I saw death (graphic description)

Miscellaneous and Personal Stuff I Must Share
1

and it made me angry. I was really afraid it squick me out, doing CPR on a dead person. In reality, you don’t have time to feel squicky, because your arms hurt and the sweat is getting in your eyes and you’re kneeling in a pile of vomit, piss, shit, stomach acid, and blood and just trying not to slip in it. It gets really frustrating waiting for the paramedics to finish administering their rounds of medication and stop fucking with the unsuccessful attempt to intubate and just get the guy in the fucking van and start driving already. When you’re the low guy on the totem pole, you’re the one doing chest compressions for thirty minutes. Everyone knew the guy was long, long gone before we even got there, but I’m not going to be the guy giving half-assed one-handed chest compressions just for show. If I’m doing it, I’m doing it right, and at least in the back of my mind entertaining the smallest hope that I’m wrong about what I’m seeing and that goddamned robot-voice will finally tell me to push the fucking shock button this time.

“No shock advised.” Yeah, I know. There’s nothing left to shock. Even the fucking robot knew this guy (a kid, really. Much younger than me) was so far gone it wasn’t worth the battery power to shock him. That’s not fair, really. The robot was just doing what it was programmed to do.

He might not be worth the robot’s battery, and I might not even have had the smallest glimmer of hope bringing him back, but the kid was at least worth the respect of my best effort.

CPR on a dead person is like pouring water into a glass with a hole in the bottom. If there’s even the smallest hope at all it doesn’t drain you nearly as fast, but when you know everything you’re doing is just wasted, it takes a lot more effort. You sweat twice as much, your arms feel like jell-o, you hear everything going on in the room and you’re wondering just why the fuck nobody else seems to be able to do their fucking jobs with a sense of urgency because you just want to stop and you can’t. You can’t stop.

Anyway, I’m not doing too well with this. This call was fucked up in so many ways, but I’m the only one who seems bothered by it. He was just a kid! Maybe it’s because I was the first one in, and I got to see the whole thing from beginning to end. I had to untie the rope and feel the wobbly bobble-head effect as I laid him down and stripped off his shirt. We were there before the cops, and the others were gone before the cops came. I had to stay behind and explain just what the fuck happened. I didn’t even know what the fuck just happened.

What most people in my profession don’t know is just how many people get involved when something like this happens. Most of us are there to load 'em up, drive 'em to the doctor, drop 'em off, and go get a cup of coffee. I don’t have that luxury. I’m in it from beginning to end, right there with the street cops and the sergeants and the detectives and psychologists and coroners and the anguished father screaming in misery and the witnesses and even the fucking clean-up crew.

There was a lot to clean up. He left a hell of a mess.

I’m home now. I think tonight might be the start of a drinking habit, but I think I deserve it.

2

I am sorry you had to go through this. I know nothing that a stranger on the internet can say will make this any easier, but you have my absolute respect for your efforts. I only hope that someone would work so hard if it were one of my family members. Go get yourself a stiff drink, and find someone to hug.

3

It really sucks to lose a patient like that, especially when they are young. My best advice to you is to have a hot shower and a cold drink, and then try to sleep easy in the knowledge that you gave this young man and his family your best effort.

(((Mosier)))

4

Unfortunately, reality sucks like that sometimes and equally unfortunately someone has to do the job you did. Thank you for giving it your best effort, despite the mundane horror and disgustingness of it all. Thank you for doing it instead of leaving the grieving father to feel compelled to do it. Thank you for having the fortitude to face such a scene and still act. Thank you for doing a job that is all too frequently nasty, harsh, icky, awful, and horrible but that must be done by someone. You are not appreciated enough. You are not paid enough. But rest assured there are those of us in the world who really do appreciate what you do, even when it seems pointless and horrible. The world would be even more bleak if there were not people like you to take on this work.

Now take a hot shower, find some way to relax, and don’t develop a drinking habit, but yeah, have a stiff drink if that helps.

5

Sorry to hear that things went so badly (both for your sake and for the family).
It sounds like there was nothing anyone could have done to save him by the time he was found, but I still think it’s not right that you were the only one responsible for chest compressions. I’ve done CPR enough to know how exhausting it is. Around here, the EMS department’s policy is that someone relieves the person doing chest compressions every 2 minutes no matter what, to make sure that the chest compressions are of high quality instead of by someone who’s too exhausted to push hard enough. Of course, EMS here also has a policy of not trying to screw around with doing intubations and just shoving a combitube in everyone, so that makes it a lot easier for the person controlling the airway to switch with the chest thumper. Our county’s statistics on survival for cardiac arrests are better than the national average and I think those two policies have a lot to do with it.

I was working in the emergency dept once when a young man who had choked to death was brought in. That was a very emotional case for everyone in the department. Seeing a young person die before their life has really started is heartbreaking. I hope you have someone you can talk to about these stressful and sad events.

6

Thanks for this response. I do have some people to talk to, and I’ve got you guys, too. My family is very supportive, and I told my wife what happened without going into too much detail. My support system is really big. I think it just takes some time to let all the emotions stop boiling and settle down.

I think the reason all the other EMTs were so casual about the whole thing is because everyone knew he was dead, we just didn’t have a doctor to call it. I’m still pretty new, so I haven’t gotten the cynicism they have in situations like this yet.

7

30 minutes? On a traumatic asystole? Who’s writing your protocols?

8

I wasn’t part of an ambulance crew. It took the crew about 20 minutes to reach me (47 stories up). They knew it would take at least 10 more to get back down to the truck from where we were working him, so they spent extra time making sure they did everything possible to save his life upstairs. The ambulance crew was on the scene for about 10-15 minutes prepping the drugs, hooking up their AED (because they didn’t trust mine) and letting it cycle a few times, trying to clear the airway and intubate, getting the c-collar on and securing him to the backboard. That amount of time in that situation is not unreasonable.

9

I’m sorry, I wasn’t trying to be snarky about the amount of time it took you guys to do your job, just trying to be sympathetic to the fact that you had to do compressions for so long. As its clear you know, the prognosis for asystole is bad, an order of magnitude worse for a traumatic etiology, and then again for one that’s gone on so long. So I’m just saying it sucks that they make you maintain the exhausting effort of CPR compressions for so long.

You aren’t part of an ambulance crew, so what do you do? Are you a police officer?

10

Wow. I don’t think I’ve seen a post quite like this before. I’m so sorry that you had to go through that. I know the images in your head probably won’t go away right now, but I’m here for you (as much as that’s possible online) and I care. Vent away anytime you like.

11

How exactly did the guy die - did he hang himself? You mentioned rope, but you also saw blood, vomit, urine, etc. Did that happen after he died or from some other trauma? Just curious.

12

Yeah, it’s tough. While working my way through college, I was a State Security Guard, and we had some add’l responsibilities, such as to remain at the scene of an accident until the real police got there.

I was the second person to arrive at an accident. A drunk had plowed into a telephone pole. His pregnant wife was out of the car and not breathing. One dude was trying some 1st aid, I sent another to call the police and ambulance (before cell phones), and I lit flares and controlled traffic.

The ambulance arrived before the police, and seeing me with a uniform, gun and badge, asked me to help- they wanted me to hold her arms on her chest while they loaded her on the ambulance (the arms were flopping down, and there was blood and stuff). I asked “will she make it?” and one said “There’s always a chance” in a loud voice- while shaking his head to me.

Her eyes were still open, but glazed. Her skin wasn’t cold yet, but still felt weird. I had basically held hands with a dead woman. I can’t forget it.

Mosier, my hat’s off to you. You did your duty. What else can we do?

13

I’m an EMT employed by a Vegas hotel/casino. Lots of Vegas hotel/casino properties keep EMTs on the payroll for times like this, because it can take so long for an ambulance crew to reach tricky areas of the property.

14

That’s part of the reason I posted here. The Dope is the best therapy anyone can hope for. :slight_smile: Thank you.

15

There’s a police investigation active right now. I’m not a doctor, so I can’t say how he died for sure, but I can say his neck was broken at the very tippy top of his spinal cord and I found him hanging by a belt (not a rope as I originally posted) from a fixture in the bathroom. Some of the squicky stuff was coming out of his mouth as I worked him, and some of it was coming out the leg of his pants. Losing bladder and bowel control is part of the process, unfortunately. There was no other trauma that I could see beyond the broken cervical spine.

16

That story sounds about as awful as this one. The body didn’t bother me, but the fact that I’ll never even know “how”, let alone “why”, will nag me for a long time.

17

Been there and done that. I live in a rural area where the closest time to a hospital, even running as hot as we can, is just short of 20 minutes. Add to that, we have 1 ambulance station in the middle of the county, and 10-15 minute response time is not unheard of.

A cardiac arrest is unrecoverable in my neck of the woods.

There’s one call that I’ve worked that left a bad impression on me. It was my first ever arrest call. We had a first responder beat us to the scene and he started CPR despite the fact that she was cold, and we thumped the lady for 30 minutes getting her to the hospital because the medical director on duty would not let us discontinue despite the reported indications for doing so. Per our protocol, we cannot cease CPR without direction, but we can under some circumstances not start, and she definitely fit those.

Hang in there. It’s a painful process to develop your cynicism gland, but you’ll get there eventually. FUBARed calls are part of the job, but they make the successes that much sweeter.

18

It’s interesting how we often zoom right to our areas of comfort/expertise – threemae’s question on protocols, for example, and now my observation: I’m sure this posting is helpful and theraputic. But given that there’s an active criminal investigation, you might want to mention to the detective(s) investigating this that you’ve made these posts. There’s a chance that you might one day have to testify about how you found the body, and little things, like the belt vs. rope business, can haunt a prosecutor if he doesn’t know about them. It’s unlikely, to be sure, but covering your bases isn’t a bad idea.

Obviously this is not intended as legal advice, and should not be relied upon as such. if you have a specific legal question, you should find a lawyer licensed to practice in your jurisdiction, which I am not. You’re not my client.

19

No. You don’t. And don’t even think about doing it.

I’ve been there, done that, had to throw the t-shirt away because of the blood on it. I know exactly what you’re feeling. Don’t drink, don’t do drugs. Find someone and talk about it in gory, explicit detail. Hell, if you can’t, then write it out in an email and send it to me. You won’t squick me out - because I’ve been there. But you do need to talk it out of your system.

Man, you did your best. That’s all you can do. And there will come a day - trust me, it will come - when you will do the same damn thing, except this time you’ll get a restart, and you’ll walk off feeling like the pinch hitter who homered in the bottom of the ninth to win the game. That’s what you need to remember.

20

This bears repeating. Calls like this are all part of the learning process. I’ve been on calls where CPR was started, and in my jurisdiction, we cannot stop without medical direction from the Doc in the Box. Unless the person has obviously been dead for days, we usually have to keep going.

Take advantage of your support system. Does your employer have a Critical Incident/Stress Debriefing team? Even just talking with co-workers and friends helps.

Please don’t start. You can come here and rant and rave; there’s several of us in EMS on the board, and we’re always willing to listen.