Newbie A Newbie – Panic Moment

Here’s another story from my EMT refresher class. It’s kind of important—especially for newbies, which is why I’m including it in my Newbie A Newbie series.

We were two hours down, with two hours to go for that night’s class. The teacher had just set us free on another five-minute break. I putzed out to the water bubbler, and filled up my little glass. I stood there, minding my own business, sipping my water. Our instructor came by, filled up a glass, and stood next to me. His face was beet red, and he kept wincing. Giving him a sideways glance, I asked, “Are you okay?” He drew down a long gulp, nodded and said, “Yes,” through a grimace. We talked casually, although you could tell his focus was on whatever was hurting him.

Break ended, and we filed back to our room. Settling in, we talked amongst ourselves, laughing, joking, carrying on as usual. You had to raise your voice just a little to be heard over all the other conversations around us. Our teacher leaned on a cabinet at the front of the class, waiting, grimacing. Someone asked him my same question, “Are you okay?”

“Yeah…I just get these terrible cluster headaches. I’ve had them since I was a kid.”

“Do you want some ibuprofen?” I kept a small bottle of them in my cubby.

“They don’t work for me,” He replied. “Although, I’ve found that Aleve works…weird. But I just took some from out of my truck.”

As the conversations started to die down, he started up his lecture, “Okay, so we’ve covered…” He took a step away from the cabinet he was leaning against. Suddenly, he collapsed onto the table before him, and then fell to the floor. He lay there, silent, unmoving.

We laughed, nudging each other. A few people got up and went towards him, all with a smirk on their faces. One man brought his coffee mug up with him, and a classmate yelled out, “Ya know, my favorite test of consciousness is pouring scalding hot coffee on the guy’s crotch.” We laughed again. Snoring respirations from our teacher was all we got in reply. Some more wisecracks emerged from the crowd. It’d been about 30 seconds so far, and we were waiting for him to jump up, chuckle, and continue to lecture after his hilarious joke.

He began twitching, which crescendoed into all out jerking, flailing movements. The jokes were becoming less and less. “C’mon, man, snap out of it. We get it,” Someone said, smirk still on his face. Our teacher started to foam at the mouth, and a young woman wrinkled her nose, saying, “Seriously? Not on the carpet! Enough’s enough. Really.” But foam continued from his mouth, drooling onto the floor. His face turned purple.

A woman looked to the other side of the classroom, at a man who wasn’t smiling, and had concern growing in his eyes. He was a former student of our instructor.

“Did he do this during your Intermediate class?” She asked. The former student shook his head. The room went quiet.

Oh shit.

One classmate got down and pushed the furniture out of the way. He adjusted our patient’s head in a way to better protect his airway. Two people were sent for the cot, another to grab another paramedic. A few others rushed out to grab equipment. Everyone else looked on in shock and horror.

Then, our teacher jumped up, wiped the foam from his mouth, and said, “So you know what the funny part about all this was?”

It was the most dedicated seizure impression I had ever seen. Granted, I haven’t been around that long. But he certainly started to worry almost everyone in that room after two ever-worsening minutes went by, and he showed no signs of getting back up.

“Everybody assumed I was faking. So everyone was calm and composed. But as soon as this turned real? As soon as this became an ‘Oh Shit’ moment? It got absolutely silent in here. Because for a moment there, this became everyone’s emergency. And that is when adrenaline gets involved. And that’s when it becomes harder for you to think and react.”

He went on to explain that plenty of tough calls get emotional. It gets even more emotional when it’s something unexpected, or someone you know. The goal is, despite all of this, to keep a level head. And it gets hard sometimes. Believe me, I know. I’ve been on a couple calls that got ugly really fast, and the patients were friends, neighbors, and coworkers. Any of you that work at home in small town EMS know that it’s only a matter of time before it’s someone you know and care about that’s lying on your stretcher. There are lots of EMTs that deliberately work away from home just to avoid that possibility. (And, for the record, I don’t fault them for that.)

When emotions overwhelm you and turn to panic, your ability to help your patient drops. A lot of those classes, tests, con-ed hours, experience…they all go right out the window when you find yourself in panic mode. The solution isn’t to devoid yourself of all emotion—that has big bad implications all on its own. The solution is to be able to dial it back to a point where your stress sharpens your skills, instead of obliterates them. It takes practice, strength, and self-awareness to talk yourself down from that point.

When your thoughts consist of, “Holy crap, this is bad. I can’t do this. I need to get out of here right now.” (And, hopefully is followed by the thought, “Hm, I can’t do that because I’ll get hurt if I leap from a moving ambulance…”) When your heart starts running away in your chest. When your palms are sweating in your gloves. When your body is quivering in your uniform. When you want to scream, cry, curse the day you ever got into EMS, and yell, “I CAN’T DO THIS!” …

Stop. Close your eyes, if you feel it appropriate. Or at least look at something blank, like a floor, wall, or sky. And take a very. Slow. Full. Deep. Breath. You just were in a place where you couldn’t do anything to help yourself, your crew, or your patient. But now, you’ve taken a deep breath, and it’s time to put the chaos aside. Look at what you have, and focus on what you need to do to deal with it. You will get through this call. And you will, sometime in the not too distant future, be in a position where you can just sit, relax, and be relieved of the responsibility of making decisions. But right now, you have a job to do. Your job is to help this person. And the first step is staying calm. Now, what’s the second step?