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.