You know sometimes you get a feeling of impending doom, like something bad is about to transpire.
That’s not what happened that fateful Shabbat afternoon. On the contrary, driving to the address, I was ever so relaxed, and for good reason. The call was for an infant choking and statistically I was supposed to arrive to find relieved parents and a smiling baby – having already coughed out the foreign object.
I have responded to hundreds of “chokings” and thankfully the patient is mostly not choking once I arrive. The Heimlich is important and does save lives, but even a veteran EMT will have only experienced a handful of “the real thing” in his career. A complete airway obstruction is a rarity, thankfully.
Unit#22 was sitting behind me on my Ambucycle, getting an earful of how I desperately wanted to return to my wife’s London broil. We are neighbors and often respond together on Shabbat. I drive and he navigates, as would a wingman in the air force. I say navigate but I mean pray – both for the patient that we are about to greet and for us, that G-d take us to our destination safely.
And in case you were wondering, I am a stupendous pilot.
We were both mid-meal and looking forward to returning to our families with the good news that all was well. But thoughts of serenity flew out of the window visor, as we turned the corner. A handful of neighbors were manning the curb, screaming and waving hysterically. Screaming to the heavens and waving at us – His messengers.
Oops, pressure’s on – this is it – the real deal.
Huge adrenaline rush, quick revision of protocols, and five seconds later we land on location; #22 jumps off mid-park and runs gloriously to the rescue. I follow 15 seconds behind laden with my equipment and defibrillator, looking slightly less glamorous. People shove/point me in the direction of the apartment, but I don’t really need much guidance – #22’s blaring voice comes from the first floor and says, with absolute conviction;
“Shmeel – CPR on location – I need you NOW.”
This is where autopilot kicks in; when a medic’s mind makes split second decisions based on both training and experience.
I know it’s a respiratory arrest. I know it’s a baby. I know what I need to do.
I know what equipment I’ll need. I know what my job is and #22, far my senior, certainly knows his.
Almighty G-d – please, please help.
I run inside and in the doorway behold the scene in an instant. Baby is blue lying on the couch. My partner is doing compressions. Mum is sobbing violently. Granddad is saying Psalms. Grandma is screaming BAMBA! And Dad is nowhere to be seen.
I throw my stuff on the other side of the couch and take out my BVM (bag valve mask) or as we call it in the field, AMBU (Artificial Manual Breathing Unit). I’ll use this to force oxygen into the toddler’s lungs. I glance up at the child – I need to know what size ‘airway’ to use. An Oropharyngeal airway is a rigid plastic curved device, which, in laymen’s terms, ensures the airway remains unobstructed by the tongue. There are several sizes (color coded) depending on the size of the patient. In the classroom you measure this in slow motion, but now I instinctively reached for the black and insert it carefully into the two year olds mouth.
AMBU covers face and I squeeze a bag-full of O2 into her lungs.
On cue in run #74 and his ambulance team. He is a sweetheart and a solid professional to match; definitely someone you want around in an emergency. He too does an assessment and decides on the next two items on the ‘to-do’ list.
One: move this scene to somewhere less soft. A couch is no place for a CPR; it lessens the efficiency of the compressions. He chooses the dining room table, counts to three and all of us move in sync to the new venue. He wants to better position himself and so he jumps onto the table and kneels amongst Shabbat delicacies, with the baby’s head in between his legs. From this vantage point he can control the scene, his teammate’s actions and also manage the airway properly.
Two: he shouts for someone to connect defibrillator pads. There is hardly any room on her tiny body for the stickers. The AED does its automatic assessment and decides “No Shock Advised.” Bad News.
#22 continues compressions. #74 holds the mask with both hands snugly to the face and shouts commands. #44 looks for a vein to start a line. #76 prepares suction and its accessories. #18 breathes air into the lungs every few seconds. That’s me.
Three minutes pass although her mother later told us it felt like thirty. The baby moves. Or is it my imagination. Nope she moves again and this time tries to breathe as well. Cautious optimism now. Everyone continues what they’re doing but now in silence and in that complete silence we hear it, a squeal or perhaps a sob, doesn’t matter – there’s a pulse. She’s alive.
The Advanced Life Support team walk in and the baby starts crying weakly, though still with eyes closed and not completely conscious.
“The baby has a pulse and is breathing spontaneously,” Chief Paramedic bellows authoritatively, “What’s all the fuss about?”
Someone attaches an oxygen mask and the ALS team carry the patient to the ambulance for immediate transport. This seemed very much like a happy ending, but she wasn’t out of danger yet.
We stayed upstairs to pack up and offer a not so silent prayer that there would be no permanent brain damage and that Malka return to her absolute self.
He heard our prayer.
Sunday: Malka is discharged from the hospital and the family is reunited back home.
Monday: Malka is her normal bubbly self and does a photo shoot, to boot.
Tuesday: I get a ‘Thank You’ package that includes wine, treats, and a picture of a smiling Malka.
Wednesday: Extended family, friends, and EMTs are reunited at a gala event to recount, remember, and thank G-d for the Miracle.
The miracle of life.
Postscript: There aren’t enough words in any language, or any lexicon, to thank G-d for happy and healthy kids. If your kids are well and healthy but are screaming, fighting, jumping, and generally causing you to tear your hair out on a Shabbat afternoon. Take a deep breath and say;
And if you want to invite me for a Shabbat meal, by all means, but no Bamba please.