An Afternoon in Resuscitation

Definitely my favourite place so far. We had three red calls, 2 cardiac arrests and 1 CVA. Unfortunately I was on break for the first arrest, but the second one came in and I was ready for it.The call came in, gave us all the details, and gave us 5 minutes to prepare; '50 year old male, cardiac arrest, 9 shocks already delivered' was the gist of it.

That's when the adrenaline started to kick in.

We got the bed sorted, aprons and gloves on, defib on, drugs at the ready. Our team consisted of me, a nurse, a cardiac specialist nurse and a few doctors. I asked if there was anything they'd need me to do, and they asked me to do his cardiac compressions. I was suprised, it was only my first week. Nevertheless I was happy to take that on, it allowed them to concentrate on operating the defib and administering drugs.

He was wheeled in, the two ambulance crew helped move him onto our bed. I started compressions. It was difficult because he was very large, but I'm sure I managed to get the right depth. They told me to be continuous while they sorted out his airway and put the pads on (which monitor his heart rhythm and deliver the shock). His heart rhythm was analysed - he was still in VF. VF is a shockable rhythm.

'Clear top, clear middle, clear bottom, I'm clear - shocking now'

He was shocked, his arms and legs jumped with it. We carried on, thirty compressions, two breaths, thirty compressions, two breaths, look at heart rhythm, administer shock, etc. We'd shocked him three times, which totalled 12 with the ambulance attempt, when the doctor in charge came over. He suggested to stop, we all agreed.

'I think we should call it, he's had three times as long as the normal guidelines'

So we stopped, but then we hesitated. The nurse put him on the heart monitor, and he was still in VF. Although, it was slowly dying down and it was apparent that it would soon be asystole (no cardiac output - in other words - dead). We all looked around at each other, silently questioning ourselves if what we had done was right.

The nurse asked me;

'Do you understand why we stopped?'

'Yeah I do. You were trying but weren't getting anywhere, there was no improvement.'

'That's right. Are you ok with all of this?'

I nodded.

I wasn't happy with it at all. I know that I am new to this, and this was my first death, but I was not happy. I had only one thought circling around in my head;

If you are going to try to resuscitate someone, surely you should give it everything. Otherwise, what's the point?

I mean, how can you live with yourself knowing more could be done. I can't stop thinking about him, I would probably be ok if I knew that we gave it our all and he still died, but we gave in. His heart rhythm was becoming less like VF and more like asystole, but how do we know that wasn’t because we had stopped our resuscitation attempt minutes earlier? I know he'd had 12 shocks and I do understand, I just don't think we gave it everything. I think I will always wonder if just one more shock would have made that difference. The chances of that happening must have been so incredibly slim, but what if?

So we were left with a body, most of the clothes had been cut off. We finished undressing him and put him in a gown. We wiped the blood from the needle sites. His hands were cold to touch. He had been intubated, and his front teeth were nearly falling out. There was blood in his mouth. This would have been caused by the laryngoscope. I was told that we have to leave the tubes in, because the Coroner would need to check they were put in correctly. We cut off the ends and pushed them into his mouth, so they couldn't be seen. There were people that needed to be informed of his death, one of which was his GP. As it turns out, this man had visited his GP that morning complaining of chest pains, only to be told he was fine and sent home. His wife hadn't been told yet, she was sitting outside waiting. The nurse went to find the doctor, she said the doctor should be the one to tell her the bad news, because he would be able to answer a lot of questions.

We wheeled the body into the viewing room. It's a nice room, a light above the head, some leather armchairs, a painting of some flowers. My eyes welled up.

I won't be in resus much, which is a shame, but I am sure about doing my nurse training and being an A&E nurse so I will be in the future. So this has been my first week, and I have seen more in this one week than I have in 2 years of doing my voluntary first aid.

Already I can understand how it makes you feel jaded. I won't forget his face. Or his wife's.