In Which I Electrocute a Dead Man

A man arrested today. The crash buzzer in Bay 4 has been a bit wayward lately, so when the bell went I was initially skeptical. I’m not sure what it was that prompted me away from the neuro exam I was doing to investigate; only that it wasn’t the urgent obligation that it should have been. I realise that now. Despite that, I was only five or so seconds behind the first doctor on the scene – my fellow F1 on the ward. I have a flashbulb image of the room, the nurse doing chest compressions, the patient flat out on the bed, unresponsive, the mirror image of panic on my colleagues face as must have been on mine. I knew what I needed to be doing but somehow doing it was just a marathon away. My memory is hazy on the next part but I remember the crash trolley arriving behind me, defibrillator pads miraculously appearing on the patient as I dug around in the crash bag for something to protect the man’s collapsing airway. The side room was packed with people and kit even before the crash team turned up, the anaesthetist forcing a path through to the head of the bed, and I was lost in the chaos. I ended up next to the defibrillator, and when the CPR stopped and the room silenced the fluctuant fluttering line on the monitor was instantly familiar even to my deer-in-headlights brain. Regaining some kind of composure (somehow) I pressed the charge button on the defib and told the entire room to clear the bedside, backed up by the shrill whine of warning tones. Looking back now, I forgot to check the oxygen was away before I discharged 200J of electricity through the patient. He jerked on the table and remained comatose. Rhythm change. Back on the chest. I am told that there were roughly five minutes more of CPR after that but it felt like about 45 seconds. I was trying and failing to get a femoral arterial blood sample, I delivered another shock. I didn’t know what to do with the needle – the sharps bin had vanished somewhere, but I managed to hand it off to someone and didn’t think about it again. I didn’t get a femoral stab; a venous sample was drawn by one of the anaesthetists and by the time I’d filled the syringe off it the patient was stable, with an output, and in the hands of far more experienced doctors than I. I realised then that I only had one glove on and that my hands were shaking. The room slowly emptied until only 5 or so people remained, and the registrar thanked both of us F1s and we left. The patient was remarkably coherent this afternoon when I saw him again. Looking at him, open eyes, alert, talking, I couldn’t help but think that he was dead this morning and how lucky he is to still be here. Realistically,I know that had I not been there things would have turned out much the same, but I’m going to hang on to a bit of pride anyway. Miraculous.

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