B
BioCatholic
Guest
I left my paramedic shift early tonight because i have had it.
we get a call for a 35 yr old female in borderline respitory arrest, so we hop it on down and arrived to find her laying on the floor with snoring respirations and moving almost no air. about 4 breaths/min. now she looks about 5-6 months pregnant, but the husband informs us that she has end-stage breast cancer. while my partner goes right for intubation, i put her on the EKG. I asked if she had all her medications written down, or any medical information so we could take it with us, and he said she had a filefolder with everything in it. so he went and got it. he shoved it in my face 2 minutes later while im trying to start an IV, and right on top is the famous “5 Wishes” living will.
so my partner struggles with the ET tube, and even applying cricoid pressure does not get the stupid thing in. by then, shes in full respiroty arrest, and has coarse V-FIB on the EKG.
i looked at the living will’s first pages to try and see what she wanted, because if she specifies she wants no extrordinary means, then i cant do a thing.
her document specifies no extrordinary means. no CPR, no tubes, no machines or feeding. NADA. i tell the husband that i cant do anything, but he said that she told him that she would want to stay alive as long as possible for the baby. The pregnancy was completely unintended, after which she refused all chemotherapy and the cancer just went wild. but he assured me she would want CPR measures.
i even called medical control for an emergency override (which isnt even in the protocol), but at least if i had an MD sign off on it, its his license and not mine. but it was denied because i had an actual document in my hand.
needless to say, 4 min of failed attempts to get an ET tube, 3 min of figuring out what to do about the will and calling for orders, and 2 shocks at 200-300 joules, and she went into asystole.
should i have just ignored protocol? i mean if i did, you can bet the Florida Bureau of EMS would have taken my license when they reviewed it. actually i did break the law by giving 2 shocks, but i figured that it might restart the heart for long enough to get her to an MD who could do something. on the other hand, arent laws and protocols in place for a reason? i mean this woman had 5-6 months of opportunity to change the will, and all i had was the word of the husband.
so tommorrow there is going to be absolute hell to pay from the Captain, 2 persons are dead, and my license may be in a sling for administering shocks against protocol. Good day, all in all.
anyone have any suggestions, either about new career choices or what i could have done differently? i hear Africa is hiring medical professionals, maybe i can get a job there…
we get a call for a 35 yr old female in borderline respitory arrest, so we hop it on down and arrived to find her laying on the floor with snoring respirations and moving almost no air. about 4 breaths/min. now she looks about 5-6 months pregnant, but the husband informs us that she has end-stage breast cancer. while my partner goes right for intubation, i put her on the EKG. I asked if she had all her medications written down, or any medical information so we could take it with us, and he said she had a filefolder with everything in it. so he went and got it. he shoved it in my face 2 minutes later while im trying to start an IV, and right on top is the famous “5 Wishes” living will.
so my partner struggles with the ET tube, and even applying cricoid pressure does not get the stupid thing in. by then, shes in full respiroty arrest, and has coarse V-FIB on the EKG.
i looked at the living will’s first pages to try and see what she wanted, because if she specifies she wants no extrordinary means, then i cant do a thing.
her document specifies no extrordinary means. no CPR, no tubes, no machines or feeding. NADA. i tell the husband that i cant do anything, but he said that she told him that she would want to stay alive as long as possible for the baby. The pregnancy was completely unintended, after which she refused all chemotherapy and the cancer just went wild. but he assured me she would want CPR measures.
i even called medical control for an emergency override (which isnt even in the protocol), but at least if i had an MD sign off on it, its his license and not mine. but it was denied because i had an actual document in my hand.
needless to say, 4 min of failed attempts to get an ET tube, 3 min of figuring out what to do about the will and calling for orders, and 2 shocks at 200-300 joules, and she went into asystole.
should i have just ignored protocol? i mean if i did, you can bet the Florida Bureau of EMS would have taken my license when they reviewed it. actually i did break the law by giving 2 shocks, but i figured that it might restart the heart for long enough to get her to an MD who could do something. on the other hand, arent laws and protocols in place for a reason? i mean this woman had 5-6 months of opportunity to change the will, and all i had was the word of the husband.
so tommorrow there is going to be absolute hell to pay from the Captain, 2 persons are dead, and my license may be in a sling for administering shocks against protocol. Good day, all in all.
anyone have any suggestions, either about new career choices or what i could have done differently? i hear Africa is hiring medical professionals, maybe i can get a job there…
