18 January 2006

Heartbreaking

"Your patient is a 39 year old male, trauma inflicted by a Bull."

We do a lot of stuff that gets routine to us......this time of year we carry a lot of Cardiac patients to get the specialized care they need in the "Big City".

Trauma patients are a break from the relative boredom of all the heart stuff.
And this one.......inflicted by a Bull!

You remember the game:
I land and cool down the engines while my crew goes in to "kick death in the butt".

I shut the helicopter down and walk into the ER to see CPR in progress on this guy.......
Easily 6 feet tall and all of 250 pounds........not much fat on him at all......solid.
He got into a stall with a cantankerous 2,500 pound Bull, and the animal crushed him against the wall.

"Everyone clear?"
Again.......
"Everyone clear?"

Zap!
Defibrillator.
It's the one thing they get right in movies and TV shows......
the patient literally jumps about 4 inches off the bed.

Once more:
"Everyone clear?"
ZAP!

Back to CPR.
"Give him some Eppie!".........adrenaline, to further kick his heart in gear.
"Chest tubes!".........
to drain blood from his chest cavity, and make breathing easier.
Blood drips all over the floor.

I move to the reception desk
and watch the monitor for trauma room 1.
Heart rate is 34. The wave shown on the monitor is 'way abnormal, and in small red letters above the wave it says, "V-tach."
Better than nothin', but not much.

After the adrenaline is given, I watch the numbers climb......58, 75, 105, 125.......
But the heartwave is still strange lookin'.
Within a few minutes, the numbers retreat........100, 80, 65, 50, back to 34.
More Eppie......
Roller Coaster.
"We need blood! Where's the blood?"

"We crossed and matched the last of it!"
Uh-Oh.

The numbers start back up, and again reach 125. Wave still looks terrible.

The Sister from Pastoral care comes in with three women, obviously sisters.
The one in the middle sees the CPR in progress and her knees buckle.
Her sisters support her.
She wails.
They escort her into the trauma room with her husband.
I'm incredulous, but this is the way they do things today.

Blood arrives from a nearby hospital.
They give it, but our patient is bleeding it internally just as fast as they can administer it.

The door to the waiting room opens.
Mom and Dad maybe, and a brother?
Strong smell of cow manure........
In the middle of this confusion........a comforting smell to a pilot raised in farm country.

Wife's sisters both on cell phones, telling others "it's bad."
More folks through the door. This hospital has a very liberal policy about this.
Within this gaggle is the 12 year old son.
This boy has the "100 yard stare" of a combat veteran.
Face, arms, and from the waist down.....covered in mud. (Or manure?)

I overhear a conversation about the boy.
Last year, a huge round hay bale fell on his grandfather breaking both his legs, and the boy was the only help the old man could depend on. The boy got on a tractor with a front-end loader and pushed the bale off his granddad, then loaded him in the bucket and drove him to get help.
He made the TV news as a local hero.
Tonight, he used the same tractor to load his Dad and rush for help.
They bring the boy over and introduce me as "the Pilot that will fly your Dad to get him help."
I hug him.
I cry.
I'm ashamed of myself for maybe taking away any hope he might have.


Heart numbers up, down, then up again, and stabilize somewhat.
It's been two-and-a-half hours since we landed.

We load him for the 19 minute flight to the Trauma Center.
Four minutes from landing, he arrests again.

He dies.

Sometimes you do your best, and it just ain't enough.
Tonight, the Bull won.

7 comments:

Infinitegtr said...

The Bull might win a battle, but as long as people like you keep putting on a flight suit beating air into submission, the Bull don't win the war.

Mommanurse said...

AND....think about what the rest of his life probably would have been like. Never out of pain, unable to have the dignity of doing an honest day's work ever again, maybe living with bags in places where there shouldn't have been bags. Most likely brain dead. Sad for the family, but a better memory overall, I would think. Wonder if they will sell/kill that bull?

Purple Tabby said...

Sometimes I feel we as healthcare workers are supporting players in a Play. The main characters are the patients and their families and all we do is support the event.

Occasionally our actions change the outcome of the Play, but not often and not always for the better.

We mostly listen to the main characters, hug them, give them comfort, sometimes absorb their anger or frustration.,,, but the Play goes on with or without us.

I'm glad you were there to hug that little boy. He will remember that moment for the rest of his life.

You improved the Play more than you know

THIRDWAVEDAVE said...

PT is spot on: The play was better.

THIRDWAVEDAVE said...

and...I tried to link you but no trackbacks.

the golden horse said...

You are right, it does stay with you for the rest of your life. The people are lucky to have a caring person as you and so many others working in such an sometime, unforgiving world. So many other countries would do well to follow our example.
I have so much empathy for you, it never gets easier.
While first married and living in B'ville, we were on the volunteer fire dept. and depending on location, we were most often the first on the scene. I had taken all my first aid courses available at that time and one night the phone rings at 2 am. Auto accident at the same location we had lost a dear fellow student a few years before. Three young men, drinking and driving and joy riding fast through the country and running the stop sign at the intersection. They hit a young man, newly wed, coming home from work. So undeserving. It took us awhile to find him, he was thrown from the car into a plowed corn field and had rolled onto him. He was covered in dust, but his wedding lay glistening on his hand and that has haunted me to this day. Sometimes, even the very best aid cannot change the course.

John said...

Keep up the good work and keep letting people know what it is you do. You might not always win, but you're contributing to something very important. Me? I just haul boxes ...