Guppy-breathing and freshly-shined boots

So, today was the day to get poked and prodded by my new employer to see if I was "EMS material". I got to give blood, get a TB skin test (which requires another needle poke) and piss in a cup to see if I was on drugs or worse...pregnant. Not a violation of privacy at all, just the modern working order of things. It only took 2 hours and then signing the paperwork for my direct deposit and getting my ID badge was a fun little 20 minutes too. I got measured for my uniforms and ordered all of my flare for the shirt and then...

The REAL fun came after I left the personnel department and traveled to the cleaners to pick up a buddy of mines boots which were being resoled at a fraction of the cost he could get it done for where he lives. Once again, G-d Bless the military. As I walk into the store, I see the owner, frantically screaming into the phone about some guy that fell and "I dont think hes moving!!!" So I turn around and sure enough, there's some poor schmo laid-out in the parking lot with 4 or 5 people standing around him. So I take off running across the parking lot, thinking all the while to myself:" This poor old guy probably tripped and these stupid people are keeping him in the freezing cold until EMS gets here..." WRONG!!! He had not tripped, he had, in fact, fallen 10 feet from a ladder and if that wasnt bad enough...I asked the guy at his head what the hell was going on, and he says to me:"He had nails in his mouth, he was up fixing the sign." So I look at this guy and holy shit Pyle, he is spewing forth a constant waterfall of bright red blood from his nose and mouth. His eyes are glazed and he's guppy-breathing. Translated, that means that he's sucking air once every 5 or 6 seconds and he isnt getting enough. He has strong radial pulses and his pupils look okay. He has a big gash on the back of his head and I'm sure a nail either in his soft palate, the back of his throat, or both. Either way this guy looked like he was CTD (Circlin' the drain). So I ask for any EMTs, and the guy at the head says that he used to be one. So I tell him to:"Put your hands on either side of that guys head and hold his neck still and dont let go until someone tells you to." I have one leftover glove and one 4x4 so I just do a jaw-thrust to open his airway and start pulling blood out of his mouth and nose. He needs to be intubated, or assisted at the very least with his ventilations but there's no pocket-face mask and theres no way I'm giving mouth to mouth to someone who's bleeding into his airway. I'm becoming very concerned that this guy is going to die right here in front of me.

I start to hear sirens in the background and I think, PRAISE G-D for the the Fire Department!!! I have no equipment, no stethoscope, no nothing and here this poor guy is dying right here in the parking lot of a dry-cleaners/tattoo emporium. As soon as the FD checks on scene, the guy stops breathing. So I tell them that and check for a pulse. There isnt one.

"Guys, we got a trauma code!!" I yell as they grab a c-collar and hand me a bag-valve mask. I tell them that I'm an off-duty medic from another county and I can only do BLS. They suction him and keep his airway open and tell EMS to step it up, they've got a code-5. I keep bagging him, the former-EMT continues with c-spine and we get a collar on him. EMS shows up and puts him on the monitor. PEA. Pulseless electrical activity. Electricity is moving, heart isnt pumping. He needs a tube, TCP (pacing) an IV and lots of drugs. What he really needs is a surgeon, which the female medic was quick to point-out; "Guys, lets hurry it up, he doesnt need a paramedic, he needs a surgeon!" The paramedics go to set up the equipment they will need to intubate and start an IV and we get him on a backboard. The FD rolls him to the bus and I continue to bag him. We load him up and shut the doors. The whole time I'm thinking to myself:"I don't start here for another 2 weeks and here I am working a code in the middle of the street." I help the FD clean up the scene and get some alcohol wipes to get the blood off of my hands. The medics take-off, code 3 to wherever.

I thank the FD and wish them a Merry Christmas and walk back to the dry-cleaners to get my boots. As I walk in, there's a soldier there who was calling 911 while I was attending this guy. He and the store-owner look at me and say:"Is he going to live??" At which point, I say, probably not.