Humpty-Dumpty code

First and hopefully last call of the day started out as a routine "fall" call. We were advised by the squad truck that we had ourselves a V-fib code. We stepped it up code 3 and hauled ass over there. Turns out the lady had left a business and basically dropped dead. She looked to be in her 60's, in a really nice white business suit that I hated to cut off of her.

The Fire Department had already combitubed her and had delivered a set of 3 stacked shocks with the AED. As we got there, they were slipping the combitube in. Turns out Pete, one of the guys on the squad, had intubated with the combitube. First time I had ever seen that...

Things started picking up after that, especially when gastric contents (squash, I think) spewed forth in a volcanic flow from the Combitube: we got a line, gave Epi and Atropine (because she was now in Asystole) and we decided to run the code with the new AHA ACLS guidelines that are coming out next month that advise to perform continuous CPR no matter what advanced interventions are taking place. She got 3 rounds of drugs, several more defibrillations, and Lidocaine en route. I rode the rail and continued CPR out to the truck and we got her loaded. Lights and sirens with 2 firefighters to Duke we went and the code was called in the ER. Transfer of care was initiated to 2 doctors at the ED, our medical director included. A blood gas was retrieved before the decision to give Bicarb was made and the patients pH was 7.35, completely normal and outright amazing for someone who had been dead for 30 minutes. Guess there's something to be said for good CPR. Turns out after coronary ultrasound, the right side of the heart was still working rhythmically, and the left side was motionless. The lady had blown out the left side of her heart, which no one can recover from.

No matter the severity of the call or the depth of effort a medic may engage, sometimes it's just a hopeless case, but you try, you give 100% regardless. Not knowing that this attempt was impossible from the beginning makes this what we call a Humpty Dumpty code: "...All the Kings horses, and all the Kings men...."

Back in the Sh*t

And so, here I sit, indecisive as I am, at a Durham County computer blogging my little heart away. That's right, I'm BACK. Back at the job I loved to constantly complain about. I got trapped in the old adage that the grass is greener on the other side. I left my job and tried something new, only to find that it repulsed me, the way calls were run and the sheer ass-backwardness of the system. I didn't make it longer than 3 months before I yearned to come home to the ghetto. How I missed the gun-shot wounds and the welfare-mooching dregs of society. How good it feels to be home.

My first real day back rivaled with the national news attention paid to this area for the impending rape trial of some of the Duke Lacrosse players. While this is national news in and of itself, the real story comes from "Rae-Rae", the leader of the New Black Panther Party that descended upon the great city of Durham to make unjust and unsolicited demands from our city manager and our legal system. A fire captain I know put it best when he said: "Who the hell invited you? " Coupled with Rae-Rae's fourth-grade education, we also got to entertain the "National Alliance", which is our nations newest white-supremacy party. (They weren't invited either...) Nevertheless, they decided to march, on the same day, as the "New Black Panthers", causing quite a stir on Fox and Friends. It was an uneventful day, a surprising day of little violence on behalf of the militant and the genocidal.

A 3 hour extrication finished the day off after a 22 year old girl flipped her VW beetle because she thought driving down a narrow, 2-lane country road at 85mph was a good idea. (guess she was in a hurry.) As she was smacking into trees 25 feet up, I bet she rethought her earlier driving decisions. She was pinned in a way I have seen few people pinned but she managed to survive, but for the grace of G-d. Climbing in to do a blind IV stick was no picnic either, but I managed to get it. She was upside down, legs pinned by the steering wheel and the dash, left arm pinned by the drivers door and the collapsed roof and her right arm pinned back behind her by more of the roof. She looked like a circus-clown stuck in a beer can one has just smashed on their forehead. On top of this hellacious predicament, she managed to land, upside-down right in between to very large Oak trees. It couldn't have been planned better if it were a strategic drop. Once we got her out, she was life-flighted to UNC where she received treatment for her broken wrist, her only injury. Talk about lucky...damn.
Here's the car:





It's good to be home, I very much missed being pleasantly surprised by the idiots ghetto and their barrage of nonemergent complaints. I wouldn't have it any other way.