The Cicle of Life

http://www.youtube.com/watch?v=vX07j9SDFcc

Today, I heard the news that one of my patients from many many years ago died. Let me tell you the story.

It was a cool night many years ago and I was working in a hospital based ambulance service. I was considered a "senior" medic but still not completely experienced.

If was a Friday night, about 10pm. We received the call about a traffic collision in Sonic parking lot with a female complaining of difficulty breathing. "Great" I thought, "another teenage girl hyperventilating from a minor collision".

We start responding and we hear the local fire suppression units get dispatched to the same incident for "vehicle smoking"..."Ok, it may be more than I thought".

As we are responding I notice alot of glass in the highway about 2 stores before Sonic and three vehicles where they are not suppose to be in the Sonic parking lot. One was in the shrubs in front of Sonic, one was against another vehicle in the parking lot, one was in the middle of parking lot where walk up orders are taken. Everyone is alright, except one. I call for additional ambulance to respond to location and move to the vehicle in the shrubs in front of Sonic...the one with the driver trapped...the one smoking.

Ok, the smoke was actually from the dust from the airbag deploying, so fire suppression units were not needed. However, heavy rescue was needed.

The female driver, looks to be in her early 20s, is unresponsive with snorous ventilations. I climb into the back of the vehicle along with a student riding with us that night to climb in. Its a small car, not a great deal of room to work, but it is something that I habitually do on entrapped patient calls. I carefully lift her head back into a neutral alignment while opening her airway, a basic EMT student clumbsily places the cervical collar on the patient with my instructions...hell, you have to learn somewhere. Airway now opened and patent, patient is still breathing slowly and is still unconscious. We start assisting ventilations with a bag valve mask and high flow high concentration oxygen.

The Lt for the fire service approaches me to ask my opinion on extrication. I am a simple person. I know very little about heavy rescue and use of the Jaws of Life along with other extrication tools. I depend on the firemen to know their job. So I told the Lt, who was good friends with me, to do what he needs to do to get her out. He knows that I will be in the vehicle with the patient. They cover the patient, the student, and myself with a heavy blanket to protect us from the glass and metal that will be cut.

While we were under the blanket, I got the student to maintain neutral alignment while she was in the left corner of the back seat of the vehicle while I got immediately behind the driver's seat where the patient was, still unresponsive. I bend myself over the seat, insert the laryngoscope blade into her mouth and visualize the glottis and me placing an ET tube throught the glottic opening. Secondary confirmation along with securement of ET tube.

I never knew that this is was a difficult way to intubate a patient, but no anesthesologist would have even attempted that intubation. And not many paramedics would have attempted it or gotten it.

By the time I got her intubated and the tube secured, the fireman had the roof cut and driver door moved out of the way. We extricated the patient to the LSB and secured and quickly loaded her into the ambulance. Once in the privacy of the ambulance, we cut the patient's clothing and started the two IVs.

Quick transport to the hospital with the patient waking up. The ED doc, a friend of mine, during his assessment of the patient, pointed to me and told the patient "you can thank him for saving your life". The patient was transferred to the Level I trauma center at the MED in Memphis and she was quickly forgotten.

Over 2 years later, a nurse came down to the ED where I was working and was asking for me. "Oh shit, who did I piss off now?" I told her it was me and I got a big hug. I could hear her crying alittle bit. I could feel her tears on my neck. She told me who she was, I didn't remember her name. She told me that she had a vehicle collision at Sonic a couple of years earlier. I finally did remember her.

She told me how the trauma surgeon told her again that the paramedic that intubated her did save her life. She told me how she cleaned up, got off drugs, finally became the mother her two small children needed, went to LPN school and is working as a nurse. She told me "thank you Michael"...her eyes told me she meant it.

I told her not to thank me, I was just doing my job. She said no, you went way beyond the call of duty.

We talked alittle more and she went back to work. I soon left that job to work with the current Ambulance company I work for.

I learned today that this woman died a few years ago in a motorcycle incident. Riding in Memphis with her boyfriend "just around the block", she fell off the back of the motorcycle, striking her head. Not wearing a helmet, the traumatic brain injury ended her life.

For some reason, this knowledge has depressed me alittle. Many many people have died around me. Dead is a common companion for us in my profession. Can someone explain to me why this one person's death has effected me.