I had been moved from day watch to evening shift and not by choice. The people on that shift live a split life. There is nothing great about working from 1730 to 0430. Your sleep and social life goes right out the window. It was better known as the vampire shift. Your up all night and sleep all day. The guys on the shift were a tight knit group and on their days off everyone spent time together. There was no one else to spend time with because of your crazy schedule.
It didn’t take long before I became part of the vampire crew. There were so many great EMTs and medics on the shift. I soon realized why they were so good. Our EMS service ran approximately 100k calls per year. Over 70% of all calls received were answered from 1800 to 0600. There were 18 ACLS class Atlanta units to handle the call volume and sometimes we still called for mutual aid. The people on the vampire shift were getting experience and they were getting lots of it.
Many of the medics were eight to ten year veterans. They loved evening watch for that was when all the action happened. These guys were big adrenaline junkies and loved to make the eleven o’clock news. It was a contest to see who could get the most action each night. It was nothing to run two or three shootings and a cardiac arrest in a single shift. Call volume averaged 10 to 18 calls per shift. People say there is know way you can run that many calls, but we were only five minutes from most emergency rooms. You turned the calls fast in hopes of getting the big one.
My friend Scott had been in a slump for over a month. Each day he would say, “This has to be the night. I need to get my fix.” The shift would end and Scott would be without the big one. He would ask, “Did you get that shooting tonight?” I would laugh and say, “I am the man.” “You will see me in the paper tomorrow.” He was in a bad slump, and there was no end in sight. Summer and fall had come and still no good Pediatric Advanced Life Support Course calls. He had not run an arrest in over 8 months. I was on a roll and every night brought me something exciting and challenging.
Scott asked that I stay late after the shift to help cover shift change in the morning. It was no problem for me because I love overtime. He said that I would shut down my unit and get on his truck at 0430. As the shift began, snow and ice had been a possibility. You’re talking about Georgia. It never happens. By the way, it happened. Oh yeah, three inches of ice with a foot of snow on top. The town looked like a winter wonderland.
The shift was over and I got my gear to get onto Scott’s truck. The call came in no sooner than I set my butt in the seat. The big abdominal, I can’t walk or poop call. See what I mean Jeff? This is all I run and these Advanced Cardiac Life Support calls are crazy. One boring call after the other. There is no end in sight for my bad luck.
We pulled up on scene and the fire engine had not yet arrived. Scott cancelled fire after we made patient contact. The patient was a Hispanic male in his late fifties. He was talking and crying while holding his stomach. Can anyone here speak English? A young said, “He is my brother.” Okay, now can you tell us what is hurting your brother? His stomach is the problem. His studying of ACLS and PALS did not help anybody. He has a history of alcohol abuse. Scott asked the patient if he had a history of Pancreatitis. The patient had not long been released for the same complaint.
Scott began looking through his discharge papers, and the patient had a follow up three days prior with his medical Doctor. The patient had not gone to his appointment because he was on a binge. The patient kept crying and moaning while holding his stomach. Scott told the interpreter to advise the patient that if he did not stop drinking the alcohol would kill him. The patient said he had taken his last drink that night. As we were getting ready to prepare the patient for transport, His brother said, “He is not breathing.” I looked back at Scott and we both thought, this guy is faking. He wants to be melodramatic and cause a scene on his way out the door.
Scott looked at the patient for about twenty seconds and said, “Call fire for back up, he is in arrest.” The EMS supervisor and fire were now en-route to our location. We placed the patient in the floor and began CPR. A quick look revealed V-Fib. “Shock at 360 exclaimed Scott!” I charged the old life pack 5 up to 360 joules and I delivered the shock. The room was crowded with family and the wife screamed when the patient’s body jerked from the defibrillation. People were crying and screaming at my partner Scott. The patient’s brother was accusing him of bringing bad luck to his family.
The supervisor and fire had not yet arrived on scene. By this time Scott had intubated the patient and was preparing for another shock. The defibrillator went off with an eerie sound. A spark jumped from one paddle to the other. That was a close one Scott replied.
I turned to see my partner going down on the floor. A family member had a knife and was trying to stab Scott. I grabbed the man around the neck while Scott took the knife from his hand. The other family members began to help us restrain the brother of the patient. I called for P.D. ASAP over the radio. As the family held the attacker, we began to work the patient again. We’ve got a pulse! The patient wasn’t breathing but at least we have a pulse.
The cavalry had arrived and we all began to prepare the patient for transport. The police had placed the man in custody when another fight spilled out into the front yard. I thought we had our hands full, but the two officers were involved with hand to hand combat. The patient was on a long back board and strapped from head to toe. It didn’t make it any easier to get up the hill. The ground was covered with ice and snow. Oh yea, the patient went back into V-Fib and PALS certification while moving him to the unit. Scott fired off another 360 joules which converted him back into a sinus rhythm. We hung lidocaine at 2/mg a minute after a 100 mg bolus IVP.
The EMTs from Atlanta Fire helped Scott work the patient all the way to the hospital. I jumped up front to drive us in. That was the longest trip ever. I am terrible driver when it comes to driving in the snow and ice. The man had a strong pulse upon arrival at the emergency room. The patient had been shocked over 19 times. The E.R. staff was in disbelief that the patient was still alive.
The man lived for 3 hours before he died in the ICU. The M.D. stated that the patient had a large inferior myocardial infarction. His heart function was less than 25%. It’s a miracle he made it to the emergency room.
Scott was so exhausted after the call. You could tell this incident was an eye opener for the both of us. As the dawn began to break, the shift ended. We sat in the EMS room reevaluating the call over and over. This run could have been our last. Never the less, Scott and I learned a great deal from this arrest and from one another as well. You and your partner are all you have sometime. You must be able to rely on one another. It could have easily gone the other way. I could have been killed or Scott may have lost his life.