The face of the one I couldn't save

[shira_emt]

I was wondering if the more experienced medics and EMT's could help me.

In October of 2005 my partner and I had a call for an eight month old "non-breather". At the time my partner was a 5yr medic and I was a 4 yr basic. As we pulled up to the trailer park a woman carrying a life less baby came running up to our truck. As we stepped out, she handed my partner the child. The child was extremely cyanotic. We bagan CPR on her immediately. My partner intubated her, and started an IO. We had a non-EMT (observer with a CPR card) with us as a ride along. He was doing compressions while I was bagging the little girl (we had a Sheriff's deputy drive). Somehow when I listened to breath sounds (to make sue the tube was good) I heard air movement in both the stomach and lungs. We pulled the tube and continues to bag her with the ambu bag, we got better perfusion that way. We continued CPR all the way to the hospital. She was showing asystole on the monitor the entire trip. Shortly after arriving at the ER the doctor pronounced her dead. This is where my problems started.

I have always said that the first rule of EMS is that people die, even the little ones. That was my first ped. code, my only ped code. It almost ended my EMS career. That run changed me. My partner and I have talked about this run on more than one occasion. Since then he has quit the company and moved on the better things. He is still a medic and a damn good one. We had had a string of bad runs that month, codes, bad MVA's, ect. This one was the roughest. It got to the point where I didn't want to come to work. The company I worked for at the time didn't do any CISD. They could have cared less about our mental well being. As long as we made them another buck (private service).

The child had a shirt on that had heart shaped buttons on it. When we cut her shirt off, the buttons went everywhere. I found one while we were cleaning the truck after the run. I kept it. I placed it on my bathroom counter and everyday while I was getting ready for work I would look at it. I guess to remind me that we can't save them all. However, after all this time I still think of her. The autopsy said it was SIDS, but we noted bruising all over the child's inner thighs, and back. I still think it was abuse. But my opinion means nothing. We documented the bruises. But...............

Is this normal to still feel this way after over a year? I function fine. I still run volunteer in my hometown. I still work private service just for a different company. But when a call comes in for a child choking or a child ill, I begin to panick a little thinking it will happen again. I know it will one day. EMS is unpredictable. I know that. I love my job, I love what I do. I love helping people, and in my opinion I'm good at it. I still have dreams of her face. And yes I still have that button. The only thing I regret is not knowing her name. You expect older people to die, but not babies, childrean, or kids. She has forever changed my life, my way of thinking. I still think of her and I begin to question myself. What could we had done differently. I know I shouldn't. But what are you do to?

Does anyone have any advice to give me on this topic? I would appreciate anything you have to say. As long as it's not "grow up, shit happens, grow some balls, etc." This is very serious to me. I say that because I have had medics (mostly men) tell me that this is why women don't belong in this field. They are assholes. I really don't need to hear that again.

Thanks for your time,

Shira EMT-I

[somedic]

Well after reviewing your post I can conclude that you are very much a human being.

You ran one of the most dreaded calls in EMS. It sounds like you and your crew did what you were supposed to do.

One year later does sound like a long time to recover from this one incident but sometimes it takes time.

Its hard to give someone advice on things like this but remember you did not cause the probelm you only responded to it. You gave that baby every chance at life that was humanly possible. Stay in touch with us here and let us know how things turn out. Sorry I could not be of more help but trust me I know what it is like for you.

Somedic

[EMSGeek]

Powerful post. Let me preface my response by saying that I am just an EMT-B with no formal CISM/D training. I have friends who have returned from Iraq in the last year and I've seen changes in them. Some of them have experienced things which are negatively impacting their day to day lives and some have experienced things which they carry with them and feel the weight of but do not give in. It sounds like you are going through what the latter of my friends are experiencing. Until someone with more experience and more letters after their name convinces me otherwise I'm going to say that you and my friends are experiencing a form of post traumatic stress disorder. PTSD is exactly what CISM/D is supposed to mitigate.

I definitely do not think you're crazy or weak. If you have a good CISD team available to you now try and talk with one of them. Explain that you had a call a while ago which you want to talk about and see if they would be open to sitting down with a beer and having a chat with you. Otherwise maybe a therapist could help...I really do not know how to solve problems like this. Hopefully some of the other people on this forum can give you information. Dust and several of the other members are deployed and have undoubtably seen people have all kinds of reactions to stress and could lend some good advice.

At the end of the day you and your crew did everything you guys could do. I believe some of the more experienced members will agree with me in saying this is one of the most painful and dreaded calls that an EMS provider can have.

Best of luck.

[chbare]

Shira_emt, I agree with Somedic. You provided the best care possible negotiated a very difficult call. One thing we must remember is that we are not responsible or accountable for all of the bad things that occur in this world. It may sound cold; however, I was nearly eaten alive by feelings of frustration, guilt, and extreme sarcasm as a new medical provider. In my first year as an ER RN I experienced several traumatic pedi deaths. Some of the deaths were related to abuse. (a few were horrific abuse cases) All we can hope to do is provide the best care possible and provide that care in a compassionate and therapeutic way to the best of our abilities. However, we are just human and cannot fix everything. In addition, we as individuals have the right to be happy and live a happy life. Sometimes we have to step back and take care of ourselves. I do not mean to imply that we turn off all emotions or become apathetic, however, we need to realize and accept that we cannot control every outcome and sometimes we cannot fix a bad situation. I hope that you find this helpful. This is just my philosophy on things and this is how I deal with the stress and horrible situations.

Take care,

chbare.

[Ridryder 911]

First, let me say ped calls are horrible. I too had one that made me seek professional attention. Saying this, CISD as Dr. Bledsoe and so many others have recognized has not been proven to be effective or even helpful.

The truth is everyone die at all ages.... Who says babies, kids, young people shouldn't or don't die ? .. No where I have read or studied ever states such. Go to a NICU unit they die all the time , PICU again kids die .. it is a reality. It sucks, it's bad .. but that is life. Unfortunately, since it is part of life, it is part of the job.

The difference of having a bad call and infatuation on one, is a bad call goes away.. and the other is one that never leaves and scenarios are replayed in your mind. Keeping memorabilia off a call .. Are you really thinking how you can not save them all or just that one ?

Again, I realize the problems of "bad calls" and again, I highly suggest seeking true professional assistance. A licensed counselor (hopefully one with emergency services or healthcare background). Discussing and talking about the problems with some helpful insights can help.

I do wish you the best..

R/r 911

[runsoversquirrels]

[/font:ba37376f3b] I have had two calls that profoundly affected me. One just two weeks ago. This time I requested CSID. The other one was five years ago. Twelve year old at MVA, unresponsive, not breathing. We performed CPR and a doc on the helicopter pronounced on scene. Mom was DWI. Daughter uninjured and front passenger critical. I was most angry about Mom causing this and my feelings of inadequacy. I should have done more. Compressions should have been done better, etc. I have pictures in my head of both these calls. Snapshots so to speak. I would recommend CSID. Not available through your service? Call state agency, they can get someone for you. The CSID for the child call was a group of us from that call. I was not comfortable talking about it with everyone there. This last one, it was just me and the counselor. It was very good for me. We had come upon a MVA just seconds after it had happened. No one on scene but us. Car crosses center line and head on into a pick-up. Could not see into driver's compartment of car. Car bursts into flames less than one minute after we stopped. Driver of truck being helped out of vehicle by bystanders. He's okay. Minor injuries. After we put fire out using our extinguisher, I tried to reach driver. I could see about a five inch spot of his arm in window. No response. I tried to follow his arm up to neck but partner pulled me away because the car was on fire again. Used other extinguisher and hollered for more. The driver's compartment was compressed to about 7 inches wide. Car had in all caught on fire about five times and we could never reach the driver. As we left the firemen were just pulling off the passenger doors to reach him. The next day all I could think about was this call. I didn't know this guy and wasn't all that familiar with the area, we had just transferred a hospice patient home. I couldn't sleep very well and just wasn't me. It was a weekend and I was ok with waiting till Mon. for the CSID guy but I also was given his number if needed. I spoke to him about this call and the old one. Been great since then and I know how to get help again if needed. Everyone reacts differently to calls. One may be okay with you but your partner may have problems. No one can predict or decide how anyone will be. Some may never have any reaction and others have different problems. Obviously everyone has different ways of dealing. You have to figure out what works for you. Decide to try CSID or something else.[/font:ba37376f3b]

[somedic]

Squirrel killer:Thanks for that huge paragraph of "I've seen worse than you" experiences and absolutely nothing for advice....I think the easy advice is CISD. Cute screen name...

Somedic

[medic001918]

Squirrel killer:Thanks for that huge paragraph of "I've seen worse than you" experiences and absolutely nothing for advice....I think the easy advice is CISD. Cute screen name...

Somedic

+1. I have to agree that the advice of CISD could have been given without mutiple stories in a single, difficult to read paragraph would have been fine. As far as CISD goes, I thought it was federally mandated (maybe it's just a state thing?) that an employer has to offer you CISD or the benefit of speaking to someone at no expense to you for a job related event. I know Connecticut has it set up, but I really thought it was federal. So for your employer to not offer CISD would be rare, and they should offer another means of you speaking to someone.

As far as the call goes, it's one of the hardest to deal with. If you feel you did the best, that's all you can ask for out of yourself. Bad things happen to good people and that's just how it goes sometimes. In time, things should get better. Good luck in talking to your employer. I hope they will work with you to get the closure you need.

Shane

NREMT-P

[Ridryder 911]

Wow ! I am suprised many are still buying into the CISD crap. When it has been determined not to be helpful and potentially hurtful ( http://info.jems.com/jems/exclus05/e0927a.html ) ... Get a professional counselor to discuss things.

R/r 911

(EDITED TO MAKE LINK WORK - ADMIN)

[Just Plain Ruff]

I agree that cisd is not worth the letters it's written on

Professional counselling is your best bet. Get someone who deals with Emergency workeres and their stresses.

If your department has a chaplain then you can go to them.

over a year and you are still dealing with it does seem quite a long time but again, it's your healing time and you may need a longer time than others.

Good luck and god speed.