I will never forget the day we dealt with a little boy who ended up in our emergency room. He was in dire straits, and it was apparent from the start just how quickly life was slipping away from him.

We were enjoying a quiet day: it wasn't busy; it was a rather pleasant day at the ER. Very few patients came through our doors; none terribly ill or injured, nothing we couldn't handle.

Then the emergency tones sounded. It was a child down, a little boy roughly about five/six years old. He was not breathing, for reasons unknown at the time: the paramedics were still trying to piece together what happened to the little boy. In any event, he was unconscious, and he was currently being tended to by paramedics, who were busy trying to revive him.

Dr. Patel, our chief ER doctor, instructed the paramedics to start an IV and hook him up to a portable heart monitor. Meanwhile, we nurses readied the ER for when the little boy would arrive. The child wasn't even at the ER yet, but already the air was tense. That always happened whenever a child was involved, particularly a child who was in danger of dying.

This child certainly sounded like it: he wasn't breathing. He was getting CPR by the paramedics. They had to get him to the ER fast if the child was to have any chance to survive without damage to his brain.

The ambulance arrived at our back door. The head paramedic (Kendall Smith) handed the child to a waiting nurse, who then rushed him to a waiting table. Immediately we descended upon the little boy like a swarm of angry bees. IV lines were soon started, a blood pressure cuff was affixed to the child's thin arm. Nothiing. The kid was asystole. He was on the verge of certain death.

Suddenly the air took on a whole new sense of urgency. More doctors and nurses came into the room, all working in tandem, trying to revive the child. Nothing. Not even as much of a wiggle of a finger or a foot. The boy remained chillingly still.

It was heartbreaking.

We worked on that little boy for over an hour before Dr. Patel pronounced him dead. It was the second pediatric death in our ER in less than three months; things were suddenly starting to look very bad for our hospital. I was afraid we'd be charged with murder or pummeled with unending questions as to what happened to the boy, what we did to kill him. We didn't kill him; we were only trying to save his life as only dedicated, caring medical personnel can when a human life is in danger.

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Eventually, as time went on, we learned what had happened that fateful day. The little boy had a sudden seizure, no warning whatsoever. It just happened. By the time his parents realized it was wrong, it was already too late. They found him lying on the floor, writhing in a horrible tonic-clonic (total body) seizure. The child was gasping, foaming at the mouth, face blue as blueberries. It was terrifying.

The parents quickly called for an ambulance. By the time the ambulance arrived at the house, the little boy was not seizing, but he was not breathng. Apparently the seizure was due to unknown causes, which sometimes happens.

It went against everything we learned as medical people. We were trained to save lives; people weren't supposed to die at our hands. Yet we couldn't stop it: not everyone could survive; death was as much a part of our lives as was living. It was a normal occurance.

Yet it didn't take away the pain. My heart still breaks when I think of that beautiful, innocent little child arriving at the ER, pulseless, breathless, completely void of life. He wasn't supposed to be in this shape: he was supposed to be running around, laughing, enjoying life. It didn't seem right: it seemed--terribly wrong.

It still does, especially when a child was involved in a dire lifethreatening emergency.

~Written by Louisiana Sandusky, R.N., Nashville, Tennessee.

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