Cardiac & Resuscitation, Columns, Documentation & Patient Care Reporting, Operations

A Reader Underscores the Need to Stay Healthy

Issue 6 and Volume 38.

Role Reversal
The job of an EMT or paramedic is by nature high-stress and both physically and mentally demanding. But when taking care of others, we have to also remember to take care of ourselves. In April, we published the compelling story of John Davis, an EMT who found himself on the other end of a cardiac monitor after years of putting aside his own health. Kristen Spencer, MS, NREMPT-P, co-author of the article “Provider to Patient: One EMT’s close call offers lessons for all providers,” received a letter from a reader whose own story further underscores the importance of being aware of your own health, not just your patient’s.

Author Kristen Spencer, MS, NREMT-P, writes: Just a few days after publication of the ”Provider to Patient” article in the April issue of JEMS, I received a heartwarming story from Bruce Kilburn, AEMT-CC, a resident of Lake George, N.Y. Mr. Kilburn expressed how he, too, experienced a “widow-maker” acute myocardial infarction while on duty—but with a far different outcome than that of John Davis, the subject of the April article. Unfortunately for Mr. Kilburn, he now requires an implantable cardioverter defibrillator (ICD) and multiple medications to maintain adequate cardiovascular function because he elected to ignore his symptoms.

It is for this precise reason that John Davis’ story needed to be shared with your readers. EMS providers are subjected to stressful events, work long hours and often fail to adopt healthy dietary habits. The article was intended to remind EMS providers that they are not invincible and can succumb to catastrophic cardiovascular events—just like the same patients they are called to treat.

‘Kicked in the Chest’
I’m an AEMT-CC in upstate New York and have been involved in EMS for 20 years. I was on call on July 22 when my partner and I got a serious personal injury call for a motorcycle accident. Upon arrival we found a young man lodged under a car. Needless to say he was in rough shape. So I did my job and took care of him and got him to the hospital.

While I was writing up my PCR in the EMS room at 10:15 p.m., I suddenly felt like someone had kicked me in the chest. The pain increased quickly, like my chest was in a vice and someone was turning the crank. But I thought it was just my dinner coming back.

You know that little voice in the back of your head? Well, it told me three times not to leave the emergency department and to tell a doctor what was going on; but I chose not to do that. I thought, “I treat people for this, I don’t get this.” But I was wrong—almost dead wrong.

I got back in the ambulance and returned to work. Fifteen minutes later the pain had become unbearable. My left arm was numb and I knew something bad was happening. I got out of the ambulance and back in the patient compartment and told my partner that I needed a monitor placed on me to see what was going on.

He did a 12-lead ECG and I could tell by his voice when he called the doctor that he didn’t like what he was seeing. I knew it wasn’t good when I heard him relay my ST elevations to the doctor. They were the same as in your article. I was having the big one: the “widow-maker.”

It took 11 minutes to get me back to the ED and I was in the cath lab within 10 minutes of arrival. I had two stents placed, one was 100% blocked and the other was 80% blocked left anterior descending. I was in the cath lab about an hour.

I was lucky to be alive. It has been a long road to recovery and I know I will never be 100% again. My ejection fraction was running between 35% and 40% and was holding until April of this year when it took a nose dive to 25%. Needless to say I now have an ICD in place to bring me back if I go into v fib or v tach. This was not something I had planned on.

I guess the take-home message here is: take care of yourself early in life and don’t think it won’t happen to you. We are not bulletproof like so many of us in this profession think we are. Also, listen to your inner voice. Had I simply said something instead of falling into denial, I probably would not have done so much damage.
Bruce Kilburn, AEMT-CC
Via email