By Jo Cerrudo, ER Nurse

August 1997…

“This is EMS. You’re getting a 9-year old boy in traumatic arrest after a direct blow to the chest with a baseball. He’s intubated; we’ll be there in 2 minutes. ” My hands shook when I replaced the EMS notification phone.

After years of dealing with gunshot wounds and stab wounds in our Level 1 Trauma Center, I was not easily fazed, but taking care of pediatric patients scared me. I worked at the Adult Emergency Room but hospital policy dictated that pediatric traumas come to the Adult side for the initial rescue interventions. Many of the ED staff have young children at home, and cases involving kids always evoked strong responses among the parents in our group. I could almost imagine some of the parents in my staff calling on the phone for their family.

The baseball stunned our patient’s heart, and it was being squeezed to life by the frantic efforts of the paramedics who initiated cardiopulmonary resuscitation at the field. Commotio cordis describes a sudden cardiac arrest from a blow to the chest. The baseball had caused a disruption on the heart rhythm at a critical point during the cycle of a heartbeat resulting in ventricular fibrillation. The quivering heart did not produce a heartbeat. There’s a 65% mortality rate. A nightmare coming to our doorsteps.

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By Grimalkin, RN

This morning, while I was giving report to the day shift nurse taking over my patients, she burst into tears.

She’s going to miss her children’s hockey play offs due to our strictly enforced every other weekend schedules. You work every other weekend, no more, no less, unless you are going to college (I work every weekend because I’m in college). She’s their hockey coach, and inevitably, each year, their last game falls on a day their mother has to work. I’ve come in early for her before.

So I offered to come in on my night off for an hour and a half so she could get to the game. I’m coming in that early because I know she won’t be done charting.

She turned me down until another day RN got involved. I reminded my coworker I only live a mile from the hospital, and it really wasn’t a big sacrifice for me. She finally agreed, and calmed down. We got permission from the charge nurse.

Nursing is one of the largest professions in the world. If you don’t know a nurse, I’m really surprised. Nurses talk a lot about the rewards of nursing. Catching that vital sign, saving lives, providing comfort, but nurses, by nature, are taught to martyr themselves on the altar of nursing.

When I was a new grad, I hated coming to work so much that I would wish I’d get hit by a car on my way to work just to get out of work. One night, while checking medication sheets, I confessed this to some experienced nurses and found out some of them still felt the same way.

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By Gina, Hospice Nurse

By Binder Smiff, Paramedic

I opened my work tray the other day to find an envelope.  Inside was a letter.  A standard letter suggesting with all integrity that I (amongst others) had managed NOT to kill someone.

Now, these letters don’t come often, but they do come.  In fact, I have a few now.  And I wager that anyone working in the job long enough will end up receiving at least one at some point.

I remember the job too . . . well, by process of elimination it’d be hard not to.  Of the five cardiac arrests I’ve done this year so far, only one of them wasn’t called on scene!

I would normally prefer to write about jobs that are either farcical in nature or tend to have some form of Frank Spencer-esque feeling about them.  So, it’s a bit weird (and rare) to write about something that . . . without trying to sound arrogant . . . went, um, so smooth.  Well, sort of.

Job simply came down as 70 year old male, unresponsive – red 2.  And, upon arrival I was presented with a venue that appeared perfect for the presentation of a cardiac arrest.  It was a large, empty, well lit room with a couple of chairs.  Near enough in the middle of the room lay my patient, on his back.  Quite possibly the best 360 degree access you could wish for.  Most people had left the room or were in the process of leaving and the only remaining folk were a couple of witnesses and friends of the patient.

As I was dumping my kit onto the floor I got the history . . .

“He said he felt a bit sick then just slumped to the floor”

Ah, short and sweet.  The way I like it!  Looking down at my patient I could see his fingers twitching and thought I could see some facial movement.  Therefore, thinking this was initially fake I leant down and went through the motions of DRABC.

D – Well, unless I’d missed a huge piano about to fall on my head or was about to be presented with an opening chest with teeth – like that scene in the film The Thing, where the chest opens and bites off the Dr’s hands when he performs CPR – I’m pretty sure I was free from danger.
R – I attempted the LAS’s preferred method of approach, calling out the patient’s name loudly and squeezing hard on the shoulder/neck region.  Nothing.  Oh, I thought, playing games are we?  I then flicked the eyelashes for a reaction.  Nothing.  Ah, I thought, that’s odd . . . in fact, is – is he breathing?
A – I quickly opened the patient’s airway for a quick check.  No resistance and clear.
B & C – Leaning down I watched his chest and instinctively went for both the patient’s carotid and radial pulses.  Nothing. Nothing and Nothing.

Well, what do you know.  I thought. You AREN’T faking it.

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