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yourdavemitchell · 5 years ago

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Max was an avid motorcycle rider who had just gotten a new Harley for his 23rd birthday and decided to take it out for a spin on the highway. After cruising along for a while, it began to rain so he decided to start heading home. As he attempted to merge over the other car also merged and clipped the back of his Harley sending him spinning. Max flew off of the motorcycle and collided with the asphalt before tumbling another ten feet. He had jeans, a leather jacket, helmet and boots on. His helmet was cracked from the collision and he couldn’t feel his legs. He laid there in shock as the driver pulled over and quickly called 911. Within minutes a team of emergency crew arrived on scene and shut down the highway. By this point Max had lost consciousness and was laying in a pool of his own blood. Sara and Dave rushed over and carefully rolled him onto his back before gently removing his helmet. His bloodied dark brown hair was exposed. His brown eyes were sealed shut and when they tried to get him to respond he laid still. They cut off his jeans and jacket leaving him in only his boxers in the drizzling rain. They put him in a neck brace and attached the electrodes to his badly bruised torso. His pulse was weak and thready as they attempted to stabilize him. He had a collapsed lung, so they intubated him while also starting an IV for fluids. They rolled him onto a backboard and loaded him into the ambulance knowing that he did not have much time. After pulling away from the crash scene Max began to deteriorate quickly as he slipped into v-fib. Aggressive CPR was started as his bruised belly rose and fell with each compression. He was hooked to a ventilator as artificial breaths filled his lungs. After a few moments that paddles were taken out and gelled as they were placed on his chest and charged to 200 joules. The first shock made him twitch on the backboard as his heart did not respond. Dave continued CPR as the paddles charged again to 300. He placed them back on his chest and shocked him again as his chest rose slightly from the higher voltage. This shock sent Max into asystole as Dave checked his pupils and found that one of them was blown. He placed the Lucas thumper on his chest and switched it on as he focused on giving meds. For the next four minutes Max stayed in asystole as they rolled him out of the ambulance and directly into the trauma room. Dr. Michael took over as the Lucas was removed and aggressive CPR was resumed. They pushed more meds and Dr. Michael inserted a chest tube as blood poured onto the floor. After a few minutes Max converted into v-fib and the paddles were gelled as they were charged to 360, they were placed on his battered chest as the shock made his arms fall off the bed. Now with each compression his arms bounced around. The paddles were placed back on his chest as he was socked as his chest rose and his feet kicked out. This shock made Max revert back to asystole. Max laid on the bed as he was clinically dead as the doctors did everything that they could to save his life. Dr. Michael decided to crack his chest as a last-ditch effort. The betadine covered his left side as the blade made a clean cut. The snapping of the bones could be heard as they were removed. His heart laid still in the doctor’s hand as he squeezed it. As Max crossed the 20-minute mark of down time he converted into v-fib as the spoon shaped paddles were placed into his chest. The shock made his body twitch slightly as his heart flailed. Compressions continued while the defib was charged and placed back into his open chest. The shock made his hands and feet twitch as he reverted into asystole again. A nurse took over compressions as Dr. Michael checked his pupils They were fixed and dilated. Max had endured a large amount of trauma. At the 25-minute mark he was still in asystole, so Dr. Michael stopped resuscitation efforts and pronounced him dead. They removed the rib spreaders and disconnected the leads as they covered his battered body with a white sheet. They placed a toe tag and tried to clean the blood off of the floor before giving his family the news of his early death.

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yourdavemitchell · 5 years ago

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Jeff’s Cornoary

Jeff hadn’t felt well in a few weeks but he thought it was the seasonal allergies, something he had ate, or a touch of stomach flu. He hadn’t realized that years of stress was catching up to him today.

As Jeff walked through the bed room he felt an immediate paralyzing pain. As his legs folded underneath him the last thoughts were the burning mashing pain in his chest. The nausea hit him just as hard and a cold sweat covered his body. As he fell on the bed his last animalistic thoughts were just to fill his lungs one more time with air. As the last life in Jeff flickered the lips turned blue, pupils dilated, and the last urination.

As fast as Jeff had suffered this massive coronary, it had stole his life. All that was left of Jeff was a 50 year old, 258 lbs. clinically dead body. That dying corpse would become a battle ground in a losing war to reverse the damage that stress and a pea size arterial plaque could reap.

As Jeff was laying on his back on the bed for several minutes. His eyes were open stirring at the ceiling. His mouth was open too as his body progressed through death. His skin cut off of fresh oxygen began to gray and his lips were purple.

Alex the step son walked into the bedroom finding Jeff on the bed. He shook Jeff who was cold and unresponsive. Alex had never been trained in CPR but knew he need to call 911. He punched 911 on his smart phone. It rang once and then a female voice at the other end responded. “911 what is your emergency”! “Uh my step dad, he’s collapsed and I don’t think he’s breathing”! “Ok sir have you tried to wake him up”? Calmly asked the dispatcher. “Yes all he did was this gross gurgling noise” answered Alex. The dispatcher flipped a light on her consul at the 911 center. That light indicated she was taking an urgent call in which a second dispatcher would listen in and start alerting responding units. The second dispatchers screen lite up with the same location info for the phone. The first dispatcher told Alex to make sure Jeff was on his back. Alex did so and now Jeff was face up eyes and mouth open, his face purple. The second dispatcher toned the closest Fire/EMS unit as well as PD to respond. The protocol for their jurisdiction. The first dispatcher told Alex to put his phone on speaker and lay it next to Jeff, she then told him that if Jeff wasn’t breathing to start CPR. Alex told her he didn’t know how. Alex was shaking with great fear. The dispatcher told him to put one hand on top of the other in the center of Jeff’s chest. Alex did so and heard her say to push down hard and fast. He did that too, but he wasn’t pushing quite hard enough to push the blood around Jeff’s chest. As the dispatcher counted Alex pushed. The dispatcher asked Alex if Jeff was still gray colored or more pink. Alex told her Jeff was still gray so she instructed him to push on Jeff’s chest hard. As Alex did he noticed Jeff’s belly distend upward as he push the chest downward. Alex paused a minute remembering watching CPR on TV as a kid. He tilted Jeff’s head back and gave Jeff mouth to mouth ventilations. Jeff’s lips felt cold as Alex pressed his against them. Alex blew hard trying to get Jeff’s chest to rise. Alex repeated chest compressions which with Jeff in bed had little effect. Alex did realize that all he was doing with the mouth to mouth was to inflate Jeff’s belly. It had been several minutes and Alex was about wore out. He also heard a siren outside and could tell it was getting close. He continued as the siren stopped apparently outside and then he heard a knock at the door. He stopped CPR to open the door finding an EMS crew ready to go to work on Jeff.

Joe the medic in charge walked in the bedroom and quickly scanned the scene. Looking for an dangers or clues to the cause of Jeff’s apparent cardiac arrest. He mentally noted clean surroundings and sat his equipment down next to the patient. Joe and Beth grabbed Jeff’s body and hurriedly pulled it into the floor. Joe’s partner Beth sat her stuff down on the other side of Jeff. Joe immediately started CPR on Jeff. He noticed that Jeff’s mouth and eyes were open and Jeff’s pants had a large wet spot at the groin. He pushed hard and fast making Jeff’s belly push up as Joe pushed down on his chest. Joe felt a pop on Jeff’s chest as he had dislocated some ribs. Beth retrieved a yellow bag mask and when Joe had completed the first cycle gave Jeff to ventilations. Both medics noticed Jeff was very gray and his eyes were open with a glassy appearance. They both knew without saying that Jeff was probably not a viable patient but they continued his resuscitation. Joe looked at Beth and said “We need to see if he’s got any electrical activity in his heart.” Beth asked Alex about Jeff’s medical history as Joe tore Jeff’s t-shirt open exposing Jeff’s hairy chest. Joe then slide the defib paddles from the Lifepack 20 and applied a puddle gel to one of them. He pushed the paddles together and gently rubbed spraying the gel on both metal shocking surfaces. He then pushed each paddles against Jeff’s hairy chest making good contact with the skin. Joe pushed the paddle monitor read button showing Jeff’s heart in the erratic ventricular fibrillation. The unit ran through the automatic sequence of tones indicating that it had charged. Joe then shouted “CLEAR”! After a quick glance he pushed the shock button and Jeff’s 250 pound body jerked involuntarily.!

Jeff’s dying body relaxed and Joe held the paddles watching for a conversion. The monitor registered a flatline as Beth felt for a pulse. She shook her head confirming Joe’s knowledge that Jeff was still in cardiac arrest. Without hesitation Joe started CPR again as before and Beth prepared the laryngoscope and a ET tube.

Beth extended the blade of the scope which switched on the light at the end of the blade. As she advanced it towards Jeff’s partially opened mouth she flicked the light into Jeff’s opened eyes. She noticed no pupillary response from the dilated black spheres almost obscuring the brown irises. She then inserted the blade into Jeff’s mouth as she pivoted the handle. The light illuminated Jeff’s airway. Beth noticed that the throat was clean and moist. She didn’t she any tail tail signs of tobacco use and visualized the vocal cords. She rooked the tube and passed it into the trachea then retracted the scope blade. She then followed protocol in securing and confirming the tubes placement.

Joe has continued chest compressions which he secretly enjoyed doing. Joe had a resuscitation fetish which he’d never shared but with his friends online. This patient was the right age and build to spark his interest. He could feel his strength and power pushing down on Jeff’s chest. Joe’s interest in his patient was the reason he started the resuscitation with the paddles. As he firmed against Jeff’s calmly chest he felt so powerful as if the paddles were extensions of his own hands. Now he paused the compressions as Beth ventilated Jeff. Joe pulled out the quick comb pads and applied them to Jeff’s chest. He then plugged them into the Lifepack 20. The monitor showed Jeff was still in asystole as Joe went back to CPR. Beth radioed our the the next arriving unit to bring in the cot and long spine board. She next set up an IV, selecting 500 ml bag of Normal Saline and a micro drip tube set. She had Alex hold the IV bag as she inserted the IV cath in Jeff’s arm. Once she saw the blood in the cath then she attracted the tubing from the bag. Joe continued the compressions fast and hard.

Now that the second EMS arrived with the cot and board Joe and Beth could switch roles. Joe took over ventilations and Beth opened a box of Epi to inject. The other crew took over compressions. Beth emptied the Epi and looked at Joe saying “Recon we need to push some bicarbonate”? Joe looked up with a “oh yes he’s been down a while.” One of the other medics readied 2 amps and handed them to Beth. As she injected them Joe watched be aroused by the site of the large syringes being emptied into Jeff.

Jeff’s wife Maureen has arrived home with their daughter. Maureen looked to be a bit older than Jeff but was only 45 medium build and brown headed. She was visibly distressed as she watch the EMS crews tending to her dying husband. Their daughter started sobbing at the site.

The drugs had caused Jeff’s heart to have some electrical activity again. The wavy line of fine VF traced across the monitor screen. Beth hit the charge button as she shouted “Clear”! The medics stopped their activities as she pressed the shock button. Jeff’s body stiffened, jerked, and relaxed as the electricity traveled through him. Joe had laid the attached bag mask against Jeff’s check. The shock cause Jeff’s head to bob back slinging the bag up and then back down. Joe watched the lifeless gaze in Jeff’s eyes as this happened. He was even more aroused by this. The monitor continued to read fine VF as Beth pushed another Epi. Jeff’s heart rhythm was still VF so Beth prepared to shock the 50 year old man. When she called clear Joe again layer the bag against Jeff’s face and again he watched the bag being slung up as the wave of 360 joules contracted the back muscles. He also watched Jeff’s expressionless face with the ET tube protruding from the mouth. When Joe picked up the bag and squeezed he could here the gurgling noise indicating some fluid in Jeff’s lungs. “Beth we need to get him moving” called out Joe. He then looked over at the older of the 2 other medics and said “Why don’t you get the family and start driving them to the hospital”. That medic named Randy nodded and walked cover to Jeff’s family.

The kids were near distraught watching this unfold to the dad. Maureen still in a state of half shock and distressed watched too but was also was craving a cigarette. She was a nervous smoker and this stress was triggering her addiction.

“Mam what is your name?” asked Randy. “I’m Maureen” she stuttered nervously. Randy took the opportunity to get a little more medical history on Jeff. “Maureen has Jeff been sick or complaining of anything?” She said “No”. “What about medical conditions or issues we need to know about?” He continued. She looked and said “Well he had an abdominal abscess several and surgery several years ago. That why he’s got that scare.” In the background Beth could be heard calling clear again as she zapped Jeff with another 360 joules. “Ok well I’m going to drive you all to the hospital now”as he patiently herded then to the door. As Joe watched them leave he thought about all those times he’d drove family. Driving a car that he had never driven with total strangers trying to find something to talk around other than the obvious.

With the family gone Joe, Beth and the other medic name Monica readied Jeff for the last trip to the hospital he would ever make. Beth and Monica rolled Jeff on his side and slide the spine board under him. Then they along with a couple policemen who had arrived lifted Jeff onto the Stryker cot. Joe started one handed compressions as they rolled Jeff through the doorways and the rest of the house. They rolled the cot out to the ambulance as Joe continued. Beth got in the back with Joe and Randy got up front to drive. As the cop shut the door he said he would lock the house.

On the way to the hospital Beth continued bagging now and Joe took back compressions. Jeff’s condition had changed one bit as he was still in the grip of clinical death. Joe called “Clear!” After charging the Lifepack 20 and shocked Jeff. Jeff’s outward lifeless appearance failed to change but the monitor showed him in asystole now. Joe pushed 3 ml of atropine and Epi with Jeff still in asystole. Beth was having trouble ventilating Jeff so she suctioned him. The suction tank collected a little yellowish pink sputum.

Some where ahead of them was the car Randy was driving. Maureen cracked the passenger side window asking Randy “would you mind if I smoked?” Randy said that was fine uncomfortable at trying to make conversation. She pulled a long white cigarette from the box in her purse and lit it the lighter. She brought the flame to the end of the long white shaft dangling firmly from her lips. As she inhaled deeply the end of the cigarette flowed orange. She exhaled a white cloud of smoke. As she held the burning cigarette between puffs she looked at it and remarked”He always was on about quitting, saying that I wouldn’t live as long as him.” As she repeated puffing away she asked Randy “Do you think Jeff will make it”? Randy be as professional as possible gave her the only answer he could “Maureen we’re doing everything for him that can be done.” Randy knew from what he saw at the scene the outcome wouldn’t be positive.

As Joe continued pumping away on Jeff’s chest Beth pick up the radio mic to call the hospital. “Med 2 to Memorial.” The voice respond over the speaker “ Memorial go ahead.” Beth continued “transporting a 50 year old male in cardiac arrest, ACLS on going, ETA to u 5 minutes”.” Memorial standing by”. Joe was sweating as he pushed down and relaxed his arms a hundred times a minute. Jeff’s face was still expressionless eyes fixed on the ceiling. Only wearing trousers obviously still wet around the groin. His belly round and distended. The monitor continued to show no electrical cardiac activity. Beth and Joe switched positions and she began her turn at compressions. Joe had wore hisself out but enjoyed every compressions in his heart. Beth did care to let him since she was in her 40’s, morbidly obese and a smoker. She could only do CPR 5 minutes and get out of breath, the harbinger of her own early death.

Randy and Maureen were standing at the ER entrance as the ambulance pulled up and backed in. Maureen was nervously puffing away on another cigarette as she watched them unload Jeff still doing CPR.

Photos by Jeff Shalley

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yourdavemitchell · 6 years ago

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Jeff’s Cornoary

Randy and Maureen were standing at the ER entrance as the ambulance pulled up and backed in. Maureen was nervously puffing away on another cigarette as she watched them unload Jeff still doing CPR.

Photos by Jeff Shalley

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yourdavemitchell · 6 years ago

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With a Diet Coke

I decided to try something new. Let me know what you think and if you would be interested in more male resuscitation? Enjoy!

Bryan is a 250 pound 30 year old man who has never cared about his overall weight and worked at the local McDonald’s. When he began his shift at 6 in the morning he didn’t feel very good and decided to wash down some pain meds with a diet coke. He brushed off his symptoms and continued on working. By the time lunch rush came he was over stressed due to the fact one of his coworkers called off sick. At 12:17 pm Bryan grabbed his chest as he collapsed to the floor. His coworker and one of the customers rushed over to him. “Bryan are you okay?” his coworker asked in a panic. Bryan was struggling to breathe and couldn’t speak. “Quick call 911, give me that jacket so we can prop his head up.” One of the customers called 911 as his coworker bundled up a jacket and placed it behind his head.

Dave and Sara were roaming the streets in their ambulance when the call came over the system. “30 year old male collapsed on the floor, requesting medical, 1800 West Broad St.” Dave looked over to Sara “That’s right around the corner” Dave flipped on the lights and sirens as he raced to the scene. When they pulled up Sara grabbed the medical bag from the back and the monitor since they werent sure what exactly they were walking into. They went behind the counter where they found Bryan on the floor and his two coworkers trying to calm him down. “What’s his name?” Sara asked as she placed the bag down and started getting out her supplies. “Bryan he’s the manager. all of the sudden he just collapsed. Is he going to be okay?” One of the workers informed them. “We’ll help him in every way we can” Dave placed an oxygen mask over Bryan’s face as they attempted to get him much needed air. Sara took the shears and cut down his shirt revealing his large belly. She took her stethoscope and listened to his breathing and heartbeat. “Sounds like there is some fluid build up and he’s not getting any air. Pulse is weak and thready.” Dave began placing the electrodes on his chest and connected the leads to the monitor. Bryan’s eyes rolled back as he started to lose consciousness and his heart rate became erratic. “He’s going into V-fib, start CPR.” Dave placed his hands on his flabby chest and started compressions. With each one Bryan’s large chest and belly bounced around. Sara took the largynscope from the bag and intubated Bryan before placing the blue tube holder around his head. She attached the blue ambu bag and started delivering air to Bryan. After the first 30 compressions Dave placed the AED pads on his chest as he let the machine analyze the rhythm. “Shock advised do not touch the patient.” They all backed away from his body as Dave pressed the button. Bryan twitched on the floor as the shock went through his body. The first shock was unsuccessful and CPR was started again. After another round they shocked Bryan again this time at 300 joules. Bryan once again twitched and his flabby belly bounced around. The second shock caused Bryan’s heart to convert to asystole as the monitor flat lined. Bryan resumed CPR as Sara had a coworker take over ventilation as she ran to the rig to grab the backboard and gurney. When she got back they rolled Bryan over and then all lifted him onto the gurney. Dave continued CPR as they rolled him out of the restaurant and loaded him into the ambulance.

Dave decided to take the back this time due to the patients overall size as Sara drove to the emergency department. Dave set up the Lucas Thumper on Bryan as it delivered compressions allowing Dave to worry about ventilation and other care. Dave set up an IV port in Bryan’s left arm and pushed a round of epi. Bran remained in asystole for another two minutes as the thumper delivered CPR. Finally he converted back to V-fib so Dave stopped the Lucas and delivered a shock at 360. Bryan bounced up against the plunger of the Lucas as he was shocked. He remained in V-fib so Dave shocked him again. This time after his body shook his heart beat came back into normal sinus rhythm. Bryan’s total down time was 7 minutes. Dave took the shears from his pocket and cut away his pants and removed his shoes and socks. Bryan was now only in grey boxers and was totally exposed. Bryan’s rhythm only lasted 40 seconds before his heart gave out to V-fib once again. Dave strapped Bryan’s arms to the Lucas as it began giving him CPR once again. Dave charged the AED unit to 360 again and shocked Bryan. He jolted on the gurney as his body bounced around. There was no response so Dave charged again. The next shock was delivered as the back doors were swung open. The nurse saw Bryan’s large feet bounce off of the gurney.

Dave removed the Lucas as they unloaded the gurney. The nurse straddled Bryan and delivered compressions as they rolled him through the ER. They rolled him into the room and transferred him over to the bed. They rolled him over and removed the backboard as Sara gave the team his info. “30 year old male sudden cardiac arrest. Is currently in his second cardiac arrest. The first lasted around 7 minutes and required multiple shocks. Current down time is 3 minutes with two shocks.” Dr. Micheal took over the code as Dave and Sara rolled their equipment out of the room. Their part of this code was over and they moved on to prepare for their next call. Dr. Micheal barked out orders as his team took over care of Bryan. “Lets push another epi and run a blood screen.” One nurse continued CPR as another removed the AED pads and replaced them with two orange gel pads. The nurse in charge of ventilation checked the pupils wish were sluggish but still responsive. Dr. Micheal charged the defib unit to 360 as he placed the paddles on his chest. The team backed away as he was shocked. His arms and legs bounces slightly as his chest twitched. The monitor showed V-fib as a nurse continued CPR and the defib unit was charged again. The next shock had the same reaction as his heart rate remained the same. They pushed another set of meds as a new nurse took over compressions. With each compression his belly extended and his flabby chest caved in slightly. Dr. Micheal placed the paddles onto Bryan’s chest once again as he was shocked. Bryan bounced on the bed as the monitor flat lined. CPR was continued for another 5 minutes. Dr. Micheal checked Bryan’s brown eyes as his pupils were now fixed and dilated. The team checked for any pulses as Dr. Micheal listened with his stethoscope. “No pulses, he has been down for 13 minutes in his second cardiac arrest. Pupils are fixed and dilated. He has been in asystole for 6 minutes. Does anyone have any ideas?” The room fell silent as they all look at the obese man on the bed. “Time of death 12:46, thank you all for your help.” The monitors were shut off as they removed the leads and gel pads. A nurse placed a toe tag on his big toe. Finally the draped a large white sheet over his obese body and left to contact any family. An autopsy was conducted that showed a large amount of fat deposits surrounding his heart.

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