So far it has been a great summer. I started helping out at Camp Zoe, where they call the First Aid Station Safestock. It is an old youth camp in Southern Missouri, owned in part by members of the band called The Schwag. They have music festivals all summer at Zoe.
The first this year was Zoe Jam, featuring great bands like Hot Tuna, Garaj Mahal, and one I simply flipped over, Karl Denson’s Tiny Universe. This is my idea of fun. Zoe has fabulous camping ona beautiful, 330-acre site with a crystal clear spring-fed creek full of happy smallmouth bass. I can go on canoe float trips, listen to nonstop live music, ogle the hot hippy chicks, and do some freestyle EMS. This is basically everything I’ve ever enjoyed, rolled up in a ball.
My first visit there resulted in my first clinical save in years. During the Zoe Jam festival, we jumped on the four-wheeler to respond to a campsite where “we had a problem”. Looked like a pretty big problem when I got there, like he isn’t breathing. Please, no, you can stop shoving ice up his rectum. Please just give me a second to find something to use to ventilate this kid. I just knew this would happen. I intentionally left my Intubation Kit at home. Yes it has everything in it you could dream of, even toys most anesthesiologists don’t have. But I just relocated back to Missouri from Philly, and I need to stay within the scope of practice of a basic CPR card. So I left it at home where I could NOT actually use it, if it were needed. Well, now I needed it. I sure as heck would have used it.
I suddenly realized I had my very first product invention with me, The White Pulmonary
Resuscitator (or WPR). I was overjoyed because I knew if I had to Bag him a long time with just an oral airway on room air, he would have no chance at all.
The WPR (patented in 1981) was the first disposable ventilatory adjunct with a non-rebreathing valve. It really predates the pocket mask, as we know it today. The big advantage is it can deliver very high concentrations of oxygen, and is comfortable to use because of the long oxygen reservoir. Like most exhaled breath powered devices, it is much easier to control the mask seal with two hands, and deliver better tidal volumes, constant flow rates and lower inspiratory pressures than with any BVM.
So I settled in for what I was afraid would be a very long wait for an ambulance. I did not have much doubt what was going on, he had needle holes in his skinny arms, pinpoint pupils, fast pulse, no
breathing, and that special look that screams, “Get the Narcan Now!”
Guess what friends, no ET Tubes, No Narcan. Nearest unit 45 minutes away. I thought, “This is going to be fun” (not), and I slowly, steadily, began breathing for him. One long, slow, low-pressure, high
tidal volume ventilation after another.
About 15 minutes later, his color was a lot better. His pulse slowed back down to normal. Jeez, then he started to try to breath. So I kept at it, keeping a tight seal with both hands on the mask. Nice long slow breaths, now timed to go in right when he tried to take his own. A few minutes later he was moving air well enough so I sat back a second, and collected my thoughts. “Well, this is it I guess, -you better give him a sternal rub and see if anything is left”, I thought to myself. I had little hope for much reaction. Maybe some bad posturing was what I expected. After all, I have no idea how long he was really down before we arrived. It took us at least five minutes just to find him.
I rubbed my knuckles on his chest and he freaking sat up, then opened both eyes
and looked right at me. I reached over and pulled the Berman airway out of his mouth and “-Wha,wha, what’s up man?” comes out of his mouth. You could have knocked me over with a feather.
Five minutes later he was up weaving around, still pretty high by the looks of him. When the helicopter landed he refused care. I transferred care to the ambulance and left the scene. As soonas my back was turned, he talked his way out and refused the trip by ambulance too. I heard later that Security put him and his little group of junkie friends out.
Well, I have seen a lot in my long career. I have seen people die at festivals. I have seen security throw people out of festivals. But I have never seen anybody die, and then get thrown out.