By Michael N. Ciampo
Responding in on an EMS run for a person who fainted in an apartment on a hot and humid night didn’t seem like anything out of the ordinary for us in the summer. Maybe the cause of fainting was dehydration, heat exhaustion, or possibly something more serious. As we entered the building and walked up the stairs, no one met us with any information. We walked into the apartment, and two people just pointed to a room and said, “In there,” with no urgency in their voices. On entering the room, we didn’t see anything but an empty queensize bed. Walking around to the other side of the bed, we located the unconscious victim on the floor in the narrow area between the bed and the wall. As we tried to slide the furniture out of the way to gain access to the victim, we noticed that the floor was wet from some ice on the ground. It didn’t initially strike any of us what the ice was for other than to cool off the person who had “fainted.”
As we interviewed the other two occupants of the apartment about what happened, one of our members began a patient assessment and said he had no pulse on the victim. Quickly, members began to set up the defibrillator and the rest of the medical equipment while beginning cardiopulmonary resuscitation (CPR). Meanwhile, we tried to interview the tenants about who this person was and what happened but were not getting results. They informed us that they didn’t know the victim; she was drinking with one of the other tenants and went into this room to nap about two hours ago. When they decided to check on her, they thought she just fainted and called 911. We asked about the water and ice; they said that they thought it would wake her up and bring her around. However, many of us know that when we respond to overdoses, we’ll find victims with ice on various areas on their body, which is thought to bring them back from their “trip.”
Luckily for us as the CPR compressions and ventilations began, EMS crews arrived and hooked up their equipment to the victim and immediately pushed some drugs into the victim in attempts to save her life. Still not happy about the information being provided and realizing the seriousness of the situation, we decided to do a little more indepth interviewing. We took the tenants into another room and spoke with a little more urgency about the situation occurring on the bedroom floor. They said that the victim’s purse was on the chair and we could hopefully get some identification on the victim. Plus, information surfaced that the victim may have been using some illegal drugs that were also in her purse.
We located the purse but did not reach directly inside of it for fear of being stuck with a needle; we dumped the purse contents out on a table. A driver’s license fell out, and the picture on it matched our young victim on the floor, who still showed no signs of a heartbeat. One of the tenants pointed to a makeup case on the table and loudly said, “In there; she took that!” Inside the case were some small packets of drugs. We quickly relayed this information to the medics, who informed the doctors, who prescribed a dose of medicine to counteract the drug effects. The makeup case and its contents were put in safe keeping until police arrived.
CPR continued, and the members rotated positions in the narrow area as the heat level in the room became almost unbearable, even with the windows wide open. Unfortunately, the bed frame was a large wood frame, which couldn’t be taken apart so easily. In some instances, when you work in smaller bedrooms, leaning the mattress and box spring up against a wall will give you more space in which to operate. After operating for awhile, the medics still were not getting any readings on their equipment; after conversing with the doctors, the decision was made to discontinue resuscitation operations.
After we left the apartment, we met near the apparatus for an informal critique. You could sense that, despite their best efforts, the members felt a sense of failure because of the outcome. Sometimes they need to hear, “You guys did a nice job in there; unfortunately, this time it wasn’t in the cards.” We as firefighters don’t like to lose—whether it’s at a fire or a medical emergency. However, from time to time we’re faced with certain odds and circumstances where we won’t win. That’s okay, as long as we gave it our best efforts and we all walk away safely, together.
● MICHAEL N. CIAMPO is a 26 year veteran of the fire service and a lieutenant in the Fire Department of New York. Previously, he served with the District of Columbia Fire Department. He has a bachelor’s degree in fire science from John Jay College of Criminal Justice in New York City. He is the lead instructor for the FDIC Truck Essentials H.O.T. program. He wrote the Ladder chapter and coauthored the Ventilation chapter for Fire Engineering’s Handbook for Firefighter I and II (Fire Engineering, 2009) and is featured in “Training Minutes” truck company videos on www.FireEngineering.com.
