Sometimes real life can be too real

Tough Choices — When a Clinically Dead Patient Happens to be the Daughter of the First Responder:  Synopsis of an Interview with an EMT Father

Time-critical response to an unresponsive patient suffering from an episode of sudden cardiac arrest is crucial for increasing the odds of surviving the event.  Wonderful and heroic first responders and EMTs across the world are trained to act quickly upon arriving at a scene, making immediate life-and-death decisions almost as if their skills were instinctually bestowed upon them.  However, a large portion of a patient’s time-critical care can become the responsibility of any citizen — friend, family, or stranger — who witnesses the event.  When this occurs, the ideal bystander-responder will immediately call 9-1-1 and begin performing life-saving chest compressions while a second witness to the event attempts to locate an automated external defibrillator, if available in the setting in which the event occurs.  Sometimes, by pure chance, the bystander happens to be a trained medical professional, such as a doctor, nurse, EMT, or paramedic.

An example of this chance occurrence can be seen in the days of old, when a cardiac event occurs in a restaurant or shopping center and bystanders are seen shouting the question, “Is there a doctor in the crowd?”  It is obvious a suffering patient is in luck when the witness to the event is professionally trained in emergency medical services, as this training will allow the bystander to immediately perform the appropriate treatment with absolutely zero to a very minimal loss of a few seconds due to hesitation.  Generally, the professionally trained witness will be a stranger in a crowded place who just so happens to be present when the event occurs.  However, certain situations can lead to the victim of the event being a close friend or relative of the off-duty EMS provider.  This can be a very challenging and awkward situation for the rescuing individual as his professional training must now blur the lines between what he is trained to do for a living with the emotional attachment and impact of witnessing a loved one suffer.  The following is an interview with a trained EMS provider, a paramedic named “Matt,” who desired to share his story.  It began when his oldest daughter was literally three-days-old, home from the hospital for less than 12 hours, when she suddenly became unresponsive:

The Interview

Q:  Hey Matt, I wanted to take the time to thank you so much for wanting to share your story with us.  As a trained professional, you clearly understand the value of awareness when it comes to bystander response to an emergency.  So, on behalf of all staff, thanks so much for your time.

A:  No problem.  Yeah, when you told me what you were doing this for, I couldn’t say no.

Q:  So, you’ve told me this story a few times over the years. I know it is very emotional for you.  If you need me to stop at any point, just let me know and we will take a short break.  I understand you had to resuscitate your brand new baby girl, do you mind if I use her na–

A:  Leah.

Q:  Thanks.  So what happened to Leah on that night?

A:  Well, we were just arriving home from the hospital.  It was a day later than normal because she was found to be dehydrated a bit at birth.  When the staff ran IV fluids on her, her IV infiltrated, so we were kept an extra day to make sure the free fluid would properly absorb.  We got settled in for the evening, I got into some comfortable clothes — you know, we had been at the hospital for 3 days with barely any sleep.  I was looking forward to my bed.

Q:  So everything was seemingly okay?

A:  Yeah, we had Leah in her bassinette — I already had it set up in our bedroom.

Q:  That’s probably a very important factor here, huh?

A:  I got comfortable, my now-ex-wife got comfortable.  Leah was sleeping sound.  We decided to try to get an hour or so nap until time to feed her came around — it was about 1840.

Q:  That’s 6:40 P.M. to clarify —

A:  Yeah, of course, my apologies.

Q:  No problem.  So you guys were in bed.  What happened next?

A:  We had on Law and Order: Special Victims Unit.  You know, this was our first child, we were over-paranoid and checked on her every couple of minutes.  She was just to the right of my side of the bed.  I looked over at her and everything was fine.  So I put my head back on the pillow.  I started to doze off and I heard a gasping sound.  I jumped up and looked at her…she was — I’m sorry, give me just a second.

Q:  Of course.  Take your time.

[Approximately 10 minutes pass while Matt regains his composure]

Q:  I’m sorry about that.  I know this is a very emotional experience, and I definitely want to tell you again how much we appreciate your willingness to spread awareness.

A:  Not a problem at all.  It’s not necessary to apologize.  So, we were at the part where I noticed her unresponsive?

Q:  That’s correct.

A:  Okay, so I went through a quick normal assessment.  This was my daughter, so I was a little scared.  It was not some guy on the side of the road.  Plus, we usually arrive after a patient is already out and someone has already begun chest compression.  To make it worse, she was three days old.  But I knew I had to save her — I can’t even think of the alternative — so I started a mental assessment.  She had no detectable pulse and her gasps were obviously not breaths.  She was dead, man.

Q:  Do you need a minute?

A:  No, it’s okay.  Well, you know, the CPR techniques are different with a child, especially an infant.  It was the first time I ever tried to resuscitate a baby.  You use your fingers instead of a full palm to push, you know, because of their small size.  You hold them like a football, open the airway, and begin the maneuver.  I started mouth-to-mouth on her along with the chest compressions while my ex-wife called for help.  The good thing here is — and I don’t want this to sound bad or inconsiderate of others — but we tend to respond with absolutely no delay when the victim or patient is a friend or relative of one of our own.  Plus, we lived in Princeton, West Virginia at the time.  It’s a small mountain town.  My home was literally about 0.6 miles from the station.  We heard sirens approaching before she was even off the phone.

Q:  Wow.  That’s amazing response time.  Glad to hear that.

A:  Yeah, we were lucky.  Hell, Leah was lucky.  So, I kept doing the repetitions with my fingers on her chest and the rescue breaths, and one of my coworkers entered with an AED to figure out what was going on — you know, was it lethal rhythm or not — well, it was.

Q:  So you had to shock her?

A:  My coworker did — I had to hand her over.  It was painful to watch her little body take it like that.  We got a pulse back after the first one, though.

Q:  So she obviously made it.  That’s the same little one I see running around here all the time?

A:  Yep.  A healthy 8-year-old little girl now.  She stayed in the hospital for a few weeks.  Turned out to be a massive VSD — that’s like a hole in the wall of one of the heart chambers — that caused the arrest.  She had to have some pretty crucial procedures done to correct it — serious for anyone, much less a baby who’s age could be measured in hours.

Q:  Well, when you put it like that —

A:  — Yeah, pretty amazing.

Q:  Okay, well do you mind if I ask you some…introspective-type questions?

A:  Shoot.

Q:  What went through your mind during this?  Did you just go into professional rescuer mode?

A:  No way.  It was my newborn daughter.  I was panicking like crazy.  But I obviously know the detriments that happen the longer treatment is withheld.  I didn’t have time to think.  When I had her in my arms, I was shaking like a leaf, but I had to act.

Q:  Such a young girl.  Do you think that your training contributed to her survival?

A:  Oh, without a doubt.  You know, I was scared to death — emotionally vested in this daughter-patient of mine.

Q:  I can’t even imagine.  You mentioned you knew you could not hesitate.  What advice would you give to someone — a parent, maybe — this happens to, but they aren’t so fortunate to save lives for a living?

A:  First and foremost — if you have kids, take a first aid and thorough CPR class.  They are easily accessible and affordable.  Even in the little town I lived in at the time, our department held public training sessions all the time.  There was a team of us who actually would go to a resident’s home in the community.  You know, 4-5 people would get together in the living rooms and we would bring out the dummies and the material.  I started really getting involved after this incident with Leah.  In this kind of situation, though, all of the panic — if I wasn’t trained, she would’ve died, more than likely.  So, get the training, before anything else, and hope you never have to use it.

Q:  Wow.  That’s pretty solid advice.

A:  Yeah, if you don’t have the training, not only will you not know how to perform these specialized techniques for babies and children, but you probably won’t realize the importance of acting without hesitation, which was probably the key to Leah’s case.  There were no abnormalities on my ex’s prenatal checkups which would’ve given any indication to do a fetal echocardiogram, so there was no way for us to know the VSD even existed.  So yeah, just — get trained.  Then tell your neighbor to get trained.  Then tell your neighbor to tell his/her neighbor to get trained.  You mentioned it already, awareness, man.  That’s the answer to saving these lives.

Q:  Well said.  Matt, I want to thank you from the bottom of my heart to open up to us and share your story like this.  There’s no doubt in my mind your story will touch the hearts of our readers, and will definitely be a compelling reason for each and every one of them to sign up for CPR classes.

A:  No problem, man.  I really appreciate the opportunity to help get the word out.  Makes me feel like I’m giving something back to my community.

Q:  You absolutely are.  Thanks again, sir.

END

Commentary

Obviously, Matt’s incredible story of literally rescuing his infant daughter speaks volumes to the man’s ability to think skillfully and critically during this bizarre emergency.  While most citizens will thankfully never have to experience an emergency such as this, especially involving a newborn infant, the message of his story is plain and clear.  The message is, community awareness is the key to giving all patients a better chance of surviving a cardiac emergency such as sudden cardiac arrest.  It is vital to think quickly and respond without hesitation in the event an emergency such as this were to occur.  Without Matt’s professional training and ability to react to the emergency even while panicking, his daughter would not be here today; and the life of this now 8-year-old, healthy, happy little girl could have ended that very day.  This story should persuade members of every community to pursue even basic CPR training, as Matt said, “and hope to never have to use it.”  While not everyone will be able to obtain the advanced training of a paramedic, even basic courses will serve the purpose of creating an informed, educated bystander community; and every sufferer of sudden cardiac arrest deserves the same chance as the next.