn't on a human.

I was a vet. tech student doing an externship. A puppy was getting some extensive orthopedic surgery to correct a birth defect. I don't remember what I was doing at the time, I wasn't involved with the surgery itself. They had just snapped an x-ray to check the placement of the pins before finishing closing up, when the monitoring equipment started showing warning signs. They hurried up to close the site, while letting everyone else know to be ready in case her heart stopped.

She coded, and all of a sudden there was a lot of orders being shouted. The crash cart was called for, and I was directed to bag her. Another vet tech was told to fetch the epinephrine from the fridge. One vet was doing chest compressions, while the other was injecting drugs into her vein.

We got her back, and they finished putting her leg into a cast. We all kept a very close eye on her for the rest of the day.

The next morning, she was on her feet and acting like a normal puppy would, with a huge cast on a leg.
 
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My first code was as an EMT-B student. I was doing my ride time with an FD run ambulance, so when we got on scene, there were already 5 paramedics and a couple LEO's running the code. They were intubating when we got there, and they had me start on compressions. I did about two minutes of CPR, then a LEO took over, then they called it.

My first code that I was running was a 54 yo M that went to a local clinic with chest pain. Updated en route that it was now a code 99, and when I got on scene, the clinic staff and FD were in the parking lot with the AED. They had already shocked once, and then I got there, switched him over to my monitor, shocked him again, and started a line. Next pulse check I found a weak carotid with vtach on the monitor. I cardioverted him and he converted to sinus rhythm, within a minute he had opened his eyes, and attempted to sit up. Once in the ambulance, he started asking questions about what happened, then he said he was going vomit...then BAM. Projectile vomit everywhere. EVERYWHERE. He ripped my IV out somehow, and I spent the next 10 minutes of transport getting another line in, and trying to clean off the cables so I could actually get a 12-lead. Either way, he's still alive with no neuro deficits.
 
sorry i mean 5 min after they found him (the FD said it was probably 10) but it was not a very reputable home to say the elast
 
My first DOA bothered me.. It was kind of hard to eat after it. My first code didnt bug me at all.. I was working with a really cool/experienced medic that made me feel comfortabe, so that probably helped.
 
My first code was my first call after being notified I had passed, but had yet to receive my card in the mail. The Asst. Chief and myself roll up to find bystanders doing CPR on a man wedged between a snowbank and a car.

I jump out, grab the O2 and Defib, and walk up to the patient. While prepping the AED, I look around for the AC and he's still in the truck on the radio. We get a couple of shocks in, drop a combitube, and the medics arrived a few minutes later. Pt. was awake and talking to them in the ambulance but died of a second heart attack later that night.

It was the only time I remember seeing latex gloves crack from the extreme cold.
 
My first and second code happened one week apart from eachother. 0530 got the unresponsive male call at the local motel. Arrived to find a 19yo male unresponsive on the floor next to the tub and the state trooper already doing compressions. I jumped right in (sternum was already broken) and continued with compressions but we never got him back...(investigated as possible homicide, there were 2 other males in the room 21yo and 23yo and they were "playing video games" and wrestling when they found him on the floor (at 0530....and coroner results showed water in his lungs..drowning?)) That sat with me for a while (given his age) and then a week later got another call 0745 for an unresponsive male at the local motel....you guessed it, walked in and you could hear the AED as soon as you steeped into the hallway. I got to the room and a local cop was alreaday working on the patient (who was cold to the touch but according to his friend he dropped right infront of him within the last 5 minutes). I jumped right in and started compressions and this time i cracked the sternum but the guy again did not make it. This one stuck with me two not becuase it was yet another code (it was an older man) but because I cracked the ribs. That is a feeling/sound that is hard to forget.

Lesson learned from these two calls:
1. The world keeps turning, we cant save them all. Some people are already passed the point of being saved before we even step through the door.
2. When going to a call (especially as a new EMT) you will be nervous, excited, feel unprepared.....however once you get there your training kicks in and you just start analyzing the situation and treating the patient.
 
My first code was in the ER during clinical. It was an older man who arrested as the medics rolled into the trauma bay. He was just in a MVA rollover and had multiple injuries and was bleeding out all over (on Coumadin and ASA...ruh roh). The nurse helped me get all gowned up and ready to go and then the Dr told me to wait and told the med student to do CPR. This kid did the most pathetic excuse for CPR I have ever seen, really slow basically no depth just slapping the patient. He definitely needed the practice. After about 30 secs of that the nurse took over and did a round and them grabbed me and let me go. I did a round and we got ROSC after a few units of blood got pumped in.
 
My first code was UP, UP, A, DOWN, B, B, LEFT, RIGHT, RIGHT.

My "patient" instantly got ROSC and got unlimited lives to boot. :ph34r:
 
duckandcover said:
Lesson learned from these two calls:
1. The world keeps turning, we cant save them all. Some people are already passed the point of being saved before we even step through the door.
2. When going to a call (especially as a new EMT) you will be nervous, excited, feel unprepared.....however once you get there your training kicks in and you just start analyzing the situation and treating the patient.
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Thank you very much for the words of wisdom. :)
 
I had volunteered on two overnights. The first was an old, extremely overweight woman in a nursing home who had been long gone. The medics I was with were nothing but stellar. She had severe effusion and rigor mortis.

The second was really saddening- a relatively young man just married and with a baby. He was overweight as well and was found lying on his bedroom floor. To this day I still wonder what happened to him and I get upset thinking about his poor wife.

Both in just one week's time! All I can say is I hope this job doesn't make me jaded.
 
oogemsquagger said:
i hear that epi can also be given with a nebulizer? would that have gotten a pulse back? not that it would have mattered since the nursing home waited so long, he would have been brain dead if we did bring him back.
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Typically epi is nebulized for croup. (Some places may give it for other respiratory issues, but that is the only time I can use it in my corner of the world.) It isn't going to do anything in a cardiac arrest, except waste the epi, since your patient would need to be breathing (although it may not be very well) to be given a nebulizer. We used to put drugs down the ET tube and bag them in, but we don't even do that anymore.

My first code was a 60-something gentleman who dropped in the middle of his living room while talking to his wife. It had to be VT/V-fib since the medic shocked him. We did get him back, and he was discharged with pretty much no deficits.

After getting a few more codes under my belt, I couldn't help but think how ironic it was for my first one to be a save, when most people don't survive, and of the few that do, most have some sort of deficit. I've always thought of it as a false representation of the job, even though I was super pumped about it at the time.
 
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During EMT clinicals at the hospital, EMS brought in a patient in asystole with unknown downtime (patient took a nap and never woke up). If the patient arrives in the ED in asystole, most likely they will leave the hospital in asystole. Also, based on the radio report, the RN had the body bag already set up like a mattress cover on the gurney.

When all was said and done, I went back to helping with other patients.
 
Never had a PT saved when CPR was involved at any point, and I've been going at it for at least a little while now... Although, I have been involved in plenty o' rapid transports to cath, respiratory palliation/alleviation, or cardioversion that arguably resulted in a save.

First code was a 27 yo F, down for ~20 minutes prior to being found by boyfriend. PT had Hx of drug abuse and was, "well medicated," PTOA. Of course it was in a hotel, and not a nice one. It was my first day precepting as a Basic for a job running 911. It was the first time I saw anything valuable performed in the field, and it was an eye-opener in regards to what I knew, what I didn't know, and how much there was to learn. Still learning today...

Discussion Points:

1. Why on Earth do so many damn people crunk out in hotels? Seriously!
2. As some else already stated, when it came time to play that first time, it's amazing how much of your training comes roaring back, no?
3. I am in hate with you if your first code was a save.
 
JPINFV said:
During EMT clinicals at the hospital, EMS brought in a patient in asystole with unknown downtime (patient took a nap and never woke up). If the patient arrives in the ED in asystole, most likely they will leave the hospital in asystole. Also, based on the radio report, the RN had the body bag already set up like a mattress cover on the gurney.

When all was said and done, I went back to helping with other patients.
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Heh, we do this routinely no matter what the radio report is. . .
 
Epi-do said:
Typically epi is nebulized for croup. (Some places may give it for other respiratory issues, but that is the only time I can use it in my corner of the world.) It isn't going to do anything in a cardiac arrest, except waste the epi, since your patient would need to be breathing (although it may not be very well) to be given a nebulizer. We used to put drugs down the ET tube and bag them in, but we don't even do that anymore.

My first code was a 60-something gentleman who dropped in the middle of his living room while talking to his wife. It had to be VT/V-fib since the medic shocked him. We did get him back, and he was discharged with pretty much no deficits.

After getting a few more codes under my belt, I couldn't help but think how ironic it was for my first one to be a save, when most people don't survive, and of the few that do, most have some sort of deficit. I've always thought of it as a false representation of the job, even though I was super pumped about it at the time.
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This. When you nebulize a drug, you also off-gas it. Take a look at the next breathing treatment you see, it'll look like they're smoking the peace pipe.

The point of giving vasopressors in cardiac arrest is to skyrocket B/P to improve CAPP in conjunction with CPR. The absorption rate for racemic epi is too slow and unreliable.
 
My first code

My first code was 16 years ago.we went to a little eldercare facility. I did chest compressions for about 10 min. And my partner got orders to call it.
I felt that the person we were working on was somehow still in the room and then she was gone. I still remember that.
 
Asclepius911 said:
First code was cva hemorrhagic stroke from lumpy road, only in LA will you find pot holes in trafficated street....
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If you want to see *REAL* pot holes you simply must come to New England in the spring. I do the best job I can getting uncomfortable conscious patients to the hospital smoothly, but usually I have to apologize. You just CANNOT get to a hospital in Fall River MA without hitting some whoppers.

And my first code was exceptionally routine. 70+ ish male alone in elderly housing, life alert, tube, lucas, IO, shock, meds, shock, meds, transport.
 
Simusid said:
If you want to see *REAL* pot holes you simply must come to New England in the spring. I do the best job I can getting uncomfortable conscious patients to the hospital smoothly, but usually I have to apologize. You just CANNOT get to a hospital in Fall River MA without hitting some whoppers.
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I think the SouthCoast might actually have worse roads than Boston itself. My time in Attleboro brought me down your way a fair bit and boy oh boy are you correct.
 
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