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Close call


HERBIE1

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Had a "near save" the other day. 12 year old boy with muscular dystrophy and autism, bedridden. Met at the door by frantic parents and family members- kid was upstairs, back bedroom, in a hospital bed. Walked in the room and saw the kid w/ agonal resps and cyanotic. The family said they were trying to suction mucous from the kid with a (tonsillar cathether) but it was not working. The boy was gagging, biting, and would not tolerate the suctioning. As the kid became more hypoxic, he was fighting them. Not any more-now he was just about ready to code. Put the kid on 02, bagged him a few times, and the kid's color improved almost immediately. He started looking around, acting more normal.

Whew. Vitals OK now, sats at 100%, but still tachy at 160 or so. The cousin asked if she made things worse by giving him mouth to mouth before we got there. I said no- she did the right thing.

The family had a CPAP machine for his use at night, in addition to the suction. I instructed them if he got that bad again and they could not get rid of the mucous plug, call us and then put him on the CPAP machine- it may dislodge the plug- or at least push it down into a bronchus, which although is not good, it's still preferable to apnea.

The kid was lucky- we were literally a couple blocks away, picking up from another call, so we were on scene in about a minute-and he literally didn't have any more time than that. Enroute to the ER, I asked the kid a few questions, and he simply repeated what I had said, looking around. Family stated that was normal mentation for him and clearly relieved.

One for our side...

I am constantly amazed at the lengths people will go to in order to care for a special needs patient at home. His room looked like an ICU, except it was covered in homemade pictures and artwork from his siblings and other family members- very touching. He was impeccably clean, no bed sores, clean gown, clean diaper, hair combed, clean linen- clearly top notch care, and obviously an abundance of love. I told the parents they- and their whole family- were doing a helluva job taking care of their son. They really seemed to appreciate that.

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  • 4 weeks later...

A near save would imply that he died, as you nearly saved him.

A near code, is what i believe you meant, as he nearly coded on you.

kthnxbye

LOL

Wow.

I'll let everyone else worry about semantics since I don't worry too much about such things.

Potatoe, potAto,

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No. You saved a life. Someone is alive, because, using your skills, you intervened. Going by the old school sentiments of doing the job, and never giving up... Anyone near death, that improves to the point where they were at the same quality of life they had prior to said incident which caused them to be near death. Read it twice, it makes sense... Is a life saved. They don't have to be resuscitated from arrest of heartbeat or lung function, to be saved. We all save so many people, that we have come to only celebrate it when someone is resuscitated from cardio-pulmonary arrest. Congratulations.

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I agree, later for the semantics. You had an unresponsive patient gone "Smurf-y" on you, and returned him to normal mentation (for the individual), and normal skin coloration. Well done, sir. Well done.

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I had to delete my previous post due to the fact that in my near brain dead condition, I mistakenly gave the praise to the wrong person. What I meant to say was:

Great job Herbie! You and your partner must have had a 'pucker factor' of at least 10+!

This, ladies and gentlemen, is why we do what we do. No, this won't happen every time; but it sure is great when it does!

As far as your comments to the parents, Herbie; I'm sure it made their day to have their efforts recognized and validated like that. After seeing some of the horrors I've witnessed at ECF's and some 'home care' arrangements, it's people like this that still give me hope for the families of 'special needs' people.

As Chris said, when you can return the patient to the condition that they were in prior to the event that led to your intervention is considered a 'save'.

A 'save' isn't only restricted to cardiac events. In this case the efforts of the responding crew prevented a cessation of life functions. How much more literal can you get with the word 'saved'?

From what I read in the original post, this child surely would have expired had not Herbie and his partner been 'in the right place at the right time', and had they not done what they did. Rather than argue the semantics of the term 'saved', it would be better that you give them the kudos that they deserve.

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