Cardiac & Resuscitation, Columns, Trauma

My First Code

It was the first run of my first day of field clinicals for my paramedic class. I had been an EMT for about a year and a half, doing mostly interfacility transports. We had a dual response system with a medic truck with two medics, Ed and Terry and a BLS transport ambulance.

The very first call of the day was a cardiac arrest. I am reminded of it even two decades later every time I pass the address. When we entered the apartment, our patient, a 50-something-year-old man, was lying on the couch — pulseless, apneic and purple from the nipple-line up. Jana, one of the EMTs on the BLS unit, walked in, took one look at him and, in one swift move, yanked him off the couch and onto the floor and started CPR. This was an amazing feat, pitting her diminutive frame against his massive (and passive) bulk.

It was like mega-code practice. Our patient threw every cardiac rhythm in the ACLS book at us. The medics couldn t get him tubed because his jaw was clenched, so we ventilated him with a bag-mask device throughout. We managed to get a pulse back and decided it was time to hit the road. We prepared to move him onto a backboard to load him on the cot.

I remembered that our instructor had taught us that we should always talk to a patient, even if the patient was unconscious, because sometimes they can hear and may even remember what was said afterward. So, being a conscientious, na ve student, I believed most things my instructor proclaimed, and said to the patient, OK, sir, we re gonna move you onto the backboard now.


Everyone froze. Mouths dropped. We looked at each other across our patient. Who said that? Did he say that?

Sir, how ya doin ? I asked. OK, I guess, he replied. Oh, my.

By the time we had him in the squad, he was talking to us. The whole time I was thinking, this is the greatest job in the world! The first call of the first day, a save, and he s talking! I m an American hero!

Of course, it was another 10 years or so until my next code spoke to me in the ambulance, and months would go by without anything more than band-aid calls. But that evening, high on the resurrecting powers of my new profession, I stopped by the patient s room in the ICU to see how he was doing.

He was sitting up watching TV. I said, Hi, my name is Guy. I was one of the EMTs who brought you in today. Without looking away from the TV, he said, Hi.

No Thanks for saving my life ; no happy hugs at the fire station just an uninterested Hi.

Thanks, pal, lessons learned. So, I guess some patients really can hear you, and just because the crustier medics don t do it doesn t mean it shouldn t be done. And sometimes you really can bring back a cardiac arrest not often, but sometimes. But most of all, it s essential to maintaining a fulfilling career in this business to find satisfaction in your own work any thanks you get are just an added, and very occasional, bonus.