Gloomy Day II

The chubby little boy was flailing his arms about like a mad man, his eyes were as big as saucers when he caught a glimpse of us rounding the corner. I presumed he was trying to direct us to the location of the emergency, but the more I focused my attention on him, and his awkward physical gestures; the more profound the dumbfounded look on my face announced itself. He started running like a whacky waving inflatable tube man and we followed closely behind. The grey clouds continued to move overhead as we made our awkward journey. Despite taking less than a minute to get to his location from the car accident we had just left, I had all but forgot about that now. Eventually the plump little boy lead us into a ramshackle apartment building, up to one of the top floors. The door to the apartment was open and we made entry with all our bulky equipment in hand and draped over our shoulders. Down the hall in a small bedroom laid an older man sprawled out on a terribly small mattress. He hadn't shaved in a few days and had cultivated himself a colorful pasture of black and white whiskers which to had dinsley sprouted from every pore on his face. In the middle of his vast field of facial hair was a prominent gaping mouth, with lips wide open. He awkwardly struggled as a fish out of water would have, fighting to suck in air. His nostrils flared attempting to increase in volume and direct more air into his body. The muscles of his neck, chest, and stomach were all firing like pistons, straining in an attempt to continue breathing. He could only speak in 3 or 4 word sentences and was in severe respiratory distress. We gave him oxygen which he desperately attempted to suck in as we moved him downstairs.



By this time he was breathing around 5 times the normal rate and not really moving much air into his lungs despite the extreme effort on his behalf. He was getting tired, he couldn't keep this up for much longer. By now he could only speak in 1 or 2 word sentences and was pending respiratory arrest at any moment. I had seen it before, his time was almost up and he would just stop breathing any moment. He needed a special ventilator called Cpap or Bipap, but we didn't have this, in the absence of that he needed a procedure called “RSI”, which we did not have the resources and materials for either. I wasn't sure he was going to make it to the hospital, so I got the breathing tube ready in case he went into respiratory arrest. It was frustrating not having the things we needed to help him. As we loaded him into the ambulance I saw the terror in his eyes, the anxiety on his face, and the violent effort he was using to fight staying alive. Every breath was a challenge for the old man, and every breath could be his last. I had no choice but to take a “bag valve mask” which we mostly use during CPR to ventilate people. I showed him the device and told him it was going to be uncomfortable, but that I needed to force air into his lungs, he agreed and begged me to do so. After connecting oxygen to the device, I smashed the mask against his face firmly to create a tight seal when he was about to inhale and squeezed the bag full of oxygen attached to it, manually forcing much needed air into his lungs. The procedure was uncomfortable and adequate, but he was working with me and would motion with his hand when he was ready for me to squeeze in more air, in return I would press the mask firmly onto his face, smashing his nose in the process to create an airtight seal, then squeeze the bag of life saving oxygen, pushing it deep into the depths of his lungs while he tried to desperately inhale. It was primitive and crude procedure, but it was working, it was buying us time and his condition started to improve slightly. We arrived at the hospital and I was wheeling him out of the ambulance while ventilating him with the bag valve mask, he glanced up to the sky. He looked into the face of the dark grey clouds of todays gloomy day, perhaps in a moment to come to terms with the possibility of death. It only lasted a second before we cleared the hospital doors and got him inside, the doctor immediately placed him on the pressure ventilator he desperately needed to stay alive. I visited his room 15 minutes later and he was breathing fine with the help of the bipap ventilator he needed. He thanked me for helping him breathe and said he was feeling much better. All he needed was this one simple device to breath, luckily he got it in time. We probably saved his life, but only barely.