DOA and a Bad Shot

I worked in the ER this weekend in a very busy ER department and I must say it was the best experience I have had yet. I ran IV's, drew blood, performed several EMT skills, many of which I have never done before except on a doll, and even saw something those working in the field have never and may never see!

1500-0300 was my 12 hour shift.

1645- Paramedics called the ER telling us to be ready. They were bringing in a cardiac arrest. Total down time so far was 35 minutes. He was dead. They brought him in the trauma room which was filled with doctors, nurses, a paramedic on staff and myself. I was first to perform compressions on the man. His eyes where open, he was intubated, his clothes completely removed.

The man was a referee during a football game and just dropped. Bystanders began CPR and hooked up an AED, the AED continuously told them "No shock advised." He was in asystole (flatline)  from the get go. He was DOA . As soon as he was placed on the bed in front of me I felt his arms, they were already cold. We worked him for what felt like hours performing CPR and pushing epi and atropine. Nothing worked. The doctor observing our life saving efforts said "Please stop CPR....Alright.....we will call it....4:45."

The man was a large man, which made compressions difficult,  but during our efforts we were getting some perfusion but there was no use, he was gone. With each compression I could hear him gurgling and had to remind myself a few times he was not coming alive again and gurgling but my compressions were creating the gurgling from the fluid accumulating in his airway now.

Later that night we discovered through his family he is a donor. His organs could don't be harvested due to the lack of perfusion during his down time but his corneas were eligible for donation. (This is the part I mentioned earlier that some in the field have never seen and may never see.) I watched a man from a donor bank remove this man's corneas. It was amazing how they do it and it was fascinating to see the parts of a human eye as I did. Once the corneas were removed I held them up to the light and it was an eerie feeling knowing I was seeing through this once alive man's eyes.

1752- A supposed security guard was brought to us in the ER by paramedics because he had been shot in the face. The GSW was just under his left eye and he had about a 2 inch long gash along with an exit wound. His zygomatic bone was obliterated, which was clearly observed during CT scan. Three Police officers accompanied him and kept watch over him for the several hours he was there in our care. He was conscious and vitals were stable. The bullet had barely missed his left eye. He had no vision problems what so ever...lucky man.

So what happen? No one really knows but him. He claims he and his partner were sitting in a vehicle. He was the passenger. His partner was cleaning his gun, no cleaning equipment was found in the vehicle, and the gun accidently discharged shooting him in the face. Hmmm things did not add up based on the path the bullet traveled through the man's face. He later changed his story saying he was in the driver’s seat which still didn't make sense. He stuck to his story last I had heard.

We also had a female prisoner who had second and third degree partial thickness burns from a boiling water pot being hurled at her back thanks to another inmate. The rest of the night was fairly calm, one drunk who punched a wall fracturing her hand, we splinted a few other bones, had a few chest pains, a headache, a mentally ill patient and a few other minor complaint patient’s. I finished my shift smoothly.

That was my night in the ER.