Friday, April 25, 2008

Make a Wish Trip

I was on Engine 10 when it happened. Engine 10 was the closest company to Disney and it territory was filled with hotels and tourists. We were dispatched to a child down in one of the hotels. We arrived at the hotel and rode the elevator up to the floor. Security escorted us to the room. We found a child around ten years old lying coded on the floor. The child was emaciated and bald. The crew started CPR immediately as I began to question the family. They were begging us to stop. They were down in Orlando on a Make a Wish trip. Their child was dying of cancer and had always wanted to go to Disney. The Make a Wish organization had organized and paid for the trip and now this happened.

At this time in our local EMS system the standing orders had not developed to the point we could stop CPR in spite of the situation. I looked at the other paramedic, Kathy Johnson. I said.
"I am going to get this thing called."
"Yeah. Let get it done."
I first got on the radio and talked to the local hospital. The doctor on duty said he would like to help but at this point he could not call a code over the radio.
"What do I do?"
"You could get the patients personal physician to call it. That would stand up."
I got the number of the personal physician from the family and called. The patient was from out of state, so it took some time and explanation but I finally go her on the phone.
"Doctor my name is Roger Huder. I am a paramedic for the Orlando Fire Department we arrived on scene to find the patient coded. We initiated CPR but have not started ALS. Because of the patient history given by the family I would like permission to stop the code. But my local doctors will not do it. They said it would have to come from the patient's physician."
There was real sadness in her voice when she said.
"Yes, I will call the code."
"I have to ask you to repeat that to my partner."
Kathy came over and the doctor repeated the order.
"You can call the code guys."
The rest of the crew stopped CPR and covered the body. Kathy took the family out in the hall.
"Doc. down here if someone dies outside of the hospital there has to be an autopsy. That means the family would have stick around for several days. Would you be willing to notify the local coroner of your decision so we can get the family out of here."
"Sure can you get me his number."
The Lieutenant got on the radio and got the coroners number from the dispatchers. I gave it to the doctor.
"Thanks doc."
"Sure." Her voice sounded as sad as I felt.
While I was finishing up the medical end of things, Kathy had been working with the hotel staff. They had called the airlines and arranged for the family and the body to be flown home that day. A funeral home would take the body to the airport.
When we left the scene I felt a mixture of sadness and pride in what we had been able to do for the family. We could have just as easily worked the code and let the system do the rest. Instead we had pushed the envelope and pulled off the best solution for a family that needed it.
That has to be over twenty years ago now and that run still comes back to me. Each time I think of it, I feel pride in what we did. Sometimes doing less is doing more.


PDXEMT said...

Wow. Definitely a rough day. Way to be resourceful and do what is right! One of the things I am most glad about -- like your comment on my blog said -- is that we can call them in the field now, and in my system we have very reasonable protocols that leave us a lot of freedom.

I really enjoy reading your stories and seeing how far we've come -- and how easy we've got it now!

RC Huder said...

Thanks. That means a lot. That is exactly what I am trying to do. You and everyone like you are building EMS into the profession it needs to be. By the way I don't think you guys have it easy, just different.