2013-05-28

Crying over a dead CPR dummy

Author: mbrewer

This post is kindof long, but I need to get it off my chest. The emotions involved still baffle me, but hopefully others find this useful or at least intriguing.

I just completed a Wilderness First Responder course with Bobbie Foster. The class I mentioned earlier where in http://www.blog.smalladventures.net/2013/05/helicopters.html where we had a medivac helicopter landing.

Yesterday was the last day of class. We'd already completed the testing the day before. As a group we'd been together for a 9 days, running scenerios and assessing each other. One kindof odd thing about medical trainings is that by the time you're done you know the resting respiration and heart rate of every person in the group, and maybe even how much it jumps when they eat. You end up with pretty tight bonds with these people after going through pretending to save lives with them over and over again, touching each other to do assessments, and asking them when they last urinated. I hope to stay in contact with all the folks I met there.

Anyway, the entire day yesterday was scenarios. We did a long term care scenario and were told it would last the entire day. We had a group of 19 with a team leader and a first aid leader. The patients were instructors for this one (Bobbie got a lot of helpers). The scenario was that we were on a morning hike to scout for good fishing holes to fish that evening, with the lodge as our base-camp on a multi-day backpacking trip. The lodge was (in the scenerio) 7 hours from the nearest phone.

So, we set out on our hike, and low and behold we came apon a terrible mudslide involving several people. There was someone lying on someone else. Someone stuck in the crotch of a tree near the ground. And a mother crying over a child (a CPR dummy). Before the leader allowed us to approach I volunteered as one of the first aid team leads, and as we walked through the scene (after the team lead had declared it safe enough) I was sent by the first aid lead up to the mother and her child.

I took a quick glance at the mother and saw that she was squatting. She had a little bleeding on her arm but not serious. From the combination I judged that she could walk, and by standard triage rules given sufficient resources, asked her to let me help the child and after a quick check for breathing and pulse began CPR.

I called for at least 2 others to help. At absolute minimum we needed a second for the CPR and someone to check the mother for serious bleeding.  3 came and I pointed at the mother and asked the first to arrive to assess her (thus also getting her out of my way). Then another helped hold C-spine for the mother and the other started helping me with CPR.

In between pumping on the chest I started checking the "child" for severe bleeding. I didn't find any. About now the two of us working on the child realized that we needed to start timing for documentation. Also the rule for wilderness is 30 minutes of CPR. So we checked the time and someone else who had stopped to see if we needed help wrote it down... 8:50.

The two of us rotated several times, occasionally checking the pulse again and glancing up at the instructor nearby hoping we'd get some sign that the child was alive. I pointed out that my partner had forgotten BSI, so did one round of CPR on my own while he got gloves on... 9:00.

We're starting to realize this isn't going to go well. We rotate several more times. Another person stops by and does chest compressions for a couple cycles to give us a rest (he doesn't have a CPR mask). We're watching the clock... 9:10. The instructor who's been watching us walks away (meaning there's no-one to tell us that the child is alive), and our hearts fall a bit.

After a couple rotations, when the person helping on chest compressions rotates out I ask him to check with the leaders if there's a medivac helicopter on the way yet. He doesn't come back for a while, but when he does the news is not good. 9:15.

A couple other's stop by to help, but they too lack CPR masks. So we keep going. Our backs are sore and my legs are shaking slightly... we know this isn't going to work... 9:20, 30 minutes... shit.

As someone walks by (the person who had swapped in with us for a bit), I ask them to get the first aid leader. Major first aid calls are their decision, so I want them to see this before we stop. The first aid leader arrives... 9:25

We talk in between breaths (I'm on the head at the time). I ask again if we've sent for medivac yet. She says no. I point out that at 7 hours to help it's 8 hours 'til anything could potentially arrive, this is way past what CPR can achieve. She wants us to go another 10 minutes... to make sure.

We decide if we're going to do this, we're going to do this right. The whole time we've been doing solid real CPR, the instructor actually mentions it later. I still feel fine. We keep it up for that last 10 minutes.

9:35... 45 minutes. I stop CPR and tell my partner to stop. I ask him to cover the body with an emergency blanket. I get up and realize I'm exhausted. I  walk down to talk to the mother.

The mother is very upset, I try to break it gently, but she pushes hard and I tell her that her daughter (Annie) is gone. I avoid the term dead for legal reasons. I can't declare someone dead, but gone is plenty clear. We did everything we could. A couple of other people who've been with the mother take her over to see the body. I go to try and help someone else.

And about 5 minutes later, I break down crying.

Annie was a CPR dummy. I was crying over a CPR dummy. I didn't understand it, I couldn't even tell what emotion I was feeling. 3 different people come over to give me hugs, which I have to say I greatly appreciated. They weren't trying to console me, or patronize me, they were simply communicating that they understood and that it was okay to cry. Eventually I stand up and go to help set up shelters, and end up helping move another patient.

In the debrief as they get to talking about Annie I try and explain what an important experience that was for me. And that if the emotions were that strong with a dummy, I'm really glad I did it with a dummy before a person. In the middle of trying to explain this I break down again.

I look around the room... several others in the room are crying too. I was kindof dumbfounded. At the time I hadn't realized anyone else was that upset. After the debrief I talked to the first aid-leader. She was crying, also about Annie. I talked to someone who had worked on a patient farther up the hill, the one stuck in the tree. She said she got tears in her eyes when she looked down the hill and saw us still doing CPR. Most people in the room had watery eyes at least. One person joked that they held it together until I started crying and then they lost it. I talked to the person who had played the mother. She said that she had been involved in that scenerio 3 times, and every time the person in my shoes broke down crying.

... over a CPR dummy.

The human mind is an absolutely amazing thing. Our ability to act, to play pretend, and to care (even when we don't want to) is kindof astounding.

Someday I hope I understand what emotion it was I was feeling yesterday, and what emotion is welling up now just trying to write about it. If it was a person I could probably (falsely) tag it with some other emotion like guilt. But I knew from the start it was a CPR dummy, and that it would probably not "live". I also know that I did everything anyone could do. This emotion was far simpler than something like guilt, more basic. Right now all I can identify it as is a need to cry.

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