We are fortunate in a way that COVID-19 has hit us at a time of year when the weather is not at an extreme. If I wear my reflector jacket, our PPE gowns don’t fit me. It’s not so cold that I can’t enter a house without my jacket on, but come winter, climbing over snowbanks in a regular shirt so I will be able to put my gown on when I get to the house may lead to pneumonia. Those who can put the PPE on over their winter coats may find themselves overheating and not able to take off their jackets should they find themselves in strenuous situations inside like having to do chest compressions in a room with the thermostat cranked up.
Even though it is spring weather, when I am gowned in full PPE with N95 mask and face shield, it can get pretty hot if you are carrying a patient or working a cardiac arrest. I can’t imagine what it will be like when it is 100 degrees and humid.
I have yet to get my full PPE routine down. Pockets that I used to always put patient information in are no longer accessible when I am fully gowned up. I did a call yesterday and was in a panic when I got to the hospital that I couldn’t find the patient’s information. She had gone unconscious on the way to the hospital so I couldn’t ask her her name and since we no longer allow family members to travel in the ambulance I couldn’t ask an accompanying family member. The piece of paper with her demographics written on it wasn’t in any of my pockets. I finally found it on the bench seat of the ambulance, thank goodness.
I was in the fly car yesterday so I was the first on scene on most of my calls. When I arrive, I go to the back of the Bronco, open up the back hatch and take out my monitor, house bag, oxygen and my PPE bag. Depending on the call, I either gown up outside the patient’s house or at the entrance to their apartment, but sometimes I find myself with the patient already upon me and other than my N95 and face shield which I always put on before I get out of the driver’s seat, no other PPE on.
It is not always possible to interview the patient at six feet of distance. I did a head on crash between two cards with black tinted windows. I didn’t know what I am was going to find when I opened the doors. When I am by myself, I can’t tie the gown at my back or at the neck because the ties are in the back and I have not mastered the art of the backward tie. I slipped the gown over my arms, but it almost immediately started slipping. I opened both car doors and instead of the person with all negative COVID answers or the person who coughs in my face (and apologizes) and then say they were on the way to get COVID tested, I find something else. Both smashed and smoking cars are empty. This is not all that unusual in Hartford. Someone steals a car, smashes or rolls it and then the last anyone sees are the joyriders disappearing down the street at full sprint, which was the case here for one of the passengers. Fortunately the other people in the cars were already on a sidewalk talking on their cellphones, and I was able to interview them at an appropriate distance.
I went to a cardiac arrest, but fortunately a BLS crew had got there just before me and already started CPR though neither of them were gowned yet. I was able to drape my gown on, and put my gloves on while I got the story. Then I got down on my knees, verified the rhythm (asystole), and then quickly dropped a combi-tube with a viral filter on it. I wanted to get my reader glasses out so I could see the man's veins to give me a better shot at getting an IV, but they were in an unreachable pocket, so I just had to go in half-blind, and was amazed to see blood flow back in the chamber. We worked the patient for 20 minutes, and then called medical control at the hospital for permission to cease resuscitation, which was granted.
I felt bad afterwards for being glad that we didn’t have to transport the man, who had likely been dead for a couple hours before we got there. His family arrived and while I quietly deconned my gear outside on the back of my car, spraying it with bleach and wiping it down, one family member cried hysterically on the phone begging her mother to come, and the other kicked and punched a fence and shouted at the sky that he refused to accept the death.
I ended my day with another cardiac arrest, an old woman with many medical problems, and had been avoiding going to the hospital because of the COVID. Whether she had the COVID herself and it killed her or she died because she had been delaying care, COVID’s fingerprints were on the reaper’s scythe.
I read an article today on line that like many was frightening.
Statistician argues that COVID-19 figures hint at ‘staggering number’ of deaths ahead
He comes up with a death toll based not on social distancing measures but simply of the disease’s death rate – how many people who show symptoms end up dying. If 20% of our population are infected by the end of the year and 80% of those show symptoms, the possible deaths based on his model would range between 350,000 and 1.2 million lacking improved treatment or the development of a vaccine.
I want to see the country back to normal as much as anyone, but the simple fact remains, as long as one person has active corona, and people who are asymptomatic can transmit it, everyone is at risk.
Yesterday, 627 more people in Connecticut tested positive in a state that still has inadequate testing. 77 more died. That doesn’t count the two people who spent their last moments with their dead eyes open looking up at me in my face shield and N95 mask appearing nothing like a fellow human.
