Sorry, I did say that didn’t I
I knelt before the man, intravenous needle in my hand. His colour was ashen grey and sweat poured from him as if it were a spray bottle I held. His free hand rubbed slowly across his chest from left to right and back again. The pain in his chest felt like it was crushing him.
Hesitating only a moment to warn him, the IV needle was plunged into a vein into his other arm. He flinched once then it was done. He had bigger pains to worry about than that. Soon after a morphine filled syringe was attached to help with just that.
My partner held the ECG strip in front of me just long enough to confirm what we both already knew. The man was having a heart attack. I nodded. We had done enough here and now it was time to go to hospital.
His wife stood nearby the whole time, hovering, concerned. She reached forward and held her husband’s hand until we helped him move across onto the ambulance stretcher. I pulled the blanket up from his legs and over his chest to help fight the cold waiting outside. His pain unabated, more morphine was pushed into the IV needle before we moved off.
“You’re going to be okay,” I said reassuringly to the man. He had been told that he was having a heart attack. Honesty was the best approach and I had been here often enough before.
“Will he really be okay?” his wife asked as we wheeled him out. I turned to her and smiled.
“The bad news is that he is having a heart attack.” I hesitated a moment creating a dramatic pause. That wasn’t intentional but seemed to work to advantage. “The good news is though,” more smiling, “that we have caught it early. He can have this pretty much sorted out in hospital. He’ll be better than new within a couple of hours. He’ll be fine with us”
Why did I add that last bit?
She nodded her head and, despite the grim expression, looked somehow heartened. I offered for her to come in the ambulance with us but she said that her son was coming to pick her up. She wanted to travel with him and would meet us in the hospital as soon as she could.
Half way into hospital it all changed considerably when his heart stopped.
We were prepared for this. Surprised, but still ready. We laid him flat and slapped the big sticky defibrillation pads to his bared chest. A moment later his body convulsed as the electricity surged through him.
It didn’t work.
We pushed on his chest performing CPR. Another shock, more CPR. Still no response. This was repeated a few more times. We decided to continue on to hospital keeping this going.
By the time we arrived the miracle had been performed and his heart had been restarted. He wasn’t conscious anymore though and his blood pressure was terribly low. The ED staff poured over him with befitting urgency.
Then his heart stopped again.
The ED staff repeated the same performance as our own and eventually they too restarted his heart again. A telephone rang and the word came through that the cardiac theatre upstairs was ready for him. This is where they would reopen the blocked artery in his heart. Timing is everything in life, and death too it seems, and at just that moment two things happened.
His heart stopped a third time prompting the well versed response to be put yet again into immediate action. Then his wife arrived just outside the emergency cubicle.
Walking right into her was unavoidable but there was never an option anyway. One of the ED doctors came out to talk to her. He asked her questions about her husband’s health and what he had complained of today. She answered but she had a question of her own.
“He is going to be alright isn’t he?” She hesitated and spoke slowly in a manner far more dramatic than mine. The doctor explained to her that things were grim but every effort would be made to save him. Being a realist though, he reemphasised the bit about things being grim. The words probably fitted well given what could clearly be seen over his shoulder.
Well her husband wasn’t alright. Ready to leave some time later, I went back into the resuscitation cubicle to drop off my patient report. The lifeless body lay on the bed. His wife sat beside him holding his hand. Her crying was less now, replaced by the look of shocked grief. She looked up at me and our eyes locked. No words were passed. I don’t know what she thought but my mind filled all the spaces. I was the one who told her everything would be alright.
I walked away.
‘He’ll be better than new with a couple of hours. He’ll be fine with us’. She fell a long way that day thanks to me.
Jeff Kenneally www.prehemt.com