EMS World

NOV 2018

EMS World Magazine is the most authoritative source in the world for clinical and educational material designed to improve the delivery of prehospital emergency medical care.

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Page 42 of 51

42 NOVEMBER 2018 | EMSWORLD.com PROFILES IN EMS Her own daughter raced to retrieve the AED. Because of their immediate actions, Anne sur vived. The day af ter the incident at Costco, Anne was home. She replayed the event in her head, this time focusing on what Rex looked like, what he felt like. For the first time she had a true understanding of what her own family had gone through. She was ver y much a visual learner, and being told what it felt like never fully equated—until now. It answered so many questions she didn't even realize she had. She broke down, cr ying inconsolably. Her son held her and prayed. It is vitally impor tant to understand that event s create impac t. CPR in it s purest form is a simple physical action in response to a set of conditions. It is only as you build in the layers of humanity around it that you begin to understand just how impor tant those t wo-minute cycles really are. What is routine to us, CPR or other wise, may be a traumatic and ultimately life-altering event to that person on the ground, couch, or stretcher. Where there is impact, there is also damage, sometimes residual and long- la s ting. Anne's guilt over put ting her family through a similar ordeal ampli- fied what she was already dealing with, ripping wounds open a gain. Guilt is a sinister emotion and can strike from the oddest directions, bringing fault where none exists. Anne's teena ge daughter strug gled for months af ter her mother's cardiac arrest. It wa sn't until much later they discovered she felt enormous guilt over the defibrillator not working. There had been no shock advised. She was unfamil - iar with the device and thought she had somehow failed her mother by applying it incorrectly. Just because we can walk away from an incident doesn't mean ever yone will be as luck y. More than 50% of lay pro- viders repor t significant psychological impact from par ticipating in a resusci- tation, with 13% of them repor ting that impact as severe. 2 We can't change what occurred, but when possible we should be able to reassure or mitigate the feel- ings of helplessness. Rex's event never went beyond internal commendations for the staff at Costco. It didn't make the papers; there was no feel-good news stor y, no social media hurrah. What there was was a 41-year old man who made it home to his family in time for Christmas. His gift was a brand- new AICD and a second chance. Rex's wife found out who Rex's rescu- ers were. She contacted Anne at Christ- mas, calling her a "guardian angel" and thanking her for helping save him. She shared pictures of their two young girls, spared having to go through life without their father. Rex was transported to the same hos- pital that treated Anne so poorly the year before (see Part 3). The same facility that branded her an addict, disregarded her histor y, ignored her pleas for treatment, and dismissed her as less than a person provided him with a new lease on life. Despite it all, the fact remains, if Anne had not been resuscitated, if she had not sur vived her overdose, then she would not have been there to assist Rex. As EMS providers it can be easy to lose sight of just how far our reach is. When we treat a patient, we are working the cumulation of a lifetime of interactions and relationships. Our decisions resonate outward and impact untold numbers in the days to come. What an honor that is. The work we do is seismic. Make your impact the best one you can. Author's note: It has been an honor and privilege to relate Anne's stor y to you. Sharing such a personal journey with the world requires a level of braver y most of us will never achieve. I am grateful to Anne and Chris for their candor and open- ness and hope their story will serve as a reminder of the importance compassion and empathy play in all levels of care. Stay safe out there. REFERENCES 1. Rice DT, Nudell NG, Habrat DA, et al. CPR induced consciousness: It's time for sedation protocols for this growing population. Resuscitation, 2016 Jun; 103: e15–e16. 2. Zijilstra JA, Beesems SG, De Haan RJ, Koster RW. Psychological impact on dispatched lay rescuers per forming bystander cardiopulmonary resuscitation. Resuscitation, 2015 Jul; 92: 115–21. ABOUT THE AUTHOR Tracey Loscar, BA, NRP, FP-C, is chief of operations for Matanuska-Susitna (Mat-Su) Borough EMS in Wasilla, Alaska. She is a member of the EMS World editorial advisor y board. Contac t her at taloscar@gmail.com. Photo by Brie Reynolds Photography

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