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 boy’s 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.

Reposted from August 2004

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