Witnessing my First Crash Call
Some details of this story have been changed to prevent anyone being recognised.
It was a normal day on the wards. If anything, it was actually a rather boring day.
I was attached to the acute/emergency surgical team. I was rather hoping that I’d see things like stabbings and emergencies such as that but I had been disappointed. It wasn’t necessarily an unreasonable thing to hope to see either – my friends based in different (albeit world-renowned) hospitals doing the same thing had seen such things practically everyday. For me, most of it was:
Although it was very useful for exam purposes, it wasn’t as exciting as what my friends were seeing. As I’m writing this, I realise how odd it is to be disappointed that there were no stabbings. It makes me sound rather…sinister.
A disturbance to the peace
As we were about to go and see our last patient, I realised that I still had the previous patient’s notes in my hands. “Sorry everyone,” I said to the team who were actually being useful on the ward round. “Let me go and put this back. I’ll meet you all in the other ward?”
They looked very pleased that they didn’t need me. I was, after all, just extra baggage.
I put the notes away and slowly started making my way to the other ward. Then, it happened.
I heard people running behind me. Looking over my shoulders, I saw two doctors running down the corridor. I moved to the side to let them pass me. Just as they were a few steps up in front of me, one of them turned around to me and shouted: “You, student! Quick, follow us, we’ll show you a cardiac arrest.”
I obliged. Suddenly, I felt the adrenaline pumping. I too ran after them as fast as I could. I can’t describe my feelings. There was some element of excitement there – this was, after all, something that I had not seen before – but there was also fear. What would I find when I got there?
Arriving at the scene
We ran to the same ward that I was meant to be in for the ward round. I can’t even remember some of the initial details. All I remember seeing is a large group of staff around a bed. I vaguely recall hearing lots of beeping sounds too, but I’m not sure if I’ve just made that up.
I went and stood as far away as I could from the team, but still close enough to see what was happening. The FY1 – junior doctor – who I had been attached to on the ward round was furiously giving chest compressions. Members from every surgical team doing their ward round arrived. The urology registrar came and initially tried to find a pulse; the colorectal FY1 came rushing over to see if he could help; the orthopaedics consultant was having a look at things from the background and put his gloves on, ready to come into action if needed.
They all seemed very pleased to see members of the crash team (the two doctors running who called me) arrive.
If I had to describe the whole situation in one word, ‘chaos’ would be the one I’d choose. There were literally so many people around the bed, each trying desperately to do something. Lots of questions were being thrown round.
“How quickly did we move him on to the bed?”
“We need to insert another cannula in – could anyone do it?”
“I can’t feel a pulse at all, but could someone else double check for me?”
“Has the anaesthetist arrived?”
Amidst the chaos, one member of the crash team eventually got the patient’s notes out. He had a quick look through them before asking:
“Is this patient Mr John Smith*, date of birth 07/05/1928*?”
“It is indeed,” came the reply of the nurse.
“Ah OK, well look,” he said, holding up the patient’s notes. It was a Do Not Attempt Cardiopulmonary Resuscitation form that the patient and his doctor had signed. “DNAR form,” he added.
“Shall we stop then?” asked someone else. Everyone else nodded their head. The FY1 stopped the chest compressions. The anaesthetist stopped his attempts to manipulate the airway. The nurses stopped trying to insert the cannula. Slowly but surely, everyone started walking away from the bed.
With everyone else gone, I had a better look at the patient. He was lying slumped there, eyes closed, his arms by his side, his mouth slightly open. There was a pool of blood around his arm from all the panicked attempts at cannulating him.
*The name and DOB are made up and are NOT the real name/DOB of the patient.
“Well, that’s certainly woken me up!” laughed one member of the crash team as she walked away from the scene. A few people laughed but others, myself included, could not. I felt some sort of lump in my neck. I pretended that I was OK, however, and pretended that it hadn’t affected me.
In reality, I was feeling rather miserable. Just like that, his man’s life had gone. He had not been admitted to hospital for any heart issue – instead, he had been under the orthopaedics team for a neck of femur fracture following a fall. I couldn’t have expected anything like that to happen. As I was later told, however, pulmonary embolisms in elderly patients requiring prolonged bed rest in this way wasn’t exactly uncommon.
Somewhere out there, someone would later be told that their loved one had passed away. Despite the team doing all they could, this patient had passed away. I tried to use the DNAR form as a way to cheer myself up – after all, the patient had wanted to go if such a situation had arisen. It was difficult to reconcile myself with that, however.
I took a deep breath and went back to join the ward round, as though nothing had happened. Back to work. Back to seeing a patient who seemed to have signs of appendicitis. Back to pretending that we were all OK.
Maybe a quiet days work wasn’t such a bad thing after all.