When not to wait.

I wish I’d been driving faster.

I know that we’re meant to drive the same no matter what. But with kids it’s different.

Everyone drives differently for kids.

My weary stupor had been snapped awake by dispatch’s static twisted voice through the radio: “We’ve got another crew on the way who may get there first, but we’ll keep you heading out…. sounds like the child’s really struggling”.

In my weary 2am in the morning daze, I had read the address….. 30 minutes away from hospital, no worries.
I had also read that it was an asthma case….. pretty routine.

I had not read that it was a 5 year old.

Whatever dreary gloom impeding my mind remained, was almost instantly torn away as the needle on speedo crept up quickly and remained possibly a bit higher than it should have (even with lights on) for the rest of trip.

We walked in. Kid was on her second neb of ventolin. She’d already taken her oral prednisolone and was on 15LPM O2. She was tachy, resp rate was up and sats were at 95. The asthma attack had started 3 hours earlier and hadn’t responded to treatment.

Oh and she’d also had multiple ICU admissions. Maybe an intubation in there somewhere to.

With a quick history taken from mum, a hospital half an hour away, and a child with a phobia of needles who was not going to let us near her for an IV without compromising what little respiratory buffers remained…….. we did not wait.

We scooped and ran. We did some stuff in the truck…. but our main management was diesel.

And it worked.

3 hours later, she was fine.

The other day we wrote about staying and playing. Calling in the resources you need, setting yourself up to win and making the most of the light and space.

Sometimes you don’t have that long.

Sometimes, you find out only enough details to give the receiving hospital a rough idea of what to prepare for.

A mechanism. A time of event. Some obs. Your treatment. Relevant existing history.

That’s it.

Patients can deteriorate very quickly. I mean under 30 seconds quickly.

So yeah, sometimes we call for backup, we set ourselves up to win, and we get our ducks in row with a nice stable patient and full team of people before we move. This is nice and pretty and makes us feel like we have earned our money afterwards.

Other times, you don’t stuff around getting history. You don’t wait 5 minutes to get an IV.

You get your patient to definitive care, where there is a theatre, lots of drugs and medical imaging.

It’s messy. It’s dirty. It doesn’t always feel nice. It can feel panicked and unprofessional.

But its a damn sight better than letting that multi-trauma/penetrating trauma/respiratory distress/dissecting AAA arrest in front of you.

Don’t be proud. Be smart.Think or you will miss it; should I scoop and run?

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