It strange to think that it’s been almost 20 years since the first time I did CPR. I still remember it so vividly. How the time flies.
I was fortunate to have good mentors and teachers in my early days in EMS. One of them was Phil Rigardo. As an EMT student, Phil had invited me to come do a few ride-along’s with him. I owe a lot to Phil. He was one of the first major influences I had in EMS and he framed the job in a fun and exciting way. I’ve managed to carry that initial frame (EMS is fun) for most of my career.
I had been riding with Phil for a few shifts when we got dispatched to a cardiac arrest. This was the first really sick person I had ever seen Phil treat. My first chance to see him in action. That was a big deal to me.
The engine crew arrived before us and the three man crew had been working for a few minutes prior to our arrival. I remember the narrow staircase that lead up to the crowded upstairs apartment. Clothes and furniture and bags and the stuff of crowded people living crowded lives filled the place. Three firefighters were crammed in to a bedroom made for one doing CPR on the bed. The Captain was speaking in a raised voice and stress was evident across his forehead. Our patient filled the bed and bounced with each compression.
Phil walked in and did something I never expected.
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Some of the stacks of trip reports were nearing four feet high and they filled the musty closet. Dividing them up, we started sorting through them in earnest. The dates indicated that the calls had been 
run between 1972 and 1978. Most of the narratives were as brief as the treatment lists.
Hall Ambulance’s station one was an older house in an early residential area of Bakersfield, California. It had been, at one time, the residence of the company’s owner, Harvey Hall. In the early days of the ambulance service, Harvey had both lived in the home and run his fledgling ambulance service out of it.
One of the crews stationed at the home had gone digging in the dusty storage closets and struck EMS history gold. Stacks and stacks of old trip reports from the Mother, Jugs and Speed days of EMS. That’s where we found it. A call run by our medical director back in his days as a paramedic for the service. A cardiac arrest, no less. The total list of treatments given; CPR, BVM, Epinephrine 1mg, Sodium Bicarbonate 2 amps.
The year was 1991. We found this hilarious. We were still in our ACLS infancy. There was no CPR first or AEDs or Amiodarone. Nobody had heard of capnography and there was nothing therapeutic about hypothermia. Yet we felt very advanced looking at our medical directors run report. The massive Sodium Bicarbonate doses of the seventies had long since gone away.
More than happy to reminisce about the call, our doc read the report with a bemused sort of faraway look and announced, “I remember this guy.” He told us the story of the overweight, mid-sixties male who had collapsed in the parking lot across from the hospital. And then he made an observation that has stuck with me my whole career.
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