Picked up n extra shift for some reason. This one was a night shift. Stupid things happen when I work extra shifts. Bad things happen when I work a night shift. This was both bad and stupid. I was working with a new partner, in a new area, with fire department personnel I had never met before.
I should probably stop picking up extra shifts.
62 year old female, witnessed cardiac arrest. Her husband saw her clutch her chest and literally fall out on the kitchen floor. Sounds like a movie, right?
After we make it to the house, which was a miracle in and of itself, as there were no lights on anywhere, nor any numbers on the house, we find what appears to be a very dead-appearing female on the floor of her kitchen.
Nice kitchen, too. Granite counter tops, nice tile backsplash, stainless steel appliances, all that stuff. I’m not sure if Home Depot charges extra for the ventricular fibrillation we found on the monitor.
The v-fib was promptly converted to asystole. Partner had retreated to the ambulance, and returned about the same time the monitor was defibrillating, with the Zoll Autopulse.
The airway had been secured with an ET tube, defibrillation performed, and good chest compressions were being delivered within 5 minutes of every one arriving on scene. Someone had started an IV somewhere, somehow. Things were running pretty smoothly.
“Let’s go ahead and log roll her onto the backboard, and get the Autopulse on her.”
“No. That thing takes too long to put on, and our policy says we can’t interrupt chest compressions for more than 10 seconds.”
Knowing full well that is not a very intelligent statement, and that I will attach the Autopulse once we make it to the ambulance, I don’t push the issue.
“Alright then. Let’s go ahead and move her to the stretcher, and to the ambulance.”
“No, we can’t. Our policy says we have to stay on scene and work the patient for 15 minutes before we can leave.”
“Okay. Wait. WHAT?”
“Our policy says we have to stay on scene of a cardiac arrest and work the patient for 15 minutes before we can leave the scene.”
Community Hospital is easily 15 minutes away, says Partner.
Frankly, I didn’t believe that anyone in any sort of management position would ever create such a policy that makes absolutely no sense. I certainly can’t imagine any medical director knowingly, and willingly, sign off on such a protocol.
What happened in the end?
The fire department went back in service, the Autopulse was applied to the patient, and a ventilator was connected. We transported the patient to Community Hospital, where she was pronounced dead approximately 5 minutes after our arrival.
No more extra shifts for me. At least for a month.