Author’s note: This story is based on a memorable call I ran as an EMT.
The tones jarred rookie paramedic Shane Hart from his catnap early that morning. “5221 Parkview Drive, 5-2-2-1 Parkview Drive on an unresponsive, calling Jefferson EMS.”
The word unresponsive worked like a double-shot of epinephrine. Shane jumped out of bed, grabbed his portable radio, and almost blew through his dorm door without opening it in his haste to reach the ambulance.
“5221 Parkview Drive, Parkview Care Center, room 324, 72-year-old male, unresponsive,” dispatch intoned. “Fire is in route. Time out, 4:36.”
Shane’s partner, Rob, a veteran EMT, jumped behind the wheel. Within seconds they were pulling out, red and blue flashes tearing up the night, wailing siren waking up the neighborhood.
They pulled up alongside the privacy fence that separated the parking lot from the three-story nursing home. Half-running to the back of the truck, Shane and Rob unloaded the cot and rolled it to a halt at the gate. “Just a minute, I’m trying to unlock it,” came a voice from the other side.
“Should’ve already done that,” Shane said, peering through the wooden slats. A middle-aged woman was fumbling with what looked like some high-tech lock box mounted on the inside of the gate.
The engine crew pulled in behind the ambulance, and four firefighter-EMTs hustled to a dead stop beside Shane and Rob. “Whadda we got, Shane?” Captain Harrington asked.
“Apparently they forgot to let us in.” Shane was bouncing on the balls of his feet, adrenaline spurting through him. He wanted to leap the fence. If the patient was coding in there. . . .
“Come on, let’s hurry it up,” the captain said.
“I’m trying, it’s just this lock . . .” the woman muttered.
“We don’t have time for this!” Shane said. “You called us out here for an unresponsive. We have to get to this patient now!”
“Listen, do you know if he’s in cardiac arrest?” Rob asked her.
“I don’t know, I . . . they sent me to unlock the gate . . .”
Shane blew out a breath, scanning the fence for a relative weak spot where the fire guys could pull it down. They seemed to be thinking along the same lines. Cap Harrington sent a couple of them back to the truck for their tools while he grabbed one of the slats and gave a heave. “Don’t do that,” the woman said. “Just one more minute, I’ll have it open.”
“We don’t have one more minute!” Shane yelled. “If this guy’s coding, every second is crucial!”
“I know, I know!” She was starting to panic.
Cap Harrington muttered something about a fire hazard. Shane shifted from foot to foot, tapping his fingers on the cot. He looked at his partner. Rob rested one hand on the cot and the other on his hip, but aside from a frown Shane thought he was acting about as unresponsive as the patient they couldn’t get to.
Finally the gate swung open. Shane and Rob and the fire guys poured onto the patio like a flood . . .
. . . only to lurch to another stop at the door. Now, the woman was trying to figure out the door code. “You have got to be kidding me,” Shane muttered.
Frantically she typed combination after combination, trying the doorknob after each one. Shane pounded on the window beside the door. Two nurses started toward the door, then stopped and looked at each other. “We can’t unlock it from inside,” one of them yelled through the glass.
Shane was ready to break some windows. “What do you mean you can’t—”
“What’s the door code?” Cap yelled back.
They looked at each other and shrugged.
“Well find someone who knows!” Shane shouted.
“Shane, calm down,” Rob said. “You’re not doing any good getting all upset.”
“Aren’t you upset?”
“Got it!” the woman shouted like she’d scored a touchdown. Shane turned and hauled the cot through the finally-open door. “Which way?” he shouted to anyone in the lobby.
“Third floor.” Someone in scrubs pointed to the elevators.
A minute later they were running down a third floor hallway toward an open door on the left. The patient was lying in bed, body bouncing as someone pumped chest compressions.
“Don’t you know not to do it in bed?” Shane yelled as the fire guys hauled the unconscious man onto a backboard. “It does no good on a soft surface.”
“When did you start CPR?” Rob asked the worker. As if it mattered, Shane thought.
“Uh . . . just now. I . . . they told me . . .”
Shane shook his head, swore under his breath. “Let’s go.”
Within moments they were loading him into the ambulance, and Shane was loudly commenting that they had a lot less trouble getting out than getting in. Rob had one of the firefighters drive, and Shane grabbed another to help out in back.
The ambulance flew over potholes and around curves, air horn blasting, siren screaming. The firefighter, Matt, manned the defibrillator; Rob dropped an oral airway and pumped the bag-valve mask. Shane couldn’t get an IV because the patient’s veins were collapsed, so he drilled an IO into the tibia and pushed a milligram of epinephrine. On the monitor, the body went from V-fib to asystole. Glancing sharply at the green line running across the screen, Matt shocked again, then started pumping chest compressions—hard and fast on a hard surface, like they’re supposed to be done, snapping a few ribs in the process.
Shane had Rob stop ventilations long enough for him to intubate. Then he radioed the hospital. Another shock; nothing. Another milligram of epinephrine; still flatline.
The ambulance pulled into the hospital. Shane and Rob hauled the cot through the ER doors, Matt riding the side of the cot, still doing CPR. They rolled into room 12, transferred the patient to the bed. A nurse hooked him up to the monitor and took over CPR. The doctor bustled in. “We’ve been attempting to resuscitate for approximately ten minutes,” Shane told her. “We were delayed by about ten minutes on scene, no word on when exactly he began arresting.”
“He’s dead,” she said flat-out.
Shane stared at her, and she added, “It’s been too long.”
Shane looked at the patient. The hospital monitor was reading asystole. He nodded. The adrenaline drained through his feet.
He trudged back out to the truck, plopped down in the passenger’s seat, and tried to start working on the run report while Rob and the firefighters cleaned up the back. He was deflated, but his mind seized like an epileptic.
Rob pulled himself in behind the wheel, wearing that calm, stoic mask he always wore. Shane stared at him. “Doesn’t that bother you just a little bit?”
He shrugged. “Just another day at the office, kid.”