2 for 7

It is 7:30 am and C-Shift doesn’t officially take over Station 16 for another thirty minutes. I am on B-Shift and right now we are recapping the night and enjoying a cup of hot coffee in the kitchen. We do this often as the off-going crew helps to get the on-coming crew up to speed. We chat about calls and training and most importantly turn over any information regarding the rigs and equipment we used. At 7:45 am the tones go off and we are informed of a man down on the fishing pier, CPR in progress. Often times we hear, "CPR in progress" and it comes to nothing; but not this time. Aid 16, Medic 17, Engine 17 and Battalion 16 respond to the fishing pier to see a small group of folks standing near the end of the five hundred foot long L-shaped pier. We unload all our gear and banter back and forth about the call, the length of the walk to the end of the pier and if the guy caught a fish. As we begin our march out, the group of people parts and we see a young man doing chest compressions. CPR in progress, indeed. Our level of intensity ratchets up a couple notches. The Medics lead the way with the rest of us in tow carrying aid kits and a defibrillator. I am marching out beside my BC and we discuss the possibility of the guy going down after catching a salmon. We arrive, take over active CPR, establish and airway and assist his breathing with a Bag Valve Mask. Now you must understand we don’t do CPR on live people. This guy is down on a cement pier not breathing and pulse-less. He is, for all intents and purposes, dead. We all work smoothly as a team. My Capt and I switch off with compressions and bagging. The medics hook up a monitor and begin and EKG. An IV is prepped and a line is established. The medic getting the needle into the patient’s arm begins to speak Vietnamese to the small crowd of Asian gentlemen standing around in hopes one of them might understand and help with a history of what happened and who our patient is. It doesn’t work. They all look at each other with puzzled faces and stop talking amongst themselves. A second Medic unit arrives and begins to assist. We have been doing compressions and bagging him for about 2 minutes when we have the defibrillator analyze his hear rhythm to see if he needs a shock to stimulate his heart to reestablish a heart rate. The d-fib shocks him and it works for about ten seconds then his heart goes back to a condition called ventricular tachycardia. V-tach is when the bottom of the heart muscle is fluttering out of sync with the rest of the heart muscle. The muscle fibers that make up the tissue that usually constricts and relaxes as one unit are not working together. The shock is a way we can oftentimes "reset" the entire hearts and get the fibers to constrict and relax as one large muscle mass. It is working, kind-of. We continue with CPR and the Medics follow their course of treatment with several meds designed to get the patient’s heard going again. We shock him four more times and each time the heart beats on its own for a few extra seconds. It is encouraging. We are keeping his blood circulating with the physical pressure created by the compressions and with each successive shock his heart is fighting to regain is position of pumping blood. As we work the thought of the situation plays out in our heads. There is a little pool of blood on the ground near the patient and we discover it is fish blood. Now most of us are fishermen and we can’t help but look around for and absent fish. A bystander with a camera phone states he took a picture just prior to the man going down. I look at my BC, who is scribing all the details and drug information on the back of small scrap of paper, and smile, our suspicions were accurate. He caught a thirty-plus inch King Salmon and had a heart attack. I ask the photographer what the time stamp is on the photo and then inform the medics that CPR started at 7:38, it is now past 8:00. CPR has been active for over twenty minutes. We begin to discuss getting the patient on a bed and to the hospital. As we discuss how this will happen we continue to think, "Where the heck is the fish?" A gurney is delivered and we strip all the pads to have a hard surface in case we need to continue CPR en route. The patient is loaded quickly and we are off to the Medic unit for transport to Stevens Hospital. While walking to the rigs I notice a small piece of paper fall from the full hands of my BC. It looks suspiciously like the note pad containing every bit of information about how the call went, what meds have been used and time stamps of each dose. It flutters to the edge of the pier and silently falls all the way to the ocean below. A bystander hears me mumble that we will need that piece of paper and he willingly climbs over the edge past the barbed wire and the "No Trespassing" sign to the rocks below. He wades knee deep to retrieve the paper and returns in less than a minute wet to his knees. A police officer on scene jokes that he won’t get in trouble for the climb. We load our patient and head out to the hospital continuing CPR and shocks each time getting more and more response from the traumatized heart muscle. I am tasked with driving the Medic unit. The four medics in the back are moving about in the rig while I drive and inform me that I need to drive slowly and carefully as we only have a seven minute trip and we are not in a huge rush. Right now the patients’ condition is improving and he is responding to the meds. As we arrive the medics try on last medication and we rush the patient inside to the waiting cardiac team. We give a short report and history to the team, direct the family to his side and depart the room to get back into service. Our work is done. Later that day we learn he was transferred to ICU for continued observation. What that means is our dead patient is now alive and expected to recover. A save, we got a save, in part thanks to the quick action of the bystander with the phone who had taken a CPR class. I am now 2 for 7 on CPR calls. A week later we are informed by the hospital staff that the gentleman walked out under his own power. He was taken home by his thankful family and fed a salmon dinner, his salmon. Apparently his buddy claimed the fish and put it into a cooler right as the gentleman went down with the heart attack. The news of his condition was delivered to our station by one of the medics and was greeted with handshakes and congrats on work well done. We all took part and worked the call well and the man survived an attack by the Fire Department. If you haven’t had a CPR class, take one. You never know when you might need it, hopefully you won’t. Tony