In my work as an emergency nurse, I witness and feel many tragedies. You learn to live with them, trying to leave them on the welcome mat at home, but it isn’t always possible. Some remain “stuck to your boots.”
We received a call for a 71-year-old woman at home with her son, reporting severe dyspnea and fever. We quickly got into the ambulance and headed to the location; time was of the essence. The road was deserted, improving our response time. En route, dispatch called to inform us that the patient was COVID-19 positive. Internal alarm bells went off, and involuntarily my mind couldn’t stop thinking about “the Bug.”
We arrived at the home; time was pressing, and along with this pressure, we had to don full Personal Protective Equipment (PPE). We covered every centimeter of our skin to feel protected. I tried not to dwell on whether that “plastic” wrapping us was certified or not, or if we were genuinely protected or merely feeling a subjective sense of security. We grabbed all our equipment and entered the home. Superheroes or super-kamikazes? Better not to think about it.
The woman was in critical condition, with very low oxygen saturation and severe respiratory distress, on the verge of collapse. She needed airway isolation right now! I was lucky: I was on shift with an outstanding EMT and an exceptional anesthesiologist who also loves emergency medicine (the airway will be secured; she is the specialist). She reached for the Frova introducer—she loves that tool—but as she opened the airway to insert it, she observed severe glottic edema, and the Frova slid into the esophagus. Sweat, heat, nerves, and tension built up inside the PPE, impeding our movement, vision, and focus. The patient was in critical condition; if unresolved, this situation would end in cardiac arrest. My colleague didn’t hesitate or waste attempts. In this case, the Fastrach laryngeal mask was the best ally. She inserted it, and it seated perfectly, delivering a breath of fresh air to revitalize her.
Sedated, relaxed, and connected to mechanical ventilation, the patient’s condition improved, though we couldn’t declare victory yet, as she still had to endure transport to the hospital.
During the journey, we kept our eyes fixed on her and all the monitors like hawks watching prey. She remained respiratory and hemodynamically stable for transfer to the ICU.
Notified in advance, the ICU team was waiting to receive her and took over care. She would be in very good hands. After two and a half hours on the call, we could finally doff our PPE. Stay calm, I told myself, because “the Bug” was clinging to my second skin of plastic. Following the removal protocol, I discarded into the biohazard bin the plastic wrapping me, my sweat and tears, my fear, and of course “the Bug.” Ready and operational, we had to push on. We still had 17 hours left on our shift.
{Image credit: Andalucía Información}
En el sector del ocio, la formación continua es la mejor herramienta de prevención.
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