What an odd thing to say I know.
I have in reality been involved in more than several end of life events, but there are only several I have been pleased to be involved with, and it is these I shall speak of. The others were very different. They were events that ended life far too soon, and were the result of accidents / incidents which potentially could have been prevented. These I consider as unnatural, but it is not for me to judge the course of terminality.
The End of Life events I speak of all involve the elderly, and none of them have passed in my company, none have required major intervention to extend life until such a time as they could be handed over.
They have been pretty much alive, however, an event has occurred, which for so many elderly patients starts the ball rolling for the demise of their life. It may be days, weeks, months, or perhaps even a few hours since the event, but, experience tells me, that such an event symbolises the beginning of the end. Again, a word to the wise, it is not for me to second guess death, and the level of care / treatment given has no reflection on the casualties state of age. It is merely understanding a probable outcome, and manipulating the events that occur in the little time available.
As people who are duty bound either through employment, or morales to assist with an emergency, we have protocols to follow. We work our way through our algorithms, delivering aid at each point as we are taught. But, outside of treating respiratory and coronary failure, and stemming the flow of blood, or stabilising a break, there is little else we can do whilst we await for an ambulance. The patient who has a clear airway, has a heart that's working, is not bleeding, but is elderly, and in the eve of their life, requires something all together different.
Of course, we are aware of shock, of course we analyse the method of injury and treat appropriately, but this treatment is usually quite quick, and the arrival of the process to remove the casualty is reasonably slow in comparison.
Take for example an elderly lady who trips and falls in the street. There were no uneven slabs, there was no loose drain cover. She just fell, and banged her head. Perhaps it was stroke, perhaps a heart condition, perhaps she is just weak from age.
One such case we dealt with, and as she started to slip away quietly in my arms, I had the power to bring her back to this world with a squeeze of the shoulders, and comforting conversation. Undoubtedly the head injury was the route cause of the problems. Assistance was on route, and with limited resources, the level of treatment that could be physically provided was low.
Her husband, close by was brought into the equation to share words of compassion and love for her, which I don't doubt stemmed back from before I existed.
This process of maintaining her level of consciousness meant two things, firstly, I wasn't required to deal with a patient who entered respiratory failure, and secondly, the valuable moments she and her husband had together to share words of love would remain for the rest of his days, and perhaps take the edge off the trauma of it all. It also would act as a bridge for the great unknown. Comforting her final moments perhaps, making whatever happens as we die not so scary (In my experience, the elderly handle their own deaths quite adequately, with little fear).
This process of maintaining her level of consciousness meant two things, firstly, I wasn't required to deal with a patient who entered respiratory failure, and secondly, the valuable moments she and her husband had together to share words of love would remain for the rest of his days, and perhaps take the edge off the trauma of it all. It also would act as a bridge for the great unknown. Comforting her final moments perhaps, making whatever happens as we die not so scary (In my experience, the elderly handle their own deaths quite adequately, with little fear).
An Ambulance arrived on scene, and I was able to hand over a live casualty, whilst my colleague continued to attend to her, and assist.
Sadly, once they had loaded her into the vehicle, it remained stationary for some time with both attendants and husband in the rear. It was at this point that she undoubtedly passed.
When we first start on the road of being a First Aider, or higher, we often think only of the fast paced world of rushing to save a life. The busy hustle and bustle in the kit bag, or back of an ambulance to get chest seals, the commands of a defibrillator shouting out as we stick pads to a lifeless body, the fast pace of compressions as we force the heart into motions.
But reality is often far from this, ranging from very minor injuries that could be self treated, through to life support, and of course, the events to which we can do little but just be human.
Compassion I suppose can be taught in later life, but where better to gain it than in your formative years. I am most fortunate to have had family that did just that.
After every event, it is right and proper to review actions to ensure protocol was followed, and to talk out any issues.
This particular event wasn't traumatic in any sense of the word, and the only regrets, as always, were that we were not adequately equipped to deal with a casualty - who is outside of the Hospital or Ambulance. We could not do our duty to the best of our ability due to the lack of resources - yet our duty, and more, was done to the best in the circumstance.
And I am pleased, and comforted in the knowledge that for these people, in this instance, the lasting memory will not be one of panic, or the sight of tubes, or electric shocks on the street, but one of being able to share a few final moments together in thought before one of them crossed over into the great unknown.
