So fairly recently I was working rescue with one of the more "talkative" medics in the area when we get a call for a fall. Ugh! I don't want to start my day off with a fall! It's funny how in this job the more stressful, demanding, and even difficult the call is, the more we want it. Well...that is how I am anyway. I would rather do back to back priority 1 calls for a 24 hour period than do 12 hours of slinging renal pts to and from the chair.
Anyway, as I digress...as we are enroute to our call were we would have to put on our happy faces and BLS the hell out of this call we hear the FD state over the radio "Priority one pt. CPR in progress". My partner and I look at each other and start to speculate on the matter at hand. Keep in mind that he has already surpassed his expect amount of word I thought he was going to say to me throughout the following 12 hours. I come up with a very plausible scenario to bounce off of my partner. "Where did this pt fall from, the Moon?". He shrugs and swears and complains to the steering wheel as he drive faster now that our priority one call is real.
Upon arrival we find our friends on the FD doing CPR on average size man who was acting strange before they got there and went unconscious in front of them. They are doing great compressions and ventilations but the AED was screaming no shock advised.
The strangest thing happened after we did another round of CPR, swapped out the pads for our own monitor...the pt started breathing again and had a relatively good pulse. It was certainly a "WTF?" moment for all of us. Then he tries to sit up. We all jump in because he is now trying to roll all over the place and not exactly being the most cooperative pt at this point. I glance over at the monitor and he is in V-Tach. Then he goes unresponsive again with no pulse. Boooooooooo.....Clear! And he is hit with 200J (Biphasic) of Detroit Edison (DTE). And we start the CPR game again. Right after the shock, the pt was in a wide, regular, and very odd looking brady rhythm. However, this rhythm quickly upgraded to a much more friendly looking sinus tach at about 130.
With CPR going on immediately in the post defib phase, the FD was getting ready to drop a King LT airway when I notice the pt reaching up for his chest. STOP CPR! The pt is again breathing and has a pulse. The game of sit on the pt starts again, making placing a line that much more difficult. I find my self sitting on his knees and placing a large bore IV at the same time. Thankfully my years of military experience have taught me the importance of multitasking in stressful situations. This allowed for a good line and a bolus dose of an anti arrhythmic to be given.
We are sinus tach still on the monitor with a great pulse and BP. He was still combative and confused so we restrained him and transported him to the closest hospital where he could undergo emergent interventional cardiology. As we are transporting with disco balls and noise makers, the pt starts asking more lucid questions like "What happened", "Why am I tied up", and "Where are we going". Looks like we got a CPC 1 upon arrival and a CPC 2 immediately upon gaining ROSC.
We get to the hospital and give report to the receiving team in the ER. He was actually stabilized and immediately transported to another facility by our MICU team for an emergent CABG.
It is always nice to put one in the win column. More often than not people usually do not survive SCA out of the hospital. This was a great example of how a quick response and teamwork can really save someones life and make you look and feel like a rock star.
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