Posted by: medicblog999 | January 5, 2011

“She was dead before she picked up the phone”

She was dead before she picked up the phone!

When following up a patient, I have never been told that before.

“She was dead before she picked up the phone”

That bothers me……..I’m not entirely sure why, but all I know is that I don’t like the sound of that at all.

“She was dead before she picked up the phone”

What I found out later was that her potassium levels were so high, that she was in effect, unsalvageable. No matter what I did pre hospital, no matter what the A&E staff did once I got her to the department, it was never going to matter. It was never going to change the course of what was about to happen.

The fact that I was talking to her all of the way in to hospital, reassuring her that she was tolerating the speed of her heart very well and that the hospital staff will be able to ‘sort it out for her’, makes it harder to accept.

“She was dead before she picked up the phone”

The fact that I was looking at the VT on the monitor screen, knowing that the hospital would be able to sort it out, makes it harder to accept.

“She was dead before she picked up the phone”

1 hour after I had handed her over to the waiting team in A&E, I managed to get back to see how she was doing. I honestly expected to see her sitting up in her bed, looking much better and telling me that she felt so as well.

What I didn’t expect was to see her lying supine on the trolley, sheet pulled up to her neck, and a concoction of syringes, ampoules, and equipment scattered all over the resus bay.

The look on the doctors faces told a story of it’s own. A story of a battle truly fought, with every last attempt made to try and stop the inevitable, but after all, it was no to no avail.

“She was dead before she picked up the phone”

That sends a chill down my spine, and I really don’t like it.

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Responses

  1. I’m not sure what puts the willies up me more, a story like that, where you think they’re savable if only you can give them enough diesel, or the transports that you know are futile yet you do anyway. Would it have made it easier if you knew she was going to die whatever?

  2. This sort of thing happens…more than you think. Shouldn’t change your treatment or overall philosophies in the back of the truck. Accept it, move on and learn from it. I suspect renal failure? Renal failure is probably the longest, most drawn out death sentence anyone can have…and difficult to manage over the long term, let alone a few minutes in the truck when blood levels are already unsustainable for life.

  3. I had a guy a couple of months ago that got stabbed in the abdomen. The thrust was upward in motion and it dissected his heart. I got his BP back up close to 90 systolic and he talked for the entire trip and then for 3 hours in the ER. Then he coded.

    Sucks to lose them once you’ve done your part and done it well.

  4. I would have to agree with flanmedic51. We as prehospital providers can only do so much. People die, it is inevitable. Sometimes the best care we can give a patient is a hand to hold and reassurance that everything possible will be done for them. Yes, it hurts when a patient dies, especially when they are as coherent as yours was. Remember, we also get to see life entering this world, and the smiles on childrens’ faces when they see us.

  5. [...] This post was mentioned on Twitter by JEMS – EMS,
    Shari Simpson, InsomniacMedic, Johnny Gage and others. Johnny Gage
    said: RT @Chroniclesofems: “She was dead before she picked up the
    phone” http://bit.ly/hdAlI3 Via @Medic999 #CoEMS [...]

  6. I wish I could say or write something that would make it easier for you but I can’t, except to say that we have all dealt with it and you can get thru this. I wish there was something else to say!

  7. sometimes there’s just nothing anyone can do.

  8. We are guardians at the final gate. Sometimes we’re able to turn them back, but it’s always just a holding action. Hopefully for a long a fruitful…but sometimes not, and the inevitability is the hardest to accept.

    We should be proud, though few may understand, that we comfort in chaos, and sometimes just carpet the exit in compassion. It is a special and rare duty, and everyone has their moments where it’s … just … too … much.

    Get some rest. See ya next tour.

  9. I had a patient a few months ago complaining of shortness of breath. Put him on the stretcher, cardiac monitor. He was talking to me in 1-2 word sentences, his lungs were clear. He was in VT. 30 seconds later he was dead. He had a massive MI, nicknamed the “Widow Maker”. Traveled the day before for more than 16 hours, threw a clot. He was coded in the ED for an hour; he never survived. He was 58. That call put me out of service for 2 hours. I couldn’t grasp the fact that I was talking to him and within 5 minutes he was dead. Still bugs me.

  10. I’m not EMS but I know that sometimes there’s nothing you can do. I’m sure the two guys that took my mum to hospital as a Drs urgent would never have imagined that less than 4 hours after dropping her at hospital she’d be dead. Things happen sometimes that we have no control over. The one saving grace from mum, and from your patient is that they died in hospital and not suddenly, at home, in front of family and loved ones. You did what you could for your patient. Her last memories will be of a kind, caring and compasionate man who did all he could to make a scary time less scary. And her relatives will know the same. Dad said to me that ‘two lovely ambulance men took mum to hospital’. That’s what’s important in a case like this, you’re remembered for what you did, even if the outcome wasn’t what you as a professional would have wanted.

  11. In my mind this is one of the most difficult situations we in EMS face. We strive to do the best we possibly can for our patients and sometimes that just is not enough. What makes these calls harder is the fact that we can’t learn much from it. There’s nothing to do differently next time. Some calls just have a bad outcome. It’s a hard concept to embrace. My thoughts are with you.


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