Call Nine-One-One

Ruby has been taking care of old Mrs. Johnson for seven years. This afternoon she finds Mrs. Johnson has been a little too quiet, even for a 93-year old. She won't wake up. Her skin is cool, and she doens't respond to the the throat rub that the doctor taught her to do. So Ruby calls Hattie the neighbor and asks her to come over and see what she thinks. Hattie comes over and examines Mrs. Johnson. When Ruby asks Hattie what she thinks, Hattie has a response for her. "I told her to call Nine-One-One!" Hattie tells me.

This conversation takes place after we have ceased our rescusitation efforts.

When we arrived we found the police doing CPR on the bed. With each compression Mrs. Johnson was swallowed up by the soft bed, seeming to almost dissappear from sight, then spring up on the rebound, then disappear again. We got her on the floor. She was asystole. While her extremities were cool, her jaw was still limber. I intubated her and we got an initial capnography of 11, but that slowly dropped. No response from the IV epi or atropine. I called her as soon as we hit the 20 minute mark.

Afterwards Ruby told me Mrs. Johnson was praying in French last night. She had recently been diagnosed with cancer.

***

Three other calls. A nursing home patient with abdominal pain, a Down's patient in a group home who choked on a piece of cucumber(her aide successfully performed the Heimlich maneuver, and an old man with open sores on his neck, who refused treatment and transport against our advice, but agreed to call his doctor in the morning.