Sad Day

New Year's Day.

I went to work as usual at 6:00. First thing I did even before checking out my truck was to read the story on the front page of the morning paper -- about the death of a police officer the night before in a shooting at a domestic.

I guess around 10:30 P.M. on December 30th, the officer a 17-year veteran of the police department responded to a domestic call. The details are sketchy, but a woman answered the door and told them her boyfriend was in the basement. As they walked down the basement stairs, the man fired an assault rifle at them -- a rifle he had reconfigured to basically turn it into a machine gun. The officer was hit 17 times. His partner and the woman retreated. The officer got the woman out of the house, then went back to the basement door and called down to his partner. No answer. As another officer said to me today, that officer made the right tactical decision not to go down into the basement to retrieve his friend.

What followed next was a daylong standoff, where for awhile they thought that the officer was still alive and being held hostage. The standoff lasted all day with sporadic gun fire as they tried several attempts to flush the man out. I guess he had big arsenal that included a gas mask that kept the tear gas from being effective. They sent in robots and tried to gain a view with fiber optic probes. In the end, convinced the officer was dead, they flooded the basement with a water hose and the gunman shot himself in the head as the water poured in.

We watched throughout the day on TV. They had several ambulances there, from the city, from the Volunteer ambulance. Even the helicopter was there, although I don't know why. The scene was only four miles or so from the hospital, and ambulance would have a patient in the trauma room before they could load a patient onto helicopter and get the engines warmed up and off the ground. They were probably there as a gesture -- there for moral support. I'm sure it was appreciated.

This morning I saw the photo of the officer. The name had meant nothing to me. The face did -- I recognized him. I've been doing calls into that town for ten years now. He was a familiar face. Nice guy. Most cops I've found are good guys, but he struck me as being especially so. Never putting on an attitude, always friendly with us. He was a big man with a big head and big hands. He reminded me of the big kid in school who was always called upon to deal out justice to the school bully on behalf of the little kids.

Its hard to think that I saw him on a call just last week. How could you ever imagine that a week later he would be walking down some basement stairs and get ambushed, mowed down by an assault rifle. Shot 17 times.

People at the ambulance were wondering if he had on a bullet proof vest. It wouldn't have matter against a gun like that -- a virtual machine gun. The police officer I talked to said a gun like that would go through the vest and right through him.

The officer was saying how many times he's gone to domestics and walked down basement steps like that. It could happen to anyone. A couple years ago, I did a call in the city. A police officer responding to a 911 hangup. A guy jumped him and stabbed him in the neck. Fortunately he was strong enough to fight him off. Still he almost died. Another couple years before then, an officer in a neighboring city responding to a robbery, went around a corner and got shot in the head, Now there is a portion of highway named after him. I'm sure soon they'll be naming some road after this officer.

In EMS they teach scene safety, don't go in unless the scene is safe. I've been to calls for unknown medical or bloody nose and walked right into a domestic. Years ago in the city we walked into calls by ourselves all the time. There were no first responders and the cops were always so busy. A lot of the medics wear bullet proof vests. I never have. I have always figured, if they were going to shoot me, they were going to shoot me. I'm big and pretty easy going. I try not to antagonize anyone. I think of myself as one of the good guys.

That's what the officer was. One of the good guys. He couldn't have been thinking that some demented fired corrections officer was laying in wait for the first officer to come down those stairs -- be it the officer who got shot or whoever else was unlucky enough to be on that day and get that call.

I remember him from the call last week as real as right now. He met us outside, gave a quick report, and that was that. You think you could close your eyes open them again, and there he would be. But you can't.

I'm sure in the coming days there will be solemn ceremonys and a funeral procession. I still find it hard to believe he's dead.

***

I've been on fifteen hours today. Another hour to go. I get double time and a half on holidays. I've done five calls(three from nursing homes), two falls, a fever, a chest pain and a cardiac arrest. The code was a nursing home patient. The patient was asystole when we got there, the nursing home staff doing CPR, the cops had put their defib on her, but no shock was advised. I tubed her right away, but had some trouble getting the IV. Once I got it I debated just working her the twenty minutes required and calling it. Our protocol lets us presume death in an asystole arrest after 20 minutes of ACLS resucitation(which includes intubation and IV meds). But since we'd already been there a good ten minutes, and with all the staff helping us and all the patients watching from the hallway, and her being a full code and her being seen talking ten minutes before they found her not breathing, I decided to bring her to the hospital. Staying there another twenty minutes and working her and leaving her didn't seem right. Besides, I had a new EMT with us, a young high school kid, and it was a chance for him to work his first code, do CPR for the first time.

I was tired and yelled at the kid several times on the way in. His CPR needed to be stronger and he kept banging against my tube. Starting today we are required to run capnography on all intubated patients, so I was doing that for the first time, and was only getting between 8-12 as my number, which I guess is poor, though maybe norm for an unwitnessed arrest.

(Capnography measures end-tidal C02 -- the best measure of whether or not you're in the trachea. A dead person or a tube in the esophagus, which is the same as a dead person doesn't give off any C02. CPR will give off a little. The better the CPR, the better the end tidal too a point anyway.) Here's a link on capnography:

http://www.capnography.com/outside/911.htm

I kept yelling at him to put some effort into the compressions, to push and not be a wimp. I wanted excellent CPR to get my end tidal number up. He was sweating and complaining about how his back hurt. The apnea alarm kept going off because I'd stop bagging to show him how to do CPR or to push some more epi. I could have used another hand in the back.

They called the patient at the hospital. I apologized for even bringing her in. I probably should have just left her at the nursing home. Worked her twenty minutes, then called her. At least her family will feel like we did everything we could. Maybe the gesture is appreciated.