The First Time I … Saved Someone I Really Didn't Think Would Make It
Dr. Sidney Fletcher
FACEP, Medical Director of Emergency Medicine and Assistant Chief of Staff, Presbyterian Hospital
I was a second-year resident. It was the afternoon, early in my shift, and I had only seen a patient or two when they brought him in, a sixteen-year-old kid with asthma. His mom drove him in instead of calling an ambulance, and he quit breathing on the ambulance deck in the loading dock. He was blue when they brought him back.
There is a huge amount of adrenaline in that situation, but you fall back on your training and experience. I'm actu- ally more nervous on the first tee box when I play golf with someone I don't know than I am during a code.
In residency training, they teach you a checklist — ABC: airway, breathing, and circulation. If those aren't managed first, the patient will have big-time trouble. With asthma, you can get some oxygen in, but can't exhale and expel the carbon dioxide that builds up in your lungs. The kid wasn't awake and couldn't breathe on his own, so we had to intubate him.
His mother was there, and we told her what we were going to do. She was cooperative. Within ten minutes, we had a breathing tube in. It's a team effort to save somebody's life. You have multiple nurses, some charting, someone putting in an IV, techs taking blood. The way I think about that is, I'm just a small part of that.
We got him breathing again, and in less than an hour after he was brought in, he was sitting up and asking for the tube to be removed. That was more instant gratification than we're used to getting. We were reluctant to pull his tube that quickly, so we left it in, medicated him, sent him to ICU. His mother was very grateful. There was a very real chance that kid could have died.
It feels good, but it's part of my job. We don't expect people to come back and say thanks. I'm happy being the safety net. —As told to Annie Monjar
Three Things ER Docs Wish Patients Knew
- There are other patients, and we have to juggle them. The ER's a messy place.
- When we're at work, we're at work. Even if we're sitting at a computer, we're still working on patient care.
- Call an ambulance when it's needed; don't when it's not.