I have worked in EMS for 10 years and nothing shocked me as much as this patient I had recently. Without disclosing too much information the background is myself along with other paramedics, doctors and nurses were responsible for emergency care during a very large Rave/EDM festival. This festival has been going on for many years and over the years has gone from having a basic first aid tent to a full blown 80 bed ER thats considered the busiest and most efficient ER in the country - complete with doctors, nurses and a CT machine that is set up and taken down 3 days every year. This festival is unfortunately known for overdose deaths but every year we work to make that number as low as possible.
Night 2 of this festival, we had two men stumble into our tent carrying another male. They put him on a cot and immediately we could see he was super sick. His respiratory rate was 4x min and oxygen level 77%. Heart rate of 180 that we watched drop as low as 40ā50 and a temperature above 105. The friends told us that he had been drinking, took shrooms earlier, then within the last two hours consumed and unknown amount of Ecstasy, GHB, acid, Molly, and possibly cocaine. I swear this guy mustāve had a death wish for combining all of that together. All of the providers in our tent agreed that he needed to go to the āpop-up ERā ASAP.
I often referred to this event as Battlefield medicine because you will see and do things that would never fly in a regular hospital or prehospital setting. We load the patient into an off-road vehicle that had been modified with a flatbed to put patients. In this particular incident we really didnāt think he was going to make it to the other medical tent before going into cardiac arrest. One of us held the patient on the back of this flat bed ATV while holding a bag valve mask to supplement the patientās oxygenation. The other was ventilating the patient while standing over them and manually feeling for a pulse in case the patient went into Cardiac arrest we could start chest compressions.
When we arrived to the makeshift ER the entire team of doctors nurses and paramedics worked like a perfectly rehearsed team with everyone in their place. It was amazing to witness the calm urgency as everyone seamlessly worked together to help this patient. The doctor made the decision to sedate, and intubate the patient and put them on a ventilator and then ādunkā them into a tub of ice water. The purpose of this is to bring down the core body temperature and induce hypothermia in an effort to prevent neurological deficits. I had a patient from this festival years prior with almost the exact same etiology who unfortunately did not survive so I was having a hard time remaining optimistic about this patient. Before we could move the patient to the ice bath, the patient goes into cardiac arrest. We start CPR and Do one round before we get pulses back. We move the patient and induce hypothermia then sent him to an outside emergency room where he could be admitted and stabilized.
I went home that night feeling a little defeated because none of us thought this patient would have a good outcome. At the bare minimum we assumed he would have lifelong neurological deficits. Itās always hard to participate in events like this where you know everyone is coming for a fun and memorable experience yet some are not going to make it home because of something preventable! The third night of the festival, I approached the lead ER doctor from the night before and asked if he heard how our patient was doing. I was shocked when he told me the patient is being extubated, taken off of life supporting measures, lab work and vital signs were good and he had minimal to no permanent neurological deficits. I was shocked happy proud and amazed that someone so close to death lives to see another day because of the incredible team and innovative medicine weāve been able to bring to this event.
itās not very often that you see this kind of miraculous recovery when you work in emergency medicine. Thereās a very thin line separating someone from life and death and we donāt get to walk that line very often, but when we do it makes all the stress, heartache, exhaustion, frustration all worth it.
I will end with my favorite quote from Abraham Lincoln which states - āNext to creating life the finest thing a man can do I save one. ā






