ROSC to the LAB

It was that time of the week for me. I did was working my agreed upon extra shift and I was lucky enough to grab a 24 hour rescue shift. Hopefully I can get some sleep and some studying done. But If I have to only choose one, I will go with sleep every single time. I can always do homework the following day. And since I have not mastered that whole doing homework in my sleep thing, I will have to make the sacrifice. Too bad for us there was not a whole lot of time for either one of things. Gotta love rescue shifts for that.
     We stayed pretty busy throughout the day. Nothing too exciting or challenging, just busy. Before we knew it, we missed lunch and were probably going to miss dinner too if we didn't make something happen soon. Most of that shift was blur so I think we just broke down and gave into the golden arches or some other poly-saturated fast food, deep fried guilt.
     It is now 2 hours past my bed time and we FINALLY get cleared back to the station to hopefully get some sleep. Apparently Murphy and his damn law were watching because no sooner did I get my boots off did the tones drop. Great. As I am tying my boots up again the radio/pager is going off in that "explain to me why this was a good idea" kind of way. I don't catch most of the call, but I do hear CPR in progress. GREAT!
    My partner and I respond priority one to the location which happens to be very close to one of the local fire departments. This is actually a very good thing for the pt. We get there to find a moderately old person in full arrest with the FD doing a great job as usual with the BLS care. We get the story as we work on our ALS stuff. It was a sudden and witnessed arrest and CPR was started right away.
     We throw the pads on for our monitor, my partner is working on getting a definitive airway, and I start working on getting vascular access. We have some trouble obtaining both of these thing initially but the tube gets placed and we get a line. And now it's about that to do a rhythm/pulse check. And wouldn't you know it, we got a pulse and a fairly good looking sinus rhythm. TIME TO GO!
     As the pt is getting packaged up for transport and loaded into the ambulance, he arrests again. Thanks buddy. I could have done without that. But we do some CPR, give some epi, and shock him back out of vfib and into NSR. This time I take advantage of the decent BP and throw in a second line. And by the time this is all said and done, we are pulling into the ambulance bay.
     As we are unloading, giving report, transferring to the gurney, and swapping leads, the second IV I placed enroute gets pulled out. WTF!? But it's OK, he still has a pulse and a perfusing rhythm. The 12 lead shows elevation in II, III, and aVF. Sounds like my friends from the cardiac cath lab are going to be getting a call very shortly.
      As the cath team starts to show up, we are starting to get more of a story and history on our ROSC pt. Apparently this person is the proud owner of 13 previous stents and a slew of other medical issues. I swear he was being kept alive by beta blockers, Metformin, and medicare.
     Once all the players were in place and the pt was placed in the cath lab, I was able to start my report. But I wanted to watch the cath too, so I did my documentation from the comfort of the control room. When they shot their first films, I could see the RCA before any dye was pushed. The Pt's entire RCA was stents. It was amazing. Not to mention the fact that he ended up with an additional stent as well.
      I have to admit, it is nice to be able to put one in the the proverbial win column from time to time. Especially when they go from dead to a live. And in true EMS fashion, it took longer to do the documentation than it did to do the call. But that is OK, because we spent the rest of the shift bouncing from post to post like zombies with drivers licenses but instead of brains we just wanted sleep.