[NT] 8 year old female cardiac arrest

[Bilateral Entry]

I saw a dead kid a few days ago. We knew she was en route to the hospital 15 minutes before she arrived. 10 health care professionals were gloved up and waiting, and a pathway was cleared into the trauma bay where resuscitation attempts would continue. Someone told me that cardiac arrests are always a shit show, particularly when it is a child. Maybe I'm not perceptive, but everything seemed relatively organized to me.

An ambulance backs in, and we open the back doors. The first thing I see is a firefighter doing chest compressions. Yep, it's them. And yep, she's still in cardiac arrest. The only other cardiac arrest I've ever seen was a 50 year old male, and that was after he regained pulse.

I open the side door and hop up into the ambulance. A small, slender girl lies on a stretcher, her eyes half open, seemingly unaware of anything that is going on. She is naked except for her underwear. The advanced life support paramedic in charge of the call looks over; he recognizes me. He's busy pushing oxygen into her lungs through a 10" tube that he had earlier inserted down her throat.

60 seconds later, we're in the trauma bay. A resident doctor loudly announces his name and that he will be in charge. Chest compressions continue, ventilation of her lungs continue. The electrocardiogram shows that she has a weak ventricular fibrillation, a shockable rhythm. We deliver a shock. She convulses for a split second and goes limp again. No pulse. CPR continues. Every few minutes another dose of epinephrine and bicarbonate is administered via IV. All of this has also been done by paramedics on scene and en route.

A heart surgeon, in the middle of another surgery, is called in. That brings the total to 5 doctors, 10 nurses, and 3 respiratory therapists present. One could retire from 1 billable hour of that room.

The girl's chest is opened, and the surgeon reaches in and gently massages the heart. He then sews tubes into a certain vein and a certain artery just outside the heart. The tubes are connected to a machine that circulates blood for the patient. The girl's blood is now being circulated by a machine, and another machine breathes for her. She is then transported to Children's Hospital where it is hoped that with some rest, her heart will heal and be able to spontaneously beat again. Even in that miraculous event, there is high potential for substantial brain damage.

I'm informed that this girl died the next day. Doctors speculate that what originated the cardiac arrest was her heart spontaneously developed an arrythmia for which no explanation can be found. The girl's mother states that the girl was having breakfast when she complained of feeling unwell, after which she collapsed.

 

[Totenkindly]

How are you feeling after all that?

I watched my dad code in front of me some years back and was holding his hand at the time. There, it was the connection that made it bad. Here, even though you didn't know the patient, the age would trigger a lot of feelings I suspect. You just never know. I hear of weird things all the time, such as unexpected aneurysms and the like. Life is fragile and can be over at any moment.

 

[Bilateral Entry]

I feel like I can't quite decide how I feel. This is the most vibrant and unstable feeling of neutrality.

 

[skylights]

You can feel the numbness in your description. Sound and fury signifying nothing. It seems to run against the natural flow of life when it is a child, especially with unpredictable reason. The whole situation is limbo. An aberrance.

 

[Bilateral Entry]

Living in a modern civilized country, we aren't faced with unpredictable death very often. When it happens we don't know how to react. It throws everything we're used to and our beliefs right back in our faces. There's always this feeling of stability. Like we can't die, or at least won't die for the time being. That is, until someone does.

What does this girl's death mean to me? I envision many birthday parties, her first job, learning to drive, falling in love, all the laughter and joy that was beholden to her fade away. All that's left is emptiness. And for her mother, more agony than most of us will ever feel.

 

[Thalassa]

Children used to die all of the time. I know that isn't what you want to hear, but people used to have ten kids because sometimes four of them would die. I used to even speculate that children might handle death better than teens or adults because they are not as attached to life and don't have as much of an established ego in the world.