My first real case upon getting ready to graduate from nursing school involved a eight-year-old girl who had a longstanding history of asthma.  Things just went from bad to worse; I was so sure that the kid involved was going to die on us.

It had been a quiet, reasonably calm day in the E.R.: no life-threatening cases, just the usual fare.  Scrapes.  Cuts.  Contusions.  An occasional toddler with sniffles, signs of flu, or soemthing stuck inside their ears (or noses).  Clingy kids with suspected sprains or fractures.  Adults with a wide variety of medical complaints. 

Then the emergency tones sounded.  The E.R. staff was alerted of a pediatric asthma case en route to our hospital via ambulance; the child, a little girl of eight or so,was having a great deal of dyspnea (difficulty breathing), and she was rapidly growing worse.  She was in a great deal of trouble.

The charge nurse of the E.R. barked at us to get ready to receive the child once the ambulance arrived at the back bay.  We went running to the back bay, gurney on hand, along with a tank of oxygen, and other necessities; we were ready to jump on the kid and try to help her as soon as possible.

Not even two minutes later, the ambulance backed up to the back door.  After the door opened, a paramedic quickly placed the kid onto the gurney and we whisked the child to the nearest available room, where we soon set to work to try to help her.  Her breathing was strident; you could hear her gaspy wheezes throughout the E.R. department.  She was really working to try to breathe.  Her color was poor, and she was soaked with sweat.

The kid was in trouble.  We had to help her fast if she was to have any chance of beating this thing.

Soon, I.V.s, oxygen, and various other tubes and wires were attached to our patient once we'd gotten her settled on the table.  Her vital signs were crappy at best; her blood oxygen levels were even worse: they were running in the fifty-to-sixty degree range.  The numbers distressed us; it was clear that the kid was trying to croak on us.

Suddenly, without warning, the room grew silent.  The gasping, labored breathing ceased, and the little girl just lay there, limp and not moving on the table. 

She had stopped breathing!!

I screamed, "We could use a little help here!!"  Soon, more doctors and nurses descended upon the kid.  A pediatric resident quickly but deftly slid a breathing tube down the child's throat and had her hooked up to a breathing bag within seconds, where he was soon breathing for her by squeezing the bag rhythmically with his hands.  Blood and other samples were taken from the child; we had to determine what had caused the attack, so we could treat her, as ordered by the head E.R. physician, who called all the shots.

It was soon discovered that the kid had accidentally ingested something that contained nuts.  It turned out that the little girl was highly allergic to nuts.  A clear case of anaphylactic shock.  The signs were all there: blotchy, pink and red hives covering her face, shoulders, neck, arms, and chest.  Swollen face and eyes.  Swollen throat, which explained for the severe breathing issues (and eventually the respiratory arrest).  Extremely low blood pressure.  Blue coloration around her lips and nose, as well as her fingernail beds.  She was not getting enough in the way of oxygen; no wonder her blood oxygen levels were so poor.

Once we gave her the necessary meds to bring her out of her attack, and it started working in her system, the child's condition rapidly improved.  From lying there, seemingly lifeless, the child gagged and tried to cough as her eyes flew open and stared upwards at us.  We tried to reassure her that she was in the E.R. and that she was going to be okay, which she was.  Her blood pressure zoomed to more normal levels, and her breathing/heart rates accelerated as well.  We had pulled her back from the brink of death within moments, and it had only been less than ten/fifteen minutes since the kid had first arrived at our E.R.

It was nothing short of a miracle, but it was a situation that still hangs on in my memory, at least nine/ten years later.  I often wonder about how the child (now probably seventeen or eighteen years old), and how she is doing, or what she is doing with her life.  I'm just glad that I was there when the child needed help; it could have very easily turned out so much worse for her (and for us, as a whole).