I suppose all members of the medical field go in with some aspiration of “saving lives” during the course of their work. At some point we come to the realization that you can’t save everybody regardless of your efforts. I know I did. I decided if I could only focus on one subset, it would be the pediatric population. You may sit around the station hoping for a good motor vehicle crash or fire, but nobody sits around hoping for a call involving kids.

At the time of this call I had been a paramedic for a number of years and had taken every possible pediatric care class I could find. Oregon started their own pediatric pre-hospital care course prior to national initiatives and I was one of the few who had been selected to become instructors. Suffice it to say I was very comfortable in my knowledge, skills and abilities to manage any pediatric problem thrown my way.

A call came in for a possible drowning in one of the local rivers. By this point in my career on the Oregon coast, drownings were a fairly routine call so no big deal. We arrived on scene at a residence along one of the deep slow moving rivers in the area. A couple of young kids had been outside playing and one boy decided to swim out into the river. He apparently got into trouble and his distraught younger brother watched him go under and not resurface. The local fire department responded with our ambulance. There was a dive team which was requested but due response times were more suited for body recovery than rescue.

As in all drowning calls I’ve been on, I start watching the clock. In the back of my mind thinking at what point has the brain been without oxygen too long making resuscitation attempts futile. As we all stood on the bank of the river a couple of the firefighters came up with a plan. They found a little row boat just downstream, rowed out to the last known location, one of them took of their shirt and started diving. I’m sure plenty of readers will start screaming “that’s not safe”, or it’s violating some policy. I couldn’t argue the point but these rescuers felt confident enough in their skill set to at least try and perform a rescue. It was the boy’s only hope. From the bank we would watch them surface, gulp some air and dive back down. After what seemed like forever but was closer to 10 minutes he surfaced with a small body in tow.

They brought him to shore and we set to work, total underwater time was approaching 15-20 minutes. He was tubed quickly and a code run textbook. We got a return of spontaneous circulation before we hit the ED door about 10 minutes later. The patient ended up getting airlifted to the Level-1 in Portland a couple hours later.

Epilogue and Lesson Learned

About a week later I got a very nice letter from a pediatric intensivist who had manged the patient at the Level 1. She said thanks to our efforts they had been able to harvest several organs from our patient that were then transplanted to other children in need. I had probably never been more ready to run a pediatric code at the time. Everything went like clockwork, but we ran out of time, we couldn’t save his life. I know it was the best possible outcome for the case but it was tough to swallow. I decided that the best way to save the next child was to prevent the drowning in the first place.

I convinced my employer that our little rural hospital needed to send me to Washington, D.C. to attend a conference of the newly formed Safe Kids Coalition. I brought the program back and started up the first coalition in the state at the time. Our department did a lot of safety fairs, presentations and activities designed to keep kids out of the back of our ambulances.

We still had pediatric calls. I didn’t save the world but at least I felt I was potentially making a difference. The lesson I learned is we have an obligation to educate to prevent not just prepare to respond. Pick a cause dear to your heart, forget saving the world and just save a little piece of it.

I hope the read was worth it and would love to hear your comments.