A Sharp Increase in Sphincter Tone.

I hit another benchmark today. Today I had my first cardiac emergency patient!

We got the call to pick up a guy at a little outpost over an hour away. The only information we got was that it was a US Army male and "unconscious and clenched jaws". That was all. Thanks a pantload people. About five minutes out from the pickup we were radioed that the guy wasn't breathing anymore and they were going to do an emergency cricothyrotomy. That means cut a hole into the trachea through his neck and push a tube down into his chest. We were still getting ready for that when we landed. So we loaded him up and took off while we hooked him up to a ventilator (that only worked for 10 seconds- we did it manualy after that) and a cardiac monitor that told us his heart wasn't beating. Instead of coming back to Bagram we flew really really fast to a closer base. After 5 or 6 minutes of CPR, two shots of adrenaline, some atropine and 200 joules his heart started beating on its own again. After the first few minutes I didn't think he was going to make it. I thought he had a head injury because he had some bruising and blood was coming out of his mouth and nose- but that blood was actually from the hole he had cut in his neck being pushed up to his mouth because of the CPR. Cardiac arrest cause by head trauma is a really bad injury. The base we went to was only about 15 minutes from the place we picked him up. I kept bagging him until we got into the hospital and then someone else took over. I also learned there that his condition was caused by a drug overdose of sleep aid and other unknown drugs, not head trauma. He looked like he was doing pretty under the other doctors care by the time we left the clinic.

It was a good thing I was flying with a more experienced flight medic and a very experienced trauma doctor. That dude was a handfull. He would have been screwed if it was just me and the crew chief. I learned a lot from that one patient about cardiac care. And about messing with sleep aids. It's too bad because I know that is a problem that a lot of soldiers struggle with here. That guy was just trying to get to sleep and nearly went to sleep forever. Plus having to wake up with a hole through his neck, subcutaneous emphesema, multiple broken ribs and an assortment of other aches and pains to be sure. Maybe he will get legal action against him by the Army as well; for drug abuse and destruction of government property. I'm glad that I'm not that guy.

So to sum it up. Yay for me for getting to learn some cool stuff about patient care and gain some awesome hands-on medical experience. Yay for the other medic and doc for saving the guy and teaching me to do awesome life-saving stuff. And yay for the patient for only being dead for a few minutes.