Watching your family member die(part 3)

 After working in EMS there have been many times where people(usually family members) have changed their minds about the wishes of the patient and requested that we "do everything". I am sure they and many people reading this don't know what that entails/means. If the patient stops breathing then normally we have to put in a tube down the trachea to breathe for them. This procedure is painful even though we sedate the patient or even if they are unconscious. Next, if the patient's heart starts to quiver uncontrollably(ventricular fibrillation) then we have to provide an electric shock(defibrillate) with our cardiac monitor. This too hurts even if the patient is unconscious. Lastly is Cardio Pulmonary Resuscitation)which is also known as CPR. This is where we push on the patient's chest to about 2 inches in depth, this normally cracks/snaps ribs. The patient at this point doesn't feel that but in the event that they do make it through all that and regain consciousness they will be in pain. My Dad had open heart surgery in 2001 so his sternum was cut in half already and being held together by wire bands(which would break during CPR).

So, according to a study by Oxford University, the chances of survival of a 70-79 year old suffering an in-hospital cardiac arrest is just over 18%, This however does not take into effect Dad's specific situation. He is on several medications to keep his blood pressure up, his lungs were in very poor shape, his heart function was only at 35% and his kidneys no longer function. I can tell you that in my 21 years in EMS, I have worked countless cardiac arrests and it wasn't until my 17th year that I actually had a patient survive to walk out of the hospital. I went to see that man a month after he was released from the hospital, he actually answered the door at his house. I got the biggest goosebumps and was just speechless, I will never forget that feeling.

Dad is in very bad shape, he has pretty much stopped talking and his respiratory effort has decreased. My sister is still 4 hours away, all hope of her getting to talk to him unfortunately is gone. The staff had already placed a large intravenous line(a central line) to accommodate all the blood pressure meds that he was on.  Dad's doctor came in and told him that the time for the possible last-ditch effort is now. She told Dad that he needed to have the tube placed to help him breathe, she also told him that chances were that if he did this there was a very good that he would not come off of the ventilator. 

I held Dad's hand and I explained everything that the staff was going to do for him. I described the meds they were going to give him to sedate him, I told him that possibly being on the ventilator would help his lungs rest, and this would also help his heart rest. I squeezed Dad's hand, I told him I loved him and he said he loved me back and I just knew that was going to be the last time that I would hear his voice. Mom and I left and sat in the waiting room for what seemed like an eternity. Mom asked me at one point "How long does it take to intubate someone?" I said well for me it is only a couple minutes total after I have all my equipment ready. When you sedate the patient, place the scope in, look for the vocal cords (where the breathing tube goes through), place the tube, inflate the cuff(what secures the tube in place and also keeps fluids out of the trachea), listen to the breath sounds and then put a clamp in place around the head to keep the tube from getting pulled out. That sounds like a lot but it goes pretty quickly with a couple people doing what needs to be done, it is however more challenging in the back of an ambulance. 

One of the nurses came out and got us, part of me expected them to say that Dad didn't tolerate it well and that he had died. That was the medic side of my brain, the son side of the brain was waiting to hear them say that he did good and that he was stable. Son side won this time.....