On Saturday morning as we were about to leave to go to the "Magic of Bubbles" festival for the standby, I received a call for a paediatric drowning at a local picnic venue, I instructed them to initiate CPR until we got there and dashed downstairs into the response car and made our way to the scene. Thankfully as we pulled out of the office we passed the ambulance that was joining us at the event, flagged them and told them to follow us, because we were going to need help.
It took us 4 minutes to get to the scene, grabbing my equipment I ran to the opposite end of the venue where the little girl was lying surrounded by a group of ladies "performing" CPR. I asked everybody to step back so we could assess the situation properly and proceed with my protocol.
Whilst checking the primary survey I tried to establish a sample history on the girl, airway was clear, although she did have 3 gag reflexes during the this time, I inserted the OPA and she accepted with no gag reflex. I began ventilating with the BVM and clearly heard the fluid in the lungs with good chest rises, CPR was continued. This is when chaos ensued.
The ladies that were there with the girl were trauma nurses from a local hospital that started the chaos wanting to run lines and proceeded to raid my bag, ripping out my IV pouch and distributing my stock all over the place, when I said STOP, wait just a sec. Too much going on and too many needles being woven around!
Thankfully ALS arrived to take over the patient care, handing over quickly the little info I had manged to obtain i.e.: 14yr, no family present, no known allergies, was playing in the water while eating a chocolate then was chased by a friend out the water where she collapsed??? Don't make no sense does it?
We continued with CPR, until ALS was ready to tube, by this time the nurses had run bi-lateral salines, gained IV access, of which 1 was not flowing, other flowing freeflow, I continued to ventilate on the ALS's instruction to 1 is to 3, while my partner was performing compressions. We paused, ALS tubes, and this is when it seemed to take a turn for the worst. If I was tubing a patient, my patient, I would want to be in control of every aspect of the process, making sure my depth of the tube and placement was correct, the cuff correctly inflated etc. Not have frantic nurses practically falling over each other, to hold the tube still, subsequently pulling the tube out an inch, grabbing the syringe and inflating the cuff for me, waving needles around with drugs and administering before tube was even secured. From having a SATS of 83%, minutes later dropping to 30% and then ALS realised the cuff had not been inflated correctly, not been able to find the syringe that was removed from the cuff, finding it and inflating it again properly this time. The result, SATS no higher than 53% & a PEA, I'm sorry, yes many hands make light work, but too many cooks spoil the broth.
Once the tube was secured we packaged and loaded her into the ambulance and she was transported to hospital. This was when I closed my bag up, thinking we were late for the event and I would pack my bag over at the event. This call was bugging all of us, it did not make sense, we only managed to suction a mere 100ml of fluid that was mixed with what seemed the remains of the chocolate. No family present, no info on this girl, just a name...
We discussed the call that entire day, discovered how much stock I had lost, and the ALS's equipment in my bag. Not cool, the last thing we need to be worried about is peoples hands diving into our bags and resulting in this situation. This stuff costs money, its my stock, and when you providing a community service for free, losing unnecessary stock and equipment is potentially a risk for the next patient. We have limited tools and resources out in the field that enable us to do what we do to the best of our capabilities, have at least respect for what we do, how we do it, this is all we ask...
The outcome was one that I expected, she didn't make it, the questions remain, the autopsy will have more insight to her death, our suspicions are that there was an underlying medical condition that caused this, besides the attempts that were made by us, even with the issues experienced, were to no avail.
Moral of the story is, parents need to take more responsibility with regards to outings like this, a child losing her life on a Sunday school outing, let alone any outing this way is a heavy burden to carry for everyone. How can you sign your child's life over to someone who makes you sign an indemnity form stating that they will do their best to look after your precious child, but legally won't take responsibility for your child should something happen...why was she in the water while eating a chocolate, as a child I was always told to wait an hour after eating before I could swim, let alone eating while swimming!
To think there were so many people there and no supervision, sadly you will have to deal with your conscience, if you have one. I can't begin to imagine the feeling of losing a child, as a father of two beautiful little girls I beseech you to be more protective over your children, make sure the correct steps and things are in place when sending your little ones on their outings, they to must experience things.
If your child has a medical history, make it known and ensure that where ever they may be going that the facilities they are going to have the necessary in place to ensure your child's safety, i.e. a paid public picnic spot by the river...suggestion maybe...lifeguard on duty??
RIP little one, you're in save hands now...
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