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My EMT partner and I had just parked the ambulance on our assigned street corner when we heard paramedics radio for back-up for a patient in cardiac arrest. We were the closest unit. When we arrived at the scene, the paramedics were working on a middle-aged woman who was lying on her back in her driveway. One paramedic was securing her airway while the other was performing chest compressions. The woman's son stood behind them, visibly shaken: "She just fell down and stopped breathing!"
I took over chest compressions and my partner started ventilating the patient with a bag-valve mask. The paramedics administered advanced life support, inserting a line that intravenously delivered fluids and medications. We shocked the patient with the defibrillator. No response. We continued CPR, suctioned her airway, shocked her again. Still no response.
We placed her lifeless body onto the scoop stretcher and into the ambulance, maintaining continuous chest compressions, and started transporting her to the closest emergency room. We shocked her again. No response. More compressions. A couple of minutes later, we reached the emergency room.
A team of doctors and nurses were awaiting us, as we had notified the hospital of the patient's status. We quickly wheeled her into one of the emergency department's many treatment rooms and placed her on a hospital gurney. "Stop CPR and check for a pulse," the physician ordered. I put 2 fingers between the patient's larynx and sternocleidomastoid and felt for the carotid pulse. There it was! She had regained her heartbeat.
"She's got a pulse," I said. Soon she had a blood pressure, as well. Excited, I also checked her distal pulses. There they were, strong and regular.
Being part of a team that brings a person back to life is an incredible experience. But I never will know what the long-term outcomes were for this woman. How had her recovery gone? Did she have brain damage? Is she functionally independent today? Is she even still alive?
I decided to become a physical therapist so I could play an active role in people's recovery from physical trauma or illness. Today, I work in home care. Most of my patients are recently discharged from local hospitals, having survived such health-related issues as strokes, cardiac events, and fractures.
One of my patients described her fear when she realized she was having a stroke. She told me how her husband frantically called 911 as she lay on the bathroom floor, unable to feel or move the left side of her body, and how the EMTs arrived, picked her up, and brought her to the ambulance. She talked with me about her recovery in acute and subacute rehabilitation-the joy she felt when she regained some sensation in her leg, and how, after hours of intense physical and occupational therapy, she again could move her extremities.
When I first evaluated this patient in her home, she needed assistance to ambulate with a walker, use the toilet, shower, get into and out of bed, and transfer to and from a chair. After a few weeks of home care rehabilitation, she could perform all these activities with modified independence, using grab bars, a shower chair, and a raised toilet seat. She also could climb stairs with supervision.
The first time she reached the top of the staircase, she yelled out for her family members to witness the moment: "Hurry! Come see where I am! I'm upstairs again!" She currently is continuing her recovery in an outpatient clinic.
I feel fortunate to play a key role in helping people regain functional independence to the greatest extent possible. Physical therapists may not literally bring people back to life. We regularly, however, bring back life to people.
Katarina Erlandsson, PT, DPT, is employed by Visiting Nurse Service of New York and works part-time as an EMT for the New York City 911 system.
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