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Thread: Just ran my first call; cardiac arrest

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    Default Just ran my first call; cardiac arrest

    I guess there's nowhere to go but up from here. I operate with a large volunteer fire department in Missouri and have been on for only a few months. I'm currently in the academy and we're on limited release (i.e can run anything but working fires) two weeks out from graduation.

    I'm sure you remember your first code. We got called out around 1900 hours for a 66 year old female, not conscious/not breathing. It took 3-5 minutes from dispatch for us to arrive on scene. Long story short, she was suffering from cancer and had been declining for some time although her death was not expected so soon. The husband called it in and was present when the arrest occurred. We began CPR and pretty quickly afterwards put her in the autopulse. Medics arrived almost at the same time as fire and artificial resuscitation was attempted for a while before they called it.

    The whole thing was kind of surreal. Mercifully, the husband appeared to be calm and composed. She had a terminal illness and although she probably passed earlier than expected, the family had a chance to prepare for it to some degree. Her husband had watched her decline and was perhaps relieved to some degree that her suffering was over.

    You've ran worse calls than this. I will run many more calls, hopefully help some people, make their day better, and so on. I doubt I'll forget my first call on Halloween night though. Did your first arrest bother you? What did you do to 'decompress'? Thank you for reading my ramblings. Stay safe.

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    Talk to your fellow firefighters about this call and if you need further assistance with dealing with it talk to your chief about a debriefing.

    My first call was a car versus semi with the care getting T-boned in the driver's door. Driver was dead with open head trauma, front seat passenger with a broken jaw and a broken pelvis, back seat passenger driver's side wrapped up in the metal of the car and the passenger side rear victim just shaaken up. My patient was front seat passenger and 29 years later I still remember her name, first and last.

    The truth is for most it gets easier, for some they just discover it isn't for them and they may hang on for a while but they eventually walk away. Only you know where you are with it. NEVER be afraid to ask for help if something is bothering you about a call.

    Good luck.
    Last edited by FyredUp; 11-01-2013 at 01:39 AM.
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    I just got off of a full arrest call myself.

    As Fyred said, talk with the guys at the station about it and seek out someone trained to help you deal with this if necessary. Everybody deals with this a little differently, and each call will be a little different. You may run a particulary bloody scene and it won't bother you, but another call that seems simple will really hit home.

    I don't remember my first full arrest call, but several others do stand out. One that comes to mind is a call on father's day. The daughter found him in bed, I was first arriving. Unfortunately, he had been down too long for us to be of any help. Probably being a father, that one just sticks with me.

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    Uh, why would they let you take calls if you're not done with your training???

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    Quote Originally Posted by johnsb View Post
    Uh, why would they let you take calls if you're not done with your training???
    The same reason they let you drive a car even though you aren't yet qualified to drive a semi - he's had sufficient training to function on a scene in a safe manner.

    Heck, part of EMT training is running actual calls (ride time).

    I don't remember my first fire call, or my first full arrest. But there are calls I remember, sometimes all too well.

    As others have suggested, talking it out with someone is the best way to deal with it. Whatever you do, don't internalize it - holding it in just tends to make it fester.

    Do the best job you know how every time out and you'll have no regrets. And don't dwell on the stuff that you had no control over. You didn't cause the incident to happen - you're there to try and make it better, or at least make it no worse than it already is. "If only" doesn't apply to you and what happened before you arrived on the scene.
    Opinions my own. Standard disclaimers apply.

    Everyone goes home. Safety begins with you.

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    yup....the first call is easy for me to remember......a driver in a single vehicle vs a tree at high speed.....after thinking through the entire 'process' I did a great job, UNTIL I started to think about it......as others note, I still remember the victim's name and where he lived

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    Quote Originally Posted by tree68 View Post
    Do the best job you know how every time out and you'll have no regrets. And don't dwell on the stuff that you had no control over. You didn't cause the incident to happen - you're there to try and make it better, or at least make it no worse than it already is. "If only" doesn't apply to you and what happened before you arrived on the scene.
    That's pretty much it in a nutshell. Not every call is going to have a happy ending. Many will not. You'll just have to accept that as fact. And you can't measure yourself based on the results of a call. The measuring stick is how you perform on the call. Success is when you answer the call and perform your level best.

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    Quote Originally Posted by tree68 View Post
    The same reason they let you drive a car even though you aren't yet qualified to drive a semi - he's had sufficient training to function on a scene in a safe manner.

    Heck, part of EMT training is running actual calls (ride time).

    I don't remember my first fire call, or my first full arrest. But there are calls I remember, sometimes all too well.

    As others have suggested, talking it out with someone is the best way to deal with it. Whatever you do, don't internalize it - holding it in just tends to make it fester.

    Do the best job you know how every time out and you'll have no regrets. And don't dwell on the stuff that you had no control over. You didn't cause the incident to happen - you're there to try and make it better, or at least make it no worse than it already is. "If only" doesn't apply to you and what happened before you arrived on the scene.
    There's a BIG difference in taking runs, and being a student observer. The stress of being on a cardiac arrest is case in point. If you're taking runs and haven't been taught about that aspect, then that's a problem.

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    Quote Originally Posted by johnsb View Post
    There's a BIG difference in taking runs, and being a student observer. The stress of being on a cardiac arrest is case in point. If you're taking runs and haven't been taught about that aspect, then that's a problem.
    First of all, basically any dumb azz can do CPR, they do teach it to civilians. Secondly, he said he was CLEARED to run everything except working fires. Thirdly, what is the real difference whether he runs his first cardiac arrest now while in the academy or one day after graduation?
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    Quote Originally Posted by johnsb View Post
    There's a BIG difference in taking runs, and being a student observer. The stress of being on a cardiac arrest is case in point. If you're taking runs and haven't been taught about that aspect, then that's a problem.
    Good, probably better to gauge his composure under duress at a CPR run where statistically the patient has a poor chance of survival to begin with than at a fire where cracking under pressure could hurt himself, other firefighters, or civilians.

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    Quote Originally Posted by MizzouRah16 View Post
    I guess there's nowhere to go but up from here. I operate with a large volunteer fire department in Missouri and have been on for only a few months. I'm currently in the academy and we're on limited release (i.e can run anything but working fires) two weeks out from graduation.

    I'm sure you remember your first code. We got called out around 1900 hours for a 66 year old female, not conscious/not breathing. It took 3-5 minutes from dispatch for us to arrive on scene. Long story short, she was suffering from cancer and had been declining for some time although her death was not expected so soon. The husband called it in and was present when the arrest occurred. We began CPR and pretty quickly afterwards put her in the autopulse. Medics arrived almost at the same time as fire and artificial resuscitation was attempted for a while before they called it.

    The whole thing was kind of surreal. Mercifully, the husband appeared to be calm and composed. She had a terminal illness and although she probably passed earlier than expected, the family had a chance to prepare for it to some degree. Her husband had watched her decline and was perhaps relieved to some degree that her suffering was over.

    You've ran worse calls than this. I will run many more calls, hopefully help some people, make their day better, and so on. I doubt I'll forget my first call on Halloween night though. Did your first arrest bother you? What did you do to 'decompress'? Thank you for reading my ramblings. Stay safe.
    Not to get off track here, but this is more of a firefighting forum. You would have better luck with this post at www.EMTLife.com

    That said, CPR should not even be initiated on a patient with terminal illness. It is very strange that no one presented a DNR or MOLST form. It could be possible the husband also withheld it in the hopes of a miracle happening.

    When someone enters cardiac arrest as a result of trauma or terminal illness the effort is simply wasted or for show. As EMS providers we don't necessarily treat illness. 99% of the time we treat acute exacerbations of chronic conditions. If a chronic condition is so far progressed that it results in death, there is nothing we can do to mitigate that problem. Same goes for a person who sustained traumatic injury to such a degree that their body cannot compensate and goes into arrest. Not even the best trauma surgeon in the world being next to you at the time of the incident is going to be able to save you.

    That said, don't feel bad for any reason that you couldn't "save" this person. Cardiac arrest survival rate in relatively healthy individuals is nothing to write home about but we are getting better. Most of the time there is simply nothing you can do but put on a show for the family and be empathetic when the time comes to break the news to them.

    Best of luck in your new career.

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    Quote Originally Posted by BrooklynBravest View Post
    Not to get off track here, but this is more of a firefighting forum. You would have better luck with this post at www.EMTLife.com

    That said, CPR should not even be initiated on a patient with terminal illness. It is very strange that no one presented a DNR or MOLST form. It could be possible the husband also withheld it in the hopes of a miracle happening.

    When someone enters cardiac arrest as a result of trauma or terminal illness the effort is simply wasted or for show. As EMS providers we don't necessarily treat illness. 99% of the time we treat acute exacerbations of chronic conditions. If a chronic condition is so far progressed that it results in death, there is nothing we can do to mitigate that problem. Same goes for a person who sustained traumatic injury to such a degree that their body cannot compensate and goes into arrest. Not even the best trauma surgeon in the world being next to you at the time of the incident is going to be able to save you.

    That said, don't feel bad for any reason that you couldn't "save" this person. Cardiac arrest survival rate in relatively healthy individuals is nothing to write home about but we are getting better. Most of the time there is simply nothing you can do but put on a show for the family and be empathetic when the time comes to break the news to them.

    Best of luck in your new career.
    I don't factually disagree with most of what you are saying but many times cpr and any other measures are done because that's what the family wants, or what they need, to know that everything that could be done to save their loved one was done. It is nothing more than a show to help the family cope with the loss.
    Crazy, but that's how it goes
    Millions of people living as foes
    Maybe it's not too late
    To learn how to love, and forget how to hate

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