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Paramedic Stories, Part IX: Pediatric Code Blue! (By Kendall V. Smith, Paramedic/EMT) by Karen Lynn Vidra, The Texas Tornado
Saturday, July 17, 2004
Rated "PG" by the Author.
A veteran paramedic writes about one of his most difficult cases involving a small child who stopped breathing.
I don't think I will ever forget the young face of that child we tried so hard to save.
It was a typical June day: warm, sunny, with the promise of good things, and absolutely no warning of what was to take place later that day. But about two that afternoon two years ago, the emergency tones went off, and the call came out over the loudspeaker, sending us springing into action. As we got our gear together and put them into our rescue vehicle, we heard the call involved a child who was down for unknown reasons. We knew we had to act quickly if the kid was to have any chance of making it through this crisis.
We had no idea why this kid was in trouble, but whenever calls involve kids, our fears and senses are heightened, and it just makes the situation more critical, more dire. We jumped into our rescue vehicle, and we flew down the streets of Nashville, with all sirens blaring and the lights flashing. We even blew the horn, telling cars to get out of the way, that we had a critical case to attend to.
We came to the scene a few minutes later. It was in a lovely residential area, full of trees and well-cared-for houses and manicured lawns, the ideal place to live and raise a family. The family who had made the call met us as we pulled into the driveway. A mother was crying that her baby boy was down and wasn't moving, and the father was holding a limp kid in his arms; he was crying, too. The kid was blue and was apparently not breathing.
I took the kid from the father's arms. He looked awful, to say the very least: he was grey all over, and when I shook him and called his name, there was no response from the kid. He appeared to be more dead than alive, and it scared me. I laid the kid on the ground, and I told my partners, Glenn and Pat, to bring the oxygen equipment and to have one of them start an I.V. in the kid and hook him up to a heart monitor. Within a few minutes, the kid was hooked up to the portable EKG unit, and even though his heart was beating, it was not beating well, and the kid was not breathing on his own. I was given the task of putting an oropharyngeal airway down the kid's throat and hooking up an Ambu bag to it, in which I would then breathe for the little boy by squeezing the bag rhythmically every few seconds, so to get precious oxygen to his brain, and to try to prevent any brain damage from occurring. The kid was tiny: he couldn't have been more than two at the most, and he weighed practically nothing: when I had taken him into my arms, it was like I was holding a feather in my arms.
As my partners and myself worked on the child, another rescue unit came onto the scene, and the parents gave the other rescue personnel information about her child. The kid's name was Ricardo Martinez, and he was only two years old. He was found lying facedown in the swimming pool only a half hour prior to our arriving on the scene, and by the time they had gotten to him, he was not responding and was limp. It appeared to be an accidental drowning.
Suddenly, without warning, little Ricardo started vomiting. I quickly turned him onto his side and took out the tube from his throat and suctioned out his mouth and nose. I then reinserted the tube down his throat, and I started breathing for him again. His heart was still not beating efficiently, and I was afraid that we were going to lose him. That was when the alarm on the EKG unit started sounding off, and we watched in horror as his heart rhythm went into a squiggly, purposeless rhythm. The kid was going into ventricular fibrillation, which told us that his heart was about to stop on us. Pat stared doing CPR on the kid while Glenn got the defibrillator going and charged, and he then shocked the kid, hoping to get his heart beat back, but to no avail. His heart continued to show v-fib, and it was clear that this kid was on his way out. But being that we are paramedics, we worked and slaved over this kid, hoping and praying that he would come back to life; and we didn't give up our efforts until he was loaded back into the advanced life support ambulance and was then quickly taken to the hospital. By now we were all exhausted, and our bodies ached from the efforts of the resuscitative measures.
It turned out that little Ricardo Martinez did not make it. He died even before they could get him to the hospital. He was all but two years of age. He had been too far gone, and even in the care of the hospital staff did nothing to bring him back. He had been down for over an hour by the time the hospital staff pronounced him dead, and even now, I can't get his beautiful little face out of my mind. He was such a beautiful little boy with huge, bright, dark eyes, a shock of wild, curly black hair, and a dimpled grin that could light up the room whenever he smiled. I knew him from when I had gone to his house on account of his mother, Rosita, who was a brittle diabetic, and I remember seeing him as I tended to his mother. He was a very active, sociable little baby, and I loved him from the first time I had seen him. Now he was gone, and even now, whenever I think of him and how hard we had tried to save his life, I can't help but cry because despite our best efforts, we could not save him, and now a precious, beautiful little child who should have lived is now gone forever.
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