IT'S NOT EVEN EASTER.

I would not believe it if it had not happened to me.

At training school I was most definitely told, “you can have a pulse and not be breathing but you can not be breathing and not have a pulse”. Set in stone. One of life’s certainties or maybe one of deaths.

Anyway on Tuesday night this was proved to be wrong. I have to say I didn’t believe it when it was going on so it took a minute to get my head together. It went like this.

Call to a difficulty in breathing. We turn up and my mate goes in to see the patient and I get the chair out the back of the bus in readiness to load up. Things are done and it seems like the man has no other complaints – no pain in the chest etc. although he is a bit clammy. We decide to do a heart tracing in the bus rather than loiter in the mans house.

In the back and we say “ok, if you get yourself on to the trolley.” The man looks at my colleague and his head slumps. Oh shit! We heave him onto the trolley and I check for a carotid pulse. Present but slow, resps at about 20 a minute, GCS E=2 V=3 M=4 so he’s not quite in a coma, but trying hard.

The defib’ pads are placed on his torso and after a second it shows VF (where the heart is having a wibble and not contracting properly). Fuck, “shock him,” the machine screams out. I say, “but he’s berating” and he is. Still berating at 20 a minute and moving his arms. We look at each other and see the doubt. What do we do? Another pulse check – no pulse. Thump the mans chest to no effect.

Decision made, shock. 200 joules thump through the man and he says “for fucks sake”, he’s still in VF. I say “for fucks sake”. My mate says “for fucks sake” and starts CPR as I try to intubate. The man has tristmis (clenching his teeth) and grabs my partners arm. He’s still in VF and becoming more agitated as the oxygen leaves his brain.

Back to basics, manage the airway as best we can and give him lots of O2. Another shock brings him back to NSR (the heart rhythm we all hope we have). Still no tube and still clenching his teeth.

All of this must of taken under 2 minutes. I jump in the driving seat and batter along the 5 minutes of road to A&E. They know were coming and are sitting there having a nice chat when we arrive. He’s been shocked again on the journey in so arrives in NSR with a GCS of E=3 V=3 M=4.

Beeeeeep. Off he goes again. The doctor shocks him and the man says, “ Fuck off, Jesus Christ”. We all look at each other again. He’s back in VF and fighting off the doctors and nurses. Bam! Another shock and he’s in NSR.

14 more shocks were delivered, along with drugs to calm the man down, and allow intubation, as were the other things for someone in cardiac arrest. Throughout all of this the man was breathing, talking and fighting people off who were trying to do CPR.

I have never seen this before. I have never even heard of this before. As far as I knew this was not possible except in Shaun of the Dead. The mans heart is not beating and he’s telling us to F off and complaining about the pain.

Apparently if you get in there quick enough there is enough oxygen in the blood to keep the brain working for a while, even when the heart has stopped. Very unusual and something I doubt I’ll ever see again.

It was a BIG learn for me. Sometimes you think you’ve seen it all but you are always learning in this job. You will never know it all and never see it all.

The man was eventually stabilised and is now in CCU. He’s a save. The first real save I’ve ever had. Sometimes you get a pulse back but that’s not a save. A save is when you run into them buying their grand kids a birthday present 2 months later.

I still can’t really believe what went on. If anybody reads thin and can shed some light on this or has had a similar experience I would love to hear about it. Crazy, totally mad.