I had just sat down to lunch with the family and Rabid's visiting parents when the tones went off for our sister fire department. It's Monday, isn't it? The tones were for an unresponsive woman in a car at a gas station across town. Seconds later, the phone rang. It was the town police chief. He asked me if I had heard there was a code in progress and was I going?
I said no; the ambulance would beat me there. He rung off.
As soon as I got off the phone, I decided I should go. I said goodbye to everyone and drove over to the scene, lights, siren, high speed.
I heard the ambulance sign off on scene. A few minutes later, I arrived.
I got out and walked to the ambulance, pulling on gloves as I walked. I got in the back of the ambulance. The dead woman was already in the rig; a paramedic was preparing to intubate while a firefighter performed CPR. The other technician from the ambulance was putting the woman on the heart monitor. I knew the woman needed IV access so I got to work. I used shears to cut the sleeve of her jacket and shirt and tied a tourniquet on her arm. Due to the lack of circulation, her veins were flat. I chose to go with an eighteen guage rather than a sixteen due to the condition of her veins. I got the catheter out and ready, then got the j-loop tubing out and flushed it with saline. I picked my site, cleaned it with alcohol, and popped in the catheter, hitting the vein on the first try. I put on the j-loop and taped it all down. The other tech handed me a tegaderm, a clear adhesive dressing, and I put it over the IV site to secure it.
They hadn't shocked her; she had PEA, pulseless electrical activity, an unshockable rhythm. They decided to try to pace her; the other tech handed me a defib pad which I placed on my side of the patient.
The paramedic asked me if I had the line. He seemed surprised that I had it done so fast and was on to other things. He ordered epinephrine and atropine. The other tech started the epi and I put in the atropine.
The tech was trying to get the pacer to work. The woman was resistant and wouldn't pace. Her anatomy was such that the paramedic couldn't intubate. The firefighter continued the compressions while the paramedic ventilated her with a bag-valve mask.
The paramedic had the firefighter stop compressions and felt for a carotid pulse... She had one! According to the monitor, the woman had developed a rhythm; sinus tachycardia; not good, but no longer dead.
Sometime after I had the line started we had left for the hospital with another firefighter at the wheel. The paramedic radioed a brief patch to the hospital and then we arrived. We unhooked the woman from all of the gear in the ambulance and wheeled her smartly into the hospital. Five or six people were waiting in the trauma room; the paramedic and I moved her from the gurney to the bed and we turned over care.
I helped put the ambulance back in service; it was a mess from all of the tools, wrappers, and consumables used and discarded. I got a ride back to the gas station with three other firefighters from the sister agency; the CPR-giver, the driver, and another firefighter who followed us over to drive us back. They invited me to come participate in their scenes whenever I wanted.
So, to recap; she was dead when I got there. She was alive when we left her at the hospital.
Awesome. This was one of the most intense events of my life. Plus, I worked the entire code in my silly pointy green hat.