Sometimes You Lose One

I was taking Kit to a medical appointment in town (in the next county), and there was an ambulance call. Not for us, so we continued on. Then there was a second call. Also not for us, but that meant both ambulances are now out.

We arrived at the appointment, and I go in with Kit — and my pager goes off. A third call, and it sounds really serious. I lock eyes with Kit. “If they don’t have a third crew available, I’m the closest.” And that’s not good, because we are 20 minutes from the call, and that’s with lights and siren.

When I didn’t hear anyone responding, I told her I’d come back for her and dashed out to my car. I got on the radio to ask Dispatch if anyone has responded to the call. “Negative.” I made the decision to order up an ambulance from Montrose, in the next county, to take the call, and ask Dispatch to get them going. And I head toward the call, which is at one of our County buildings.

Definitely Serious

The update comes when the town marshal arrived, and it’s bad: “CPR in progress.” I let him know what’s up: I’m on the way, I have a defibrillator, and I’m the closest, yet still 20 minutes away. That County building doesn’t have an AED — a defibrillator that anyone trained in CPR can use — but the next County building, five minutes away, does. They ask “someone” to bring that one. The Montrose ambulance is rolling, but they’re 10-15 minutes behind me. Ugh.

I know the head of the department in the building I’m going to. Chris is part of the vehicle extrication squad, which rolls on all crash calls. He’s got good training, and a level head. He also expects his guys to take CPR classes, so I know that whoever is doing CPR is probably doing a good job.

Helpful Workmates

When I finally arrive, I find everyone outside the building: the patient dropped in the driveway, and they’re working on him right there. Good: at least there’s plenty of room!

And indeed the guys are doing good CPR — on a co-worker. They had gotten the AED there before I arrived, but it was saying “No Shock Advised” — it doesn’t work “just if” the heart is stopped, it has to be a “shockable” rhythm. Sometimes you need to get drugs in to get the heart active enough to shock it. I start to work on setting up an I.V. so that when the Advanced Life Support medics arrive, they can hit the ground running, getting those drugs in.

Chris is there, and I recognize several other of the guys. “You OK to continue CPR?” I ask. They are, and are switching off the way they were taught — a tired rescuer can’t do good CPR, so the training is to switch off every two minutes, when the AED checks to see if a shock will help. I know that the ambulance is still at least 10 minutes away, so I get going on the I.V.

Sometimes That’s Hard

There’s only one problem: when you go to the doctor and they want some blood, they put a band around your arm so your veins stand up, right? There’s only one way that happens: your blood circulation pumps down the artery in your arm, and the band keeps it from leaving your arm via the veins. The veins get engorged and pop up, so there’s a target for the needle.

But you have a blood pressure! This patient didn’t: his heart was stopped, and CPR only barely keeps blood circulating. No veins popped up. It’s hard to start an I.V. in that situation. Not impossible — I’ve done it several times before — but a definite challenge. Sometimes people’s veins are a challenge even when their heart is beating.

But I could feel a vein, and maybe I could get it. I tried, but nothing. I tried again, and nothing. Just then the ambulance pulled up. Cool! I switch the band to the patient’s other arm so they can try. In some ways, I’m relieved when they can’t get a vein either.

There’s another emergency route to get drugs in, though: we can pop a needle into a bone! It’s called intraosseous infusion, or I.O. — osseous means relating to the bone, and it’s a way to get drugs in effectively that works pretty much as well as an I.V., but it’s almost a “sure thing” to get it established whether the patient has “good” veins or not.

As you might imagine, it hurts, but it’s not deathly pain: I once saw a paramedic volunteer to get one in his humerus (upper arm bone). He winced, but he took it. Our patient, though, was beyond feeling pain, and they popped it into the preferred location: his shin. We had a drug route.

We Can’t Always Win

But, to make a long story short, the drugs didn’t get his heart to react. We never got a “shockable” heart rhythm, and the patient was pronounced dead.

Normally, that’s the end of things for me. Kit was done with her medical appointment now, and I “could” go pick her up. But she has a new job in the county: the first of the year, she was appointed Deputy Coroner. I called her and told her what was up. She called her boss, who happened to have to drive by where Kit was to get to the scene. So she picked Kit up and brought her to start a “Death Scene Investigation” and, the part I sure wouldn’t want to do, go notify the patient’s wife. I waited with the body so the wife, if she desired, could come see him. And she desired it.

We’re too small of a county to have a “Coroner Van”, so we have an arrangement with a local mortuary to pick up bodies. I told their driver he’d have to wait, and asked him to park off to the side, as the Coroner and Kit brought the wife to the scene to say her goodbyes.

The Angel of Death, as depicted on a 1909 Tarot cardSo that was my afternoon, rather than finishing up True on time! I love it when we get a good “save,” plucking a patient away from the Grim Reaper (not this time, buddy! Ha hah!) But sometimes, no matter how hard we try, we can’t save them, and the Angel of Death wins. It’s part of the job: we have to be ready for it.

And if you think medics are somehow “special” for what we do, I have to say the Coroners and their deputies are very special too: they take the really tough job of notifying the family, and being there for them. They watch out for the interests of the deceased: securing their property, and advocating for them, for instance ordering an autopsy if someone dies at work and it’s unclear why. It’s not a job I would want, but my wife has taken it on, because she wants to be sure that the dead have someone watching out for them.

So next time you meet a Coroner or a deputy, shake their hand and say thanks. I think they have a tougher job than I do.


The county administrators really didn’t like that I posted this. It’s not a HIPAA violation (dead people don’t have privacy rights under that law), but they figured anyone who knew the patient would know it was about him. To me, that’s OK, even if his wife read it: she’d know that everything possible was done to save her husband, and a lot of people jumped into action.

In truth, the autopsy showed he was basically dead by the time he hit the ground. He wouldn’t have survived if he this has happened in front of doctors and nurses in a fully equipped emergency suite. The reason I write these stories is because few people know what really happens in a medical emergency like this, and what goes through the rescuers’ heads. And that’s true even if you’ve seen every episode of the Emergency! TV show. Seriously: did they ever have a CPR case where the patient didn’t wake up and go on their merry way?

So I made no apologies for writing and publishing this. People learned from it, and maybe the patient’s wife got some questions answered. We tried, but “Sometimes you lose one.”

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34 Comments on “Sometimes You Lose One

  1. This has been stated before, but bears repeating. The readers will wait. The work you do as an emergency services provider is far more important than getting your newsletter out on time. If your emergency service job causes you to be late with the newsletter — premium or not — it causes you to be late, and we will deal with it.

    I have seen this quote many times, but do not have a proper attribution for it. I think it sums up this situation nicely. Those who matter don’t mind, and those who mind don’t matter.

    Yep, I know, and appreciate it. I still will let readers know (e.g., by posting on Facebook) when I know there will be a delay, so you all know what’s up. -rc

  2. The hardest of all would have to be notifying parents of a child’s death. When EMS and/or the coroner are involved, it’s nearly always a case of a preventable accident.

    No, not at all. This case, for instance, was not an accident, preventable or otherwise. Indeed most of our calls are not for stupid (aka preventable) accidents. Deaths become coroner’s cases when the death is unexpected. An autopsy is performed only if the cause of death isn’t known — no doctor is available to say “I expected it, due to ____ medical condition.” and is willing to put that cause on the death certificate. -rc

  3. As a long time subscriber and a one time emergency responder, I will say simply that you can be as late as you want with your newsletter — priorities matter. Thank you and your wife for all you do for your community, local and worldwide.

  4. I really can’t add anything to Tim’s comment except that everybody is aware of your service and that it comes first. That is not even up for discussion. You got to do what you do. I won’t pretend to having the patience of a saint, but we will be here when the truly important stuff is done and you have the free time. And be sure to take time for yourself to just decompress.

    While I hate to lose one, and it sucks that there was a delay and I had to be “the” medic there for awhile, I’ve been in the biz long enough that these cases don’t really bother me — I’m not the one who has to deal with sending a spouse off to work, and never seeing them alive again. For me, it’s simply part of the job. I’m just glad it wasn’t a kid: that’s hard for medics, “part of the job” or not. -rc

  5. Obviously it’s unfortunate you and your colleagues weren’t able to bring this particular person back from the brink of death. But there are a lot of positive aspects to take from this incident, in that: the system worked, flawlessly.

    The fact your newsletter got delayed… meh, we’ll live.

  6. Thanks for all you and Kit do, Randy. Your compassion, and understanding, of humanity is a wonderful gift. The fact that you share it with your neighbors and community is a reward for all of us. As others have said, priorities matter and the publication timing isn’t high on the list compared to a person’s life or well-being. My condolences to the family and friends of the man who passed away.

  7. Kit & Randy, Thank you for the services you provide to our communities. We love you and appreciate what you do for us.

  8. I agree, priorities must be observed! I know how it is when there are few individuals to respond to emergencies. Thank God you and the others are well prepared.

    My sympathy and admiration for your wife!

    I think that’s why a lot of readers say they couldn’t handle such a sideline: it’s because they’re not prepared! So of course they wouldn’t be able to handle it. (Still, sometime they may have to, such as if a child or grandchild gets badly hurt, and they’re it until an ambulance comes!) We’re extremely well trained, and refresh and test that training on an ongoing basis. There are absolutely challenges to meet, and new things we’ve never seen before, but we “fall back on our training” and handle things one thing at a time. The basics are the “ABCs” — Airway (got one? If not, fix it!) Breathing (are they? If not, do it for them!), and Circulation (is their heart pumping? If not, do it for them: CPR!) If those are all good, great! Then move on to other things. Once the training becomes second nature (with experience), it’s not so daunting. -rc

  9. You have my deepest appreciation for what you and your fellows do.

    I had a pacemaker and 2 mechanical valves in 2007. My heart decided to ignore my pacemaker and wouldn’t work. Paramedics found me on the floor of my apartment. They shocked me and started and IV and got things working again. Spent 2 weeks in hospital and and had a defibrillator installed. It has never had to shock me. These people saved my life for which I am very grateful to every EMS worker out there.

    Thank you for what you do.

    We love hearing about such saves — people who don’t just live a few hours so the family can say goodbye, but go on to lead full lives. That’s what makes it so worthwhile! -rc

  10. Great write up Randy and excellent work as always. I especially liked how you mentioned that AED’s only work when there is a specific heart rhythm present. As I’ve said before, take all the time you need in cases like this. If I don’t get my True fix on Monday night it’s that much better on Tuesday.

  11. It is easy to recognize and thank those who where the uniform. It is almost impossible to recognize and thank the thousands of volunteers like you & Kit. Keep up the good work, and THANK YOU!

  12. As a retired American Heart Association Faculty Member I can tell you that all of your efforts were well considered and appropriate to the situation. You did your best. It is always a good idea to totally review each step you have made so as to make sure you have done the right things in the right order and then move on. If we win, good. If we lose we cannot overly invest in our own concerns. After all, we must all die sooner or later and to lose this battle is simply to admit that when it is over, it is over.

    I would mention one small thing. This is Florida and you too live in a very hot state. We here in Florida must be careful to protect patients from overheating from pavements or concrete slabs, etc. I carry one of the aluminum sheets that reflect heat/cold away from you in my truck. Placing them under a patient that is being resuscitated outdoors has saved a few survivors from burns. I suppose the same would be true of frostbite but I have no experience with that type of cold weather.The patient may have been already protected from thermal injury and it simply was not mentioned. I apologize if this was the case but my role as teacher is ongoing even if my health precludes the physical task of teaching CPR classes anymore.

    Please thank the wife for me as I am well aware of the difficulties of her job. And the necessity of it as well. I know several ME assistants and that is one tough job. Not nearly like the glamorized work of CSI, the tv program. (Dear CSI please do not work with corpses without your hair covered by appropriate disposable caps!)

    Your first paragraph perfectly describes my feelings; thanks for saying it in a concise yet precise way. As for the second paragraph, cold actually helps cardiac patients. I wouldn’t consider Colorado to be a hot state, but the weather was great yesterday: cool and dry. No need to move the patient to protect him. But indeed, that is a consideration we consider when things aren’t ideal! -rc

  13. I applaud your efforts there, even knowing the infinitesimal odds of getting a pulse back — much less having survival to discharge neurologically intact — after a 30 minute down time. It’s good that everyone tried, and tried hard.

    Have you considered getting your own IO? Whether the EZ-IO or one of the spring-loaded models (the Bone Injection Gun), that’ll get you into the circulatory system quickly. In my area, the protocol is to NOT attempt an IV in a code, but just go straight to the IO.

    I have one gripe, though: “I love it when we get a good “save,” plucking a patient away from the Grim Reaper — not this time, buddy! Ha hah!” The “not this time, buddy!” is tasteless, and the “ha hah!” strikes me as callous and cruel. I understand gallows humor (I’d better, I’ve been a paramedic for 15 years!), but we keep that to ourselves, especially when its about death. It wouldn’t be appropriate to say in front of the family, and there’s enough detail that people in your town would know exactly who you’re talking about.

    Be safe out there, brother!

    I don’t think laughing in the face of death is either callous or cruel. It’s what we strive to do, in fact. As for buying my own stuff, I have to balance the cost with the benefit. I’m not certified for I.O.s, so I’d have to take a class and stay current, on top of everything else, and keep the drill maintained/charged, for those few times that I could use it before someone else that has a service-purchased unit behind me by a few minutes. I have a few other things I’d rather have that cost less, and give a bigger bang for the buck. #1 on my list is 1:1000 epi for anaphylaxis, which I don’t currently carry. -rc

  14. I have been a longtime True subscriber, and an amateur writer. Deadlines, however urgent, can sometimes go by the wayside for various unforeseen reasons, and there is not much the writer can do about it.

    As for any True subscribers who might be inclined to complain, why not simply put a link into the delayed issue of True, to your blog, wherein they can see exactly WHY the issue was late?

    Your write-ups of incidents like this are very well done. Information is given, but not the details which violate the patient’s privacy, or anything tabloid worthy, such as “Senator X was found unresponsive in the bed of an underage prostitute, with a crack pipe in his hand, while wearing a negligee.”

    I hope I get to write that story someday! No one has complained. Even if I got 1000 complaints, I would ignore them, since taking the time to respond would delay the issue that much more. As for putting in a link, I included the whole story in last night’s issue since I thought they would find it of interest, whether they were irritated by the delay or not. Many (most?) don’t read it until morning anyway, so they didn’t see any delay. -rc

  15. Thank you SO-O-O much,Randy AND Kit….I’m just kinda curious why y’all are SO far apart?? Maybe he could’ve been saved if y’all were closer?? Damn, I HATE watching people die, y’kmnow??

    You’re AMAZING in all you do, and I thank GOD everytime you share these things w Us…I don’t DO Facebook, FYI.

    I’m unclear how I would know where to be when. I have a life to live, and can’t know in advance where an emergency will be. So I simply live my life, and jump into action when I can make a difference. And we all die sometime. This man had CPR-trained friends right there with him when he dropped, and they did a great job. He could have been in the emergency room with all the equipment, drugs, doctors, and such ready to go, and still die. That’s part of life, and you can’t pretend it isn’t — we’ll all be there sometime. -rc

  16. I would gladly give up an issue (or more) to hear that you’d been successful in saving a life. But even when, sadly, you can’t, True isn’t that important in the overall scheme of things. What you and Kit do just makes True all the better — because of the heart behind every story. The same heart that gives you the strength to do what you.

    Thanks for always being there and doing what you two do.

  17. Thanks for all you and Kit do to save lives. Not everyone can do your job due to the emotional toll of it.

    I have a question on the AED. We have one at work, and I was of the impression that anyone could setup and use this-even someone with no CPR training. I thought that the machine would “talk you through it”. Sounds like this is not the case?

    The AED doesn’t do all the work: if someone’s heart stops, you have to do CPR correctly AND shock them with the AED. Yes, the AED talks you through it, but they’re unlikely to survive with just a shock. Resuscitation is a package deal. Just take the CPR class and learn it all. -rc

  18. My sincere appreciation and admiration go out to you for your relentless dedication over the years to exposing the foibles of the society we live in. And even more heartfelt thanks for your work as an EMT — it is a sometimes very thankless task, and when you lose one, it’s heart-rending.

    Now, Kit has joined the ranks of those selfless people who do what they see as needing to be done. You are a very fortunate person, Kit is too — and society is also better off because of you two. Please give each other a huge hug, I would do it in person if I could.

    Please keep up the great work in all that you, and now Kit, do.

  19. I have more than once seen emergency medical response in action — including when I had to make the call myself for my grandmother’s heart attack. I’ve seen lives saved from the jaws of death, and I’ve seen death takes lives from the jaws of safety. More times than non-medical personnel should, in fact.

    With that said, I ask only this of you, Randy: If anyone EVER complains to you about delaying True due to emergency calls, or has the audacity to criticize you for failing to save a life despite your best efforts, please make sure to post it on the site and bring upon him an online smackdown.

    I doubt it will happen. I apologize not because I think people will be upset, but simply because I consider commitments important. It’s just that sometimes, other things take priority, and properly so. It’s still worthy of an apology. -rc

  20. I appreciate and applaud you for your efforts.

    Your writing is almost always top notch, clear, and captivating, but I too got tripped up by this: “I love it when we get a good “save,” plucking a patient away from the Grim Reaper (not this time, buddy! Ha hah!)”, and suspect it would have been easier to parse had you punctuated it like this:

    I love it when we get a good “save,” plucking a patient away from the Grim Reaper and saying: “not this time, buddy! Ha hah!”

    As it was written, it wasn’t clear that the “this time” referred to a time when you’d saved someone, vs. “this time, the story I’m telling about the guy I tried to save,” and thus raised the question about gallows humor.

    I understand the confusion, but can’t be perfect all the time. I would hope that people would understand it, even if they had to pause and think about it for a few seconds. -rc

  21. I think Brian from Louisiana misunderstood your comment about “not this time . . etc.” You weren’t saying it for this particular occasion, but in previous times when you DID manage to save the victim. So while it might have been callous to say it now, it certainly isn’t when you do “win one for the gipper, rather than the reaper.”

  22. I am so thankful for people like you and your wife. Several years ago when my mother had an aneurysm rupture she was taken by the local volunteer ambulance to the local hospital, both of which by people she knew well. At the hospital they did not know what was wrong yet but determined it was beyond the scope of what they could do as they were not a high enough Trauma Care unit, they simply did not have the skills.

    She was Life Flighted to another hospital about 40 minutes away, about 25 if you really pushed it. We got down there and found out what was wrong and they had just stabilized her and were getting ready to Life Flight her on to a Trauma 1 hospital about 1.5 hours away.

    The point to the whole story was the first responders who picked up my mom from her house were friends and took great care of her. The people who took her from one hospital to the next were total strangers and they took just as good care of her.

    I have nothing but the greatest of respect and gratitude for any and all first responders, whether they are Firefighters, Ambulance Crew, or whatever. I give the greatest respect of all to those who have to do the hardest work in the world; notify the next of kin of the death of a loved one. This is the reason above all else I could never do any job relating to the healthcare field. I am to empathetic and am easily swayed emotionally. I would never hold it together in a serious problem like that one you described in this week’s True.

    I just had to give you both the recognition I feel you both deserve over and above anything you get already. Some day you may just get a chance to meet me and get a true token of my appreciation of everything you folks do.

  23. Thank you for responding to this emergency. It sounds like everyone did their best for the patient. I am, however, never quite sure just why you tell these stories. I am a crisis counsellor who also responds to emergencies and it is usually my job to go with the police officers to inform the casualty’s next of kin but here we keep such stories to ourselves. It is considered confidential and anyway, it is (in the Australian personality) considered “not the done thing” to blow your own horn in any way.

    I am amazed that you worried about a delay of 20 minutes. The mandated “standard of care” is for an ambulance/paramedics to attend within 40 minutes of a 000 call and 73% of the time it doesn’t happen and I am in a capital city of 4.5 million people!

    A good friend (85) of mine went shopping last year but had a small stroke, fell and broke her hip, and lay there half on the road for 2 hours for the ambulance to arrive — in summer. By that time she had had a heart attack as well. She stayed in the ambulance in the hospital emergency bay for another 2 hours before a bed in the emergency department became available. This is pretty much standard experience here. So 20 minutes response is amazing to me — especially when you are country and we are big city with hundreds of ambulances and paramedics available.

    I don’t see writing about a failure as horn-blowing of any sort. Simply, I write about calls I have first-hand knowledge about for two reasons: they’re interesting, and people don’t understand the EMS world very much, and reading about real-life cases, where I don’t reveal personal medical information, helps that. -rc

  24. First of all, thank you to you and Kit for your services to your community. While I served in the Navy for 20 years and made some sacrifices, your type of service is not one I would like to join, I just don’t have the stomach to be able to do it on a more-or-less daily basis. That said, I do keep up my CPR and AED training once a year through my company and am willing to do what is necessary should the need ever arise.

    Thanks for your service, John. You are indeed still in service (of my sort!) by keeping your CPR refreshed. Thanks for that, too! -rc

  25. It probably wouldn’t have mattered this time, but are there ever times when you leave the scene of an incident thinking: “If only I (or someone else) had been closer, this person would still be alive”? And if so, how do you deal with those feelings?

    We can only do what we can do. There’s a saying: “It’s not your problem, it’s the patient’s problem.” And that’s true. We try to help make things better. We sometimes go WAY above and beyond the call. And if it’s not enough, oh well. Too, we do understand that part of living in a rural area is we don’t have an ambulance 3 minutes away. It’s part of the tradeoff for living here. -rc

  26. The basics are the “ABCs” — Airway (got one? If not, fix it!) Breathing (are they? If not, do it for them!), and Circulation (is their heart pumping? If not, do it for them: CPR!) If those are all good, great! -rc”

    ABC? I was under he impression, from a 10-hour Magen David Adom (the Red Star of David)-provided first aid course at my high school a couple years back, that the guidelines had been modified, to place circulation first, making it CAB — performing the first set of chest compressions before the airway check and breaths, to get the blood that’s already oxygenated in the lungs out to the body ASAP. Is that change not an international one?

    The reality is, professional medics are taught very differently than civilians in first aid classes. I teach medics who are new and unsure of themselves to follow the ABCs, since that’s easiest to remember. In reality, once we have experience and don’t suffer panic, we do basic assessments all at once, and go for the biggest life-saving procedures based on what will do the most good the most quickly. -rc

  27. Having been an emergency responder of several stripes (firefighter, EMT, hazardous materials technician) since 1983 (which means that I’m getting OLD), I agree with the multitudes that have chimed in that your “side gig” rightfully takes priority. You continuing to do what you do, given the demands on your time for training, meetings, training, responses……did I mention training???………are to be applauded.

    On my and my wife’s honeymoon, we were walking out of the amphitheater at Silver Dollar City in Branson (MO) and I saw an older lady fall ahead of me. At least I thought she just fell……in reality she had coded. I started CPR and continued alone for a while until another gentleman arrived. It seemed like the longest wait in the world until the park medics and the ambulance got there. They DC’d the CPR after a conversation with their medical control and we gathered our things and left the park.

    My wife asked me “What next?” and was surprised/shocked when I said “Dinner.” She looked at me like I had two heads as I explained to her that the lady had died and that I was hungry, not to mention extremely sore. Doing CPR for an extended period of time is bad enough but we had worked her perpendicular to the slope back down into the amphitheater which meant that she would have rolled down the hill if she hadn’t been against my knees. Not the best way to perform CPR and, looking back, I’ve asked myself why I didn’t take time to turn her parallel to the downhill slope so that she wouldn’t roll away, but you don’t think of these things when you’re in the heat of the moment. My back hurt terribly from being in a contorted position to do the CPR.

    All this to say that I know the thoughts that go through your mind when the tones go off and you need to make decisions quickly, often on auto-pilot. Keep doing what you’re doing and we’ll wait. We know the issue will be coming and if there’s a hiccup, we know you’ll tell us the cause.

    Another good example of “You do what you can do, and then you continue with your life.” And a good example of “You’re never really off-duty.” Thanks, Lane. -rc

  28. Life happens and saving lives definitely takes priority. I’m sorry to hear the patient died this time, but, like you said, you can’t save them all. I’ve worked on the veterinary end of things as a vet tech and it can be tough when you work hard to save an animal and they die anyway, but you do your best and know that’s all you can do. One case I’ll never forget is a basset that came in for a nail trim and became so worked up he suffered heart failure and, despite the best efforts of at least two vets, died. He was in the back treatment room, on a table right near the drug cabinet, so he was in the ideal spot for treating his cardiac emergency, and it was a multi-vet practice so it was only seconds before there was a doc right there, calling for the epi and the atropine. IIRC, someone did chest compressions. It was quite hectic for several minutes, and then the first vet who’d showed up called it. I felt so terrible for the owners. They brought their dog in for a nail trim, and now a vet is telling them their dog is dead.

    Congratulations to Kit on her new position. She’s an excellent choice for Coroner.

    Lest her boss think a coup is in progress, I’ll hasten to correct that to Deputy Coroner. -rc

  29. I have CERT training and I can’t remember the mnemonic (LOL) but I think it is something like BBB, for Bleeding, Breathing and Brains. If they are gushing blood, that must be addressed first. Then make sure they are getting oxygen (air) and circulation. Then later, check their brain (mental status).

    I can see it now: “I knew they were serious, but all I could think of was the Better Business Bureau!” 🙂 CERT stands for Citizen Emergency Response Team. -rc

  30. Thanks for all the hard work as a First Responder. Do you carry a IO kit in your gear bag, and if NOT, why? I just passed my PALS & BLS and the IO kit seems to me to be the way to go. I would enjoy what you have to say on this item. And I love This Is True.

    See my response to Brian, Louisiana for my thoughts on that. -rc

  31. In 13 years as an ALS provider, I never had a “save”. And I don’t know many medics who have had save. The trick is to get to them before they are dead.

    I have one save after at least 11 minutes of compression-only CPR (which I guess would make it CR, rather than CPR!) So he was only mostly dead, which means he was a little bit alive </princess bride>. I still see the patient “out in the wild” now and then, and Sunday will be the five-year anniversary. The story is here. -rc

  32. 1. The comment about gallows humor. I have to agree with you, you did not insult the victim, you insulted the grim reaper.

    2. The comment about the someone not trained in CPR using an AED. At some point, the AED will say, continue CPR. At least, the ones i trained on do.

    3. Your comments on how to teach first aid, like BBB. A CPR instructor told me, the first class he ever taught was high school teachers. The first thing he said to do was, bare the chest, meaning remove the clothing done to skin. A week later a 15 year old girl fainted and all they remembered was, bare the chest. So, yes, you have to be very careful how you teach CPR.

    4. Many areas are more remote than you. I was watching a show from alaska where a man was in a clinic in the early stages of a heart attack. All they could do for him was load him on a single engine plane and fly him to the nearest small town that had a volunteer fire/ ambulance service so they could give first aid and take him to a hospital . The man had to fly alone, not even an EMT could fly with him. So, be thankful for the resources you do have.

    EMS is a job i could never do, so thank you for your service.

    Indeed I know there are places that have it much worse — hours from any hospital, weather that usually (not occasionally) precludes medical choppers. No medical choppers. And more. I certainly don’t complain: we have very good people who are very well trained and try really hard. Sometimes, that’s not enough, but that’s part of the tradeoff for living here. -rc

  33. Thanks for all you and Kit do. It is not an easy job even if you get paid for it. Personally I don’t mind if “This is True” is a little late I usually read it late anyway and I also find your EMS stories interesting and informative. This was the first I had heard about injecting drugs into a bone. May I also note that we sometimes have cases of crewmen airlifted of fishing boats that have not medical facilities onboard so they have to wait for the Coast Guard (who also do an excellent job).


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