96 hours, an I/O, and a full arrest. What could be more fun?

     This week was a very busy [EMS] week for me. Meaning that we had a ton of calls. I worked new years eve day and new years followed by 4-6 12 hour shifts after that...I think. It has been kind of a blur. Either way, we were hammered with calls. On the "holidays" we did 16 calls, and up until today every shift had an average of 7 calls. Ugh. Busy stuff.
     Most of the past week has been stuck in what I am sure have mentioned before as "priority 3 purgatory". However, today we recieved a call for pt in their 60s who was having trouble breating. So much trouble in fact that this person's heart stopped beating. So it's a CPR in progress kind of day. It was a bit of a unique code situation. Our patient had a trach which made the "A" part of airway, breathing, and circulation much easier. The staff at this menagerie of tirtiary care was performing good compressions but bagging like hyperventilation was going to bring them back. The first few things we did was confirm the arrest, place the defib pads, and check a rhythm which turned out to be PEA. The staff was told to slow their bagging down to about 12 times a minute and we then looked to gain vascular access. This particular pt was a...um...vascular challenge to say the very least. My partner and I didn't even try to start an IV. We just popped in an IO in the right tibia. It was super easy and was the first state side IO I have done in a while.
      Then the strangest thing happend. Before we gave any drugs, fluid, or electrical therapy, we achieved ROSC (return of spontaneous cirulation). The pt had a pulse again. So we took the opportunity to switch the pt on to our ventilator and transported priority one to the area's only trauma center for further care. The BP was still low, but the pt was perfusing.
     On our way to the ER, the pt decides to throw me a curve ball and codes again. Just so everyone is aware, doing CPR in the back of an ambulance is not easy, fun, or comfortable. Plus, its very traumatic to the pt. In this case, I am pretty sure the pt had a floating sternum, meaning the sternum detatched from the ribs and was basiclly floating around the chest. Not a very nice feeling or sound. So I start CPR again and reach for an amp of epi, since the pt was still in PEA (sinus tach was the underlying rhythm). I push the meds just as we roll up to the ER.
     As we roll through the doors of the resusitation room, I give my report. One of the ER residents was ready and very willing to intubate this pt, but I kind of stole her thunder when I told her she has a trach in place. She looked alittle disappointed. Oh well, so we get the pt over to the bed and again we get ROSC.
    Once that whole tornado of ACLS is brought under control, the doctor mixes a neosynepherine drip. That's right, the doctor. You don't see that very often. He said he wanted to make sure we kept this pt alive until family can show up to say "good bye". So we clean up, do our paperwork, and clear. Before I leave, I ask one of the nurses if the new registration girl is single or not. Haha.
     Several hours later, we return to the area's only trauma center to find that our pt is still with us. Surviving the night is another story. But as much work as we did this week, it was good to use our skills and critical thinking again. Gotta love life on the MICU.