Lessons I Learned From My First Cardiac Arrest

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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Lesson From The Street: Skin Doesn’t Lie

I hope you’re sitting down for this. I trust that a good number of my readers do indeed sit while surfing the internet so I’m just going to tell you this strait up. Sometimes … patients lie. They do.  Occasionally they intentionally tell us bold, outright lies. And it gets worse. With even greater frequency they are just plain inaccurate. They may not be intentionally deceiving us, they may be confused, misinformed, exaggerating, in denial, overwhelmed or embarrassed. Regardless of the reason, we are frequently faced with subjective information that isn’t all together accurate.

What’s an EMT to do?

I don’t want to suggest that you should skip or disregard your subjective assessment. The things that your patient tells you are vital and important clinical findings. Even inaccurate information can give you vital clues regarding the patient’s mental status and physical condition. But I’d also suggest that you put a premium on physical findings that give you instant and accurate information about the patient’s physical condition. The longer I work in emergency service the more I find myself falling back on basic patient assessment truths like this one:

Pay attention to your patient’s skin.

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