Fake Code

Three year-old vomiting copius amounts of blood. Lights and sirens response. I'm thinking. No way. We get there, the kid is okay. Alert, good color. Has a bloody nose. Has a history of bloody noses. The blood in the sink isn't a whole lot. Bright red -- just spit up from blood from the nose. The mom doesn't want to go to the hospital. She says she'll take the kid to the pediatrician.

We had our paramedic student/ veteran nurse riding with us today. We set up our fake code in the back room. It was interestiung to see her go through it. She is very smart, very experienced, runs codes in the ER, knows her stuff, but having to run a chaotic street code, was frustrating for her.

The way we do it is I start out as a patient having chest pain. One of members -- a seventy six year old Italian lady -- plays my mother, and she harrasses the medic student as she tries to treat me. "Help him, can't you help him!"

My chest pain quickly deteriorates. I keel over -- in arrest. The patient then becomes the two maniquins we have on the floor -- an Intubation head and a CPR mannequin. She gets CPR started, then goes for the tube.

After a few minutes, my "mother" brings over the heart monitor and says "What's this machine for? Can't you help my son? he doesn't look very good."

The patient has to be treated, loaded on the stretcher, extricated to the ambulance bay, loaded in the ambulance, driven around the block with CPR, a patch made to the hospital, then unloaded again.

She was very embarrassed she forgot the monitor/defibrillation. Hey I told her -- that's why we're doing the drill. You know ACLS cold, I told her later, you just need to learn the coreography of an EMS code. I wish I'd had more practice before my first one on my own years ago. What a disaster that was.

I went over with her, how to lay out your equipment, how to see the big picture, how to order people about, how to get the code run and the scene controlled and to extricate the patient and not forget to bring your equipment along. We'll do it again next time she comes in. She will be very good once she gets some calls under her belt.

The only call we did was for a guy who drank, shot up some heroin, went to pick his sister up, then passed out in the car. She called 911, by the time we got there he was awake and alert, though sluggish. With the persuasion of an officer, we took him to the hospital -- he really didn't want to go -- and once there he walked out before we had even finished our paperwork.