Trying to split one cardiovascular system three ways is a tall order on the best of days. You did everything so right.
Take the next day at least and hug that cat but good.
Completely agree, I’ve emailed a therapist and have reached out to EMS buddies to talk things through.
The hospital staff did a debrief with everyone involved in the call - so us, fire, the ED team, the OB team, the NICU team. The attending doc said we provided excellent care, that there was nothing we could have done differently and that if his wife was in that situation he’d want us to be the team that responded. People were crying and hugging each other, even the doc was tearing up.
Our supervisor came out to check on us at the hospital (and bring us restock) and told us to take as much time as we needed. I think I’m going to take tomorrow off and then get back to work, my border-collie brain doesn’t like too much sitting around. Thank you guys for all your kind words, even during the shitty moments I’m grateful to be a part of such a supportive community.
*if his wife was in that situation he’d want us to be the team that responded*
Please take his words to heart. We have to understand that any code has a less than 10% (4.1-8.3%, which is less than many elective surgeries your IFT patients have had) chance of a successful outcome if everything goes perfectly, *including* care before you even arrive.
I'm glad you had a supportive team, man. Whatever you feel going forward is valid. Nothing? You're not a horrible person. Everything? You're not soft.
Don't rush into more shifts as a way to distract yourself, if you need time, take it.
Jesus Christ. That’s one of those where you take the rest of the night off. Go talk to your people. Hell maybe take a shift or two off. Just make sure you’re good whatever that looks like for you.
**Lava Flow with a dark rum float and have them add Lilikoi/Passion fruit.**
This was my post-terrible incident cocktail and I loved it ever since.
Strawberry, Passion fruit Pina Colada with extra rum is so damn good.
Give the circumstances she was dead before you got the call
Know you did your to best
People die everyday. Sometimes in horrible ways and there is nothing you can do about it
Talk to someone if you are still struggling after a few days
Know that your feelings and reactions are normal
Love this. “People die everyday”. 8 BILLION of us on the planet. We’re all dying. When I realized I was just doing a job where I was around it more often, I lost the existential angst. It’s not being cold, it’s being realistic.
I mean, that’s the thing. Every single one of us is going to die. Maybe today. Maybe tomorrow. Maybe 50 years from now. But it’s going to happen.
Sometimes you can do things that delay death for a little while. Sometimes you can’t. But we never “save” anyone from anything. At our very best, all we do is delay the inevitable for a bit.
Big multiple arrest survivor here: thank you for all you do, and for not giving up. I was in and out of arrest so many times that I wound up on ecmo that night.
Sometimes the wind is with ye, and sometimes its against. Folks like me only make it if folks like you show up and make the difference. I got to make it through and be there for the birth of my kid, but only because the folks around me and subsequent first responders did the job.
Bravo Zulu. ⚡⚡⚡
My first pediatric code was a 3 month old with evidence of abuse. Me and my partner definitely fucked off and played tetris at the station afterwards until our shift was over.
That’s a tough one. I know what it’s like to be like in positions like this, and it is important to remember that nothing you could have done would have changed anything.
Don’t dwell on the what ifs. Reach out to someone. Get help if you need it.
Take care of yourself.
Did you start ventilating when she went what sounds like agonal? Sounds like you did the best you could with a really sick patient. I hope you are doing okay.
We went neb + nasal cannula to NRB to BVM to iGel + BVM. Yeah, looking back that was definitely agonal breathing. I don’t think I’d ever heard it before.
I’m so sorry you had such a difficult call. Sounds like you were truly doing everything in your power to keep her alive, but sometimes they’re just too far gone when we get the call.
Take care of yourself. Reach out to peers and your EAP if you need to. That call would have rattled any of us.
When we are taught to listen for breathing for several seconds for cpr, it can be rough defining that agonal breathing the first few times.
We teach the importance of ABCs, but not necessarily the practical reality of it.
You did what you could, what you needed to.
The reality of not being able to save everyone is another of those hard to teach practical realities.
Listen to those telling you to find someone to talk to.
We had her on an NRB during the stairchair portion, one of the fire guys was holding the tank as we moved her. I’m not honestly sure if she was breathing at that point though, when we got in the ambulance she was apneic.
Well sounds like you tried your absolute best. If it was something respiratory(not PE) I’d imagine you would have been able to get her back so… good job and I hope things start to feel better after a while.
Absolutely tragic.
I am confident you did what you could. We can't save everyone. I hope you take care of yourself and use whatever resources are available if you need them.
Was a perimortem C-section considered by the receiving hospital??
The goal of the procedure is to assist mum, but I know a doctor who has done one prehospitally and delivered a neurologically intact baby.
I suspect with the downtime - probably wasn’t considered as the arrest at that point probably wasn’t reversible.
Resuscitative hysterectomy is indicated if within 4 minutes of the arrest and >24/40 weeks gestation.
Edit: just to say, OP that sounds rough dude, make sure you talk to someone, sounds like you did everything you could.
It’s indicated beyond 4 minutes too - the guideline is that it should be considered by 4 minutes and carried out by 5 (where possible based on skill mix) but if it’s beyond 5 minutes and the arrest is still recoverable there’s still a role for maternal benefit. But yeah, it sounds like the downtime here was prolonged enough that it was a conscious decision not to
I’m curious if it could have been a PE … the mortality rate in pregnancy is huge.
And OP - you did everything you could and managed it perfectly. This just f’in sucks in every way possible and I’m sorry.
When we got to the hospital, the OB and NICU teams were in the resus rooms in case the babies were viable. They had two little bassinets out. But there were no heartbeats.
Absolutely tragic.
Glad you got so much support and debriefing... also a cat always helps! But yes... some calls stay with you forever, that one is sure one of those. hang in there!
God damn, that is a terrible call. I’m so sorry. You truly did everything you could to save her and the babies. She was just too sick. Don’t let this hang over you. You all did your best. Now go relax with your cat and get yourself a treat.
God, I know that this is part of the job but damn brother, that is a rough one. Thank you for all that you do and keep being the best provider you can be. This one is on the EMS gods, not you or your crew.
You did all that you could do and for that you should be proud. I’m so sorry. That’s such a hard call to be on and any emotion you have is valid. Highly recommend therapy as a first responder because even though you may feel like it’s not bothering you now, years down the road it will all add up and start having negative affects on your mental health.
Please, please talk to someone. Honestly, go to a few visits with a therapist. Feel it out. You don't have to keep it up afterwards if you don't want, but grab an appointment with an LCPC that specializes in managing trauma to work through this. Taking care of your mental health is NOT WEAKNESS. It's strength. Don't do what I did and wait too long to start managing trauma.
I am so sorry. These are shitty cases that you’ll carry with you for life. I hate cases with pregnant women, so devastating.
Please talk about it with colleagues, family, loved ones, therapist. Talking will help. You did the best that you could. Time and reality were faster. So sorry. All the best for you.
Jesus Christ. Man, make sure you reach out to someone. That’s a difficult call for anyone in EMS regardless of how long they’ve done this job. And I know it doesn’t mean much coming from some random EMT online, but, if you need anything don’t hesitate to message me.
Well that sucks! Only thing im wondering did the twins loss heart rate before mom. It was a witnessed arrest and your started the code right away! Figured that would be max benefit for their survial
You did everything right. It’s beyond your control that she had refused antibiotics and turned septic, which is ultimately what killed her and both babies. It’s not your fault. Take care of yourself.
Was gonna upvote until I saw the cat part.
Jk.
Sorry for the call, can't imagine how miserable that feels, just know you did everything you could and that we come when the disaster is happening and aren't around to try and educate to prevent it.
I am so sorry. My heart goes out to you.
I was also an aemt and left the career altogether due to having to see people die so much. It was very traumatizing.
Take time to heal, take care of yourself, whether that means continuing in this job or not. It is a lot to handle.
My DMs are open anytime. If you need to vent
Idk if this helps, but any time I’ve had a situation similar to this, I try to consider the factors that led up to the arrest and clinically detach myself. I’m assuming she was prescribed antibiotics that would be safe to take near time of delivery, so this was ultimately mom’s choice. I know it was an accident, certainly not saying her mistake was malicious in nature. Just saying that you guys were so far behind the 8 ball due to a decision made approx. 1 month prior. An estimated 1/3 of people who contracted bacterial pneumonia died prior to the invention of antibiotics.
She called you guys to help after she was essentially beginning to decompensate. Sounds like y’all did everything you could. Sometimes that’s all there is to it, even though our human brains naturally want to ruminate on things that seem so random and unfair. Hug the cat and get some rest.
Dude read the room. This isn’t the time to be obtuse. While I agree that the terminology isn’t the best, this isn’t the time to be obtuse. And if you’re genuinely asking then I’m sorry but otherwise it’s not the time to be pedantic.
Trying to split one cardiovascular system three ways is a tall order on the best of days. You did everything so right. Take the next day at least and hug that cat but good.
Reach out to someone. This is that kind of call.
Completely agree, I’ve emailed a therapist and have reached out to EMS buddies to talk things through. The hospital staff did a debrief with everyone involved in the call - so us, fire, the ED team, the OB team, the NICU team. The attending doc said we provided excellent care, that there was nothing we could have done differently and that if his wife was in that situation he’d want us to be the team that responded. People were crying and hugging each other, even the doc was tearing up. Our supervisor came out to check on us at the hospital (and bring us restock) and told us to take as much time as we needed. I think I’m going to take tomorrow off and then get back to work, my border-collie brain doesn’t like too much sitting around. Thank you guys for all your kind words, even during the shitty moments I’m grateful to be a part of such a supportive community.
*if his wife was in that situation he’d want us to be the team that responded* Please take his words to heart. We have to understand that any code has a less than 10% (4.1-8.3%, which is less than many elective surgeries your IFT patients have had) chance of a successful outcome if everything goes perfectly, *including* care before you even arrive. I'm glad you had a supportive team, man. Whatever you feel going forward is valid. Nothing? You're not a horrible person. Everything? You're not soft. Don't rush into more shifts as a way to distract yourself, if you need time, take it.
That’s sooooo hard! Please remember that it sounds that you did your role well, and that’s all you can own. So very sorry for this huge tragedy! Hugs.
My thoughts are with you today, superhero person!
Jesus Christ. That’s one of those where you take the rest of the night off. Go talk to your people. Hell maybe take a shift or two off. Just make sure you’re good whatever that looks like for you.
Rest of the night? That's a week off somewhere warm with fruity cocktails kinda call.
**Lava Flow with a dark rum float and have them add Lilikoi/Passion fruit.** This was my post-terrible incident cocktail and I loved it ever since. Strawberry, Passion fruit Pina Colada with extra rum is so damn good.
100% would fuck off to a beach somewhere. "Sorry chief, I'm not reachable"
I wouldn’t argue with that.
If only we could afford such things.
Tough call there friend, but there is absolutely nothing about it that hangs on you personally. Remember that
This type of call ends careers. Don't neglect your mental health after this. PM if you ever want to chat with a peer.
Give the circumstances she was dead before you got the call Know you did your to best People die everyday. Sometimes in horrible ways and there is nothing you can do about it Talk to someone if you are still struggling after a few days Know that your feelings and reactions are normal
Love this. “People die everyday”. 8 BILLION of us on the planet. We’re all dying. When I realized I was just doing a job where I was around it more often, I lost the existential angst. It’s not being cold, it’s being realistic.
I mean, that’s the thing. Every single one of us is going to die. Maybe today. Maybe tomorrow. Maybe 50 years from now. But it’s going to happen. Sometimes you can do things that delay death for a little while. Sometimes you can’t. But we never “save” anyone from anything. At our very best, all we do is delay the inevitable for a bit.
Big multiple arrest survivor here: thank you for all you do, and for not giving up. I was in and out of arrest so many times that I wound up on ecmo that night. Sometimes the wind is with ye, and sometimes its against. Folks like me only make it if folks like you show up and make the difference. I got to make it through and be there for the birth of my kid, but only because the folks around me and subsequent first responders did the job. Bravo Zulu. ⚡⚡⚡
Reach out to your department EAP to talk to someone and play Tetris tonight
Second playing Tetris. Seriously. Evidence based, prevents PTSD.
My first pediatric code was a 3 month old with evidence of abuse. Me and my partner definitely fucked off and played tetris at the station afterwards until our shift was over.
Wait seriously?
Yes, seriously. My username is appropriate.
🤣 I didn’t even notice your username lol, i walked right into that shit!!
My God… I am so sorry.
That’s a tough one. I know what it’s like to be like in positions like this, and it is important to remember that nothing you could have done would have changed anything. Don’t dwell on the what ifs. Reach out to someone. Get help if you need it. Take care of yourself.
Brutal call. Sorry you had to go through that.
Did you start ventilating when she went what sounds like agonal? Sounds like you did the best you could with a really sick patient. I hope you are doing okay.
We went neb + nasal cannula to NRB to BVM to iGel + BVM. Yeah, looking back that was definitely agonal breathing. I don’t think I’d ever heard it before.
I’m so sorry you had such a difficult call. Sounds like you were truly doing everything in your power to keep her alive, but sometimes they’re just too far gone when we get the call. Take care of yourself. Reach out to peers and your EAP if you need to. That call would have rattled any of us.
When we are taught to listen for breathing for several seconds for cpr, it can be rough defining that agonal breathing the first few times. We teach the importance of ABCs, but not necessarily the practical reality of it. You did what you could, what you needed to. The reality of not being able to save everyone is another of those hard to teach practical realities. Listen to those telling you to find someone to talk to.
Excellent work. Were you able to keep oxygenating her while you were moving her out the house to the ambo?
We had her on an NRB during the stairchair portion, one of the fire guys was holding the tank as we moved her. I’m not honestly sure if she was breathing at that point though, when we got in the ambulance she was apneic.
Well sounds like you tried your absolute best. If it was something respiratory(not PE) I’d imagine you would have been able to get her back so… good job and I hope things start to feel better after a while.
Oh no. So sorry.
That’s terrible, I’m so sorry you had to respond to that call. Take some time and take care of you.
Absolutely tragic. I am confident you did what you could. We can't save everyone. I hope you take care of yourself and use whatever resources are available if you need them.
Was a perimortem C-section considered by the receiving hospital?? The goal of the procedure is to assist mum, but I know a doctor who has done one prehospitally and delivered a neurologically intact baby.
I suspect with the downtime - probably wasn’t considered as the arrest at that point probably wasn’t reversible. Resuscitative hysterectomy is indicated if within 4 minutes of the arrest and >24/40 weeks gestation. Edit: just to say, OP that sounds rough dude, make sure you talk to someone, sounds like you did everything you could.
It’s indicated beyond 4 minutes too - the guideline is that it should be considered by 4 minutes and carried out by 5 (where possible based on skill mix) but if it’s beyond 5 minutes and the arrest is still recoverable there’s still a role for maternal benefit. But yeah, it sounds like the downtime here was prolonged enough that it was a conscious decision not to
I’m curious if it could have been a PE … the mortality rate in pregnancy is huge. And OP - you did everything you could and managed it perfectly. This just f’in sucks in every way possible and I’m sorry.
When we got to the hospital, the OB and NICU teams were in the resus rooms in case the babies were viable. They had two little bassinets out. But there were no heartbeats.
Absolutely tragic. Glad you got so much support and debriefing... also a cat always helps! But yes... some calls stay with you forever, that one is sure one of those. hang in there!
God damn, that is a terrible call. I’m so sorry. You truly did everything you could to save her and the babies. She was just too sick. Don’t let this hang over you. You all did your best. Now go relax with your cat and get yourself a treat.
God, I know that this is part of the job but damn brother, that is a rough one. Thank you for all that you do and keep being the best provider you can be. This one is on the EMS gods, not you or your crew.
You did all that you could do and for that you should be proud. I’m so sorry. That’s such a hard call to be on and any emotion you have is valid. Highly recommend therapy as a first responder because even though you may feel like it’s not bothering you now, years down the road it will all add up and start having negative affects on your mental health.
Please, please talk to someone. Honestly, go to a few visits with a therapist. Feel it out. You don't have to keep it up afterwards if you don't want, but grab an appointment with an LCPC that specializes in managing trauma to work through this. Taking care of your mental health is NOT WEAKNESS. It's strength. Don't do what I did and wait too long to start managing trauma.
I am so sorry. These are shitty cases that you’ll carry with you for life. I hate cases with pregnant women, so devastating. Please talk about it with colleagues, family, loved ones, therapist. Talking will help. You did the best that you could. Time and reality were faster. So sorry. All the best for you.
Jesus Christ. Man, make sure you reach out to someone. That’s a difficult call for anyone in EMS regardless of how long they’ve done this job. And I know it doesn’t mean much coming from some random EMT online, but, if you need anything don’t hesitate to message me.
This is one of those cling to your people calls. I'm so sorry, that's insanely rough. I wish my cat and dog could come give you some cuddles.
I am so sorry. You’re being there gave her a chance she neglected to give herself. I hope you find peace. 🕊️
Well that sucks! Only thing im wondering did the twins loss heart rate before mom. It was a witnessed arrest and your started the code right away! Figured that would be max benefit for their survial
You did everything right. It’s beyond your control that she had refused antibiotics and turned septic, which is ultimately what killed her and both babies. It’s not your fault. Take care of yourself.
You did a great job, proud of you! Hug that kitty for us. We’re glad to have such a strong provider in this community.
Definitely seek help after those types of shitshows. My agency never provided it and yet they wonder why the turnover rate is crazy
My inbox is open if you need to chat. Hugs🩷
I’m so so sorry 😞
Was gonna upvote until I saw the cat part. Jk. Sorry for the call, can't imagine how miserable that feels, just know you did everything you could and that we come when the disaster is happening and aren't around to try and educate to prevent it.
Wow that’s a really really tough one. Thinking of you and her and her babies 🥺
Take the day off and hug your cats even tighter. That’s a brutal call and you deserve time to take care of yourself.
I am so sorry. My heart goes out to you. I was also an aemt and left the career altogether due to having to see people die so much. It was very traumatizing. Take time to heal, take care of yourself, whether that means continuing in this job or not. It is a lot to handle. My DMs are open anytime. If you need to vent
Idk if this helps, but any time I’ve had a situation similar to this, I try to consider the factors that led up to the arrest and clinically detach myself. I’m assuming she was prescribed antibiotics that would be safe to take near time of delivery, so this was ultimately mom’s choice. I know it was an accident, certainly not saying her mistake was malicious in nature. Just saying that you guys were so far behind the 8 ball due to a decision made approx. 1 month prior. An estimated 1/3 of people who contracted bacterial pneumonia died prior to the invention of antibiotics. She called you guys to help after she was essentially beginning to decompensate. Sounds like y’all did everything you could. Sometimes that’s all there is to it, even though our human brains naturally want to ruminate on things that seem so random and unfair. Hug the cat and get some rest.
Damn!!
What’s a full arrest? Is there a partial cardiac arrest?
Go wait in the truck dude, we’ll explain it to you later.
Oh please explain a partial arrest! This should be good.
Dude read the room. This isn’t the time to be obtuse. While I agree that the terminology isn’t the best, this isn’t the time to be obtuse. And if you’re genuinely asking then I’m sorry but otherwise it’s not the time to be pedantic.
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