By: Dan Limmer
A student recently told me about their first call where they saw dextrose rapidly reverse hypoglycemia. The excitement of the call was still present for this student days after their shift.
I remember my first time administering dextrose and how miraculous it seemed. It was even more miraculous because my partner and I were part of this “miracle.”
I began thinking about the concept of miracles and thought of five classic EMS “miracles.” It is important to reflect on what we do, especially the good, and most especially the miracles. Here are my top five.
Reversal of Hypoglycemia
This may be the classic. In medicine, it is technically low-hanging fruit. Low on sugar, give sugar. But the results are so rapid and dramatic that almost everyone remembers their first call like this. This simple and astonishingly effective field treatment removes the negative calls, codes, and traumas.
Reversal of Opioid Overdose
While naloxone has been around for a long time, it wasn’t until the recent opioid epidemic that the naloxone-fueled reversal became a commonplace occurrence. Joining hypoglycemia in the miracle category (albeit with baggage around unpleasant side-effects from the patient waking up aggressively), naloxone nonetheless has a place in the EMS miracle category.
Return of Spontaneous Circulation
ROSC, formerly and simply known before as “we got a %$#@ing pulse back!” falls among the greatest EMS victories, the fight against death itself. This wasn’t common until recent advances in science and practice brought out-of-hospital survival rates from 1 – 3% in the 1990s up to about 10% nationally now and considerably higher in some cities.
We’ve worked with communities to hold CPR classes and get AEDs in public places. Survival is a team effort. When we are celebrated, we must celebrate with the whole team.
Childbirth is a natural process that was done for centuries without EMS and hospitals. But there is still something about delivering a baby in the field that may be one of the ultimate EMS experiences. Fueled by the rarity of this type of call and the epic consequences if it goes poorly, Childbirth holds a solid place in the top 5 EMS miracles.
The Thank you
Every one of the previous four miracles can come with a thank you. A very meaningful thank you. But the concept of having a patient and their family come by the station and offer a personal thank you (often accompanied by delicious baked goods) is particularly rewarding.
What surprised me over the years is that the deepest and most appreciative thank you doesn’t come from the most significant or most miraculous calls. The simple fact of EMS being there, listening, caring, providing the buffer between fear and death is enough for someone to offer their thanks.
It is essential for us to remember how simple things make a difference to a patient in crisis. The simple act of being there is often the best medicine.