My 1st code

Yes, it happened. I've actually had 2 so far, but we'll just talk about the first for now.
I was working on the Wolcott Hill Express one fine evening when my pager went off for a 37 y/o male in seizures in the next town north (one of the 3 towns in our first due).
I knew pretty much right away that if he was still actively seizing we were going to have to call for a link-up (still no narcs...). I got to the fire station and waited for the rest of the crew, Mike and one of our Basics. We called en route and headed north (about a 7-10 minute trip). About a minute out, FD got on the radio and told us that the pt was still actively seizing, and had been for almost half an hour. WTF. He seized for 20 minutes prior to the family calling 911. We grabbed our stuff and started heading into the house... The fire chief met us half-way across the yard, making the "Glove up" motions... Then told us that the pt had HIV and Hemophelia. Nice. No extra pressure there...

We got into the house and sure enough, this scrawny, sickly looking guy is on the floor flopping around in a grand mal seizure, eyes wide open, foaming at the mouth. We got the info on what had happened, put him on a blanket (couldn't get the stretcher in the house) and carried him out to the stretcher. Before we left the house I asked the family where they wanted to go... they said Syracuse. I said No way, not in his condition, pick something closer. They did and we headed outside. We got him in the rig, got him on the monitor, got an 18 ga to the AC on the 1st try (thank goodness). I told the driver to call for a link-up for narcs and we got moving.
I felt kind of helpless, because all we could do was monitor his airway and his condition... Breathing was adequate, sounded like he aspirated a bit... Monitored pulse, rhythm, resps, etc. He was still seizing, staring straight at the ceiling with this wide-eyed look of terror... It was chilling.

About 15 minutes into the transport, he suddenly stopped seizing. I thought "Well, this is a good thing!" Then I looked up at the ECG and said "Oh fudge, that is not a good thing at all..." A very irregular bradycardia. He had a relatively normal rhythm and pulse rate up until that point.
I jumped up for the Atropine, pushed it, flushed it.... Annnnnd he went asystolic. Dammit.
I looked back at him and i actually saw his lights go out... His body just went limp, his eyes almost closed, and his face went completely slack.

I jumped up, grabbed the box of code drugs, grabbed the airway kit, grabbed a BVM, and told my driver that we now had a code. He asked if i wanted to cancel the link-up rig and I said No way, I could use an extra set of hands.
I pushed Epi and another Atropine, I did some CPR, then handed the BVM and the compressions off to my partner while I set up the ET Tube kit.

I got everything set up, donned safety goggles and a mask, and then went for the tube. His throat was full of fluid so I suctioned him out and saw his vocal cords, dropped the tube, inflated the cuff, hooked up the BVM and verified the tube placement. In the middle of getting the tube, we met up with the other rig and their paramedic jumped on board with us just as i was dropping the tube in. He took over CPR and asked what the story was.

After a round or 2 of Epi and Atropine, the pt went into an idioventricular rhythm, but nothing more, no pulses.

We got him to the hospital, gave report, they worked him for a little while longer, then called him.

I went outside after leaving his room to have my post-code smoke, wrote my paperwork, then we headed home.

Not too bad for my first code as ALS, i thought... other than him coding in the first place, there were no major snags as far as codes go.

Thennnn, i got home. My girlfriend called me and said "You need to call Paul (a friend of ours). That was a really good friend of his and he's really broken up." Crap. Not only was I bothered a little because this call was the first time in my life that I actually watched someones lights go out, but it also had to be a very good friend of a good friend of mine.

Over the next several days, I found out that pretty much everyone that i associate with in town was friends with this guy. It was kind of hard... Seeing them so upset, wondering what was going on in their heads, if they were blaming me in any way for this guy's death... It took me a little while to get over that and not feel uncomfortable around everyone. I knew I couldn't talk about it because of the HIPPA shit... All i could and did tell them was that I did everything that I could possibly do for him.

My gf was friends with him too, so I wound up standing in a corner at the funeral... After the funeral, I got a bit of a laugh. Joanie (my gf) was talking with our friends Paul and Missy, so i went over to them and chatted with them for a few... And suddenly I smelled something peculiar. All 4 of us looked at each other and I asked "Is that what I think it is?" We looked around and saw the source of the herbal odor... A circle of people around the casket, in the funeral home, passing around a bowl.

My pt had been a dedicated stoner and usually took in loners, gave them a place to crash, befriended them... so he had a pretty tight circle of friends. And in his honor, at his funeral, they gathered around his casket and lit one up. For me, it was an interesting combination of touching, comical, and disbelief.