Death in a Nursing Home

We’re called for a child not breathing. The address is a convalescent home. It makes no sense.

Then we pull up. There is a car parked askance by the entrance, two front doors and a back door open. The engine still running.

In the front lobby two nurses and a police officer kneel over a small body– a boy of maybe six years. One nurse does chest compressions, while the other holds the bag valve mask over the boys face and tries to breath for him. The police officer attaches a defibrillator.

I kneel down by the head. The robotic voice from the defibrillator says, “No shock advised. Check pulse. If no pulse, continue CPR.”

The boy is lifeless. I feel for a pulse. None.

My partner Annie attaches the cardiac monitor to the patient while I take out my airway kit.

I slip the tube into his throat. I glance up at the monitor. Asystole. Flat line.

I look at his arms for a vein. I see nothing, so I take out an IO bone needle. I pull back his pant leg, swab his tibia, then twist the needle down hard like a screw. It pops as it goes through the bone.

I push epi and atropine. No response.

What happened? I ask now.

His parents were driving by, a nurse says. They brought him in, he wasn’t breathing. They said he wasn’t feeling well today. We started coding him right away.

I look up at a woman sitting in a chair, looking glazed. A man stands behind her, no hand on her shoulder. Then I notice a silent row of residents in their wheelchairs in a semicircle around us.

I see in my head this scene from above. Us kneeling around a lifeless child, trying to make his heart beat and to fill his lungs with air. The honor guard of the aged around us. The scene gets smaller and smaller as the camera view goes up through the roof, through the night clouds and up into the stars.

2 Comments

  • Anonymous says:

    My first dead baby call was at a nursing home when I was a new EMT. The infant was the child of a nursing assistant that worked at the nursing home. She found her baby dead and didn’t know what to do so she took it to the nursing home. We got there and the fire department was performing CPR on it. My paramedic partner went to intubate, and the whole baby moved as one stiff unit when he went to position the airway. The poor color I remember I know now as “dependent lividity”. At the time I thought it was odd, but he let the mother hold the child while we and the staff waited with her there until a chaplain showed up. I don’t think it odd now. Funny I never remembered that call until reading this. It was a long time ago.

  • Lt. Anthony Wight EMT-P says:

    In early Dec,1997 my partner and were prepapring to end our shift when we received a run to an MVA scene. Enroute to the scene we talked about the wreck being minor and nobody injured and we’d be sure to get off almost on time. Once at the scene on Southern Pkwy in Louisville, Ky we noticed an obese male in one car with his left knee blown apart. As we were quickly assessing the scene a bystander said we needed to check the other car because there was a woman with her face gone. I told my partner I’d be right back after I went and checked this probable laceration to the face. I approached the vehicle and as I reached the drivers window the woman seated in the drivers seat turned her head towards me and I thought I was seeing a horror movie. The womans face was completely avulsed and hanging by a few muscles. She was in and out of shock and kept trying to pull her face off. I had to restrain her arms and screamed at the firefighters who had just arrived to hustle it up. They took one look and obliged me. The patient was placed in a c-collar and fullboard. I fully anticipated having to intubate her but as I assessed her it became apparent that she was maintaing her airway quite well and I held off. Pt remained hemodynamically stable eroute to the Level 1 Trauma Center University of Louisville Hospital. In my call in to the center I advised of a fully avulsed face on the pt but was met with disbelief or the inability of the MD on the other end to fully comprehend what I had. Well as soon as we rolled into Room 9 I had a full room of believers. The pt ended up with 1000 plastics sutures to fix her face, a broken neck and various facial fx’s and a broken ankle. I saw the pt @ 4 yrs later while on a run and she began telling a story of how she had her face ripped off. I looked into her eyes and remembered them now, I told her who I was and couldn’t tell she had anything ever wrong with her….amazing!

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