WHERE THERE'S PROTOCOL, THERE'S A WAY
July 7, 2016
By Shannon Shuler
Mom and I had returned home after a day of shopping and unloaded our new treasures before settling down to watch a movie with our three little dogs. Twenty minutes later, she was unresponsive and making a weird noise that sounded like a snore, just not her usual one. I called out to her.
When she did not answer, I called louder, “Momma!”
She still did not answer. I went to her and called her again, becoming frantic, “Momma?!”
I patted her arm—nothing. I patted her harder—nothing. I shook her shoulder. I called my brother’s cell; it went to voicemail. I hung up and called back. He answered.
“Bubba, come home now. Something’s wrong with Momma.”
“I don’t know. She won’t answer me and just keeps making a weird noise. You need to come home.”
“Call 911 and get the medics started. I’m on my way.”
The person at the Orangeburg County Sheriff’s Office (S.C.) communication center who answered my 911 call was hard to hear, and the line kept breaking up. I made sure she had our address and told her the patient was a 57-year-old female who was unresponsive and not breathing, but the phone went dead before I could be sure she had heard all the patient information. If she heard me, she would get the medics on the way. I knew that was the full extent of the help I could expect from our 911 system.
Orangeburg County had not adopted, and has yet to adopt, the Medical Priority Dispatch System (MPDS) with Pre-Arrival Instructions, which I use as a fire/EMS dispatcher for Charleston County Consolidated 911, S.C. Orangeburg County was hopefully sending help, but I could do more than just wait. Even if they did not have the information, mom raised two firefighters and had a whole department that looked to her as a mom. We would get her to a hospital one way or another.
I prepared for the arrival of anyone who could help. I opened the front door and turned on the outside light. I moved mom to the floor. I am CPR certified for my job and as a volunteer with Eutawville Fire, and I am a certified instructor through the Red Cross. I knew what to do, right? Not so much. I could not remember how many compressions to give at a time. I went from 20 (“No, that’s not enough”) to 40 (“No, that’s too many”) to 30 (“That’s not right either. Oh dang! How many is it?!”); I settled on 30 compressions. If I had the number wrong, they were still helping.
I said over and over again, “No, Momma, you can’t leave me. We still need you.”
My brother, who is Eutawville Fire Chief Stephen Shuler, turned the 10-minute drive from his house to ours into less than five. He switched to the EMS channel and advised “CPR in progress,” before moving the furniture for an access point and came over to assist. He checked for a pulse and verified her breathing. Air was moving out but not in. Her lips were blue. Her eyes were unfocused and vacant. We began two-person CPR. I continued compressions, and he gave breaths.
Orangeburg Medic 5 arrived. One paramedic asked what happened, and the other set up the AED. I put the dogs in a secured room. They shocked her once with the AED and loaded her in the ambulance. I closed up the house and put out the dogs before going to the only hospital in Orangeburg County.
I walked into the emergency room waiting area shortly after midnight. Not even an hour had passed and it was already the longest night of my life.
My brother, who was at the hospital, told me, “They got her [breathing] back in the ambulance, but she started fighting them while they were trying to tube her.”
I took a seat in the waiting room. My brother sat beside me, and we discussed what the paramedics told him about mom. I could not stop the tears running down my face. They moved us to a private “family room” where I watched my tough-as-nails brother cry silently, and I pretended not to notice except to move the tissue box between us. Other family members arrived. The hours in the room were interminable and without any updates.
At 6 a.m., more than five hours after I had arrived at the hospital, we were allowed to see her. She was intubated, heavily sedated, and restrained since she had tried to fight the ER staff, also. An hour later, she was moved to an ICU suite. At noon, my brother and I went home.
I returned to the hospital later that night and stayed for the next two weeks. I drifted between not knowing if I would be planning a funeral to coordinating visits. My brother came when he got off work; his boss was extremely understanding. He stayed with her on the weekends.
At each new move and with each new nurse, I would hear them talking: “Is that the one?” or “She’s the one that kept her alive.” It took me a long time to realize that it was me they were talking about, referring to the CPR that I had initiated before help arrived. The doctors and paramedics told my brother that the ending would have been tragic if CPR had been delayed any longer.
Mom does not remember anything. She has no recollection of shopping or watching a movie. My brother and I did tell her the full story. Her favorite part is about the dogs. The puppies, DJ and Liam, were on either side of her on the floor during CPR. When I gave her the first rescue breaths, DJ climbed up and laid on mom’s stomach. With every compression, he stretched his paws to my hands. Liam licked her face twice, copying (I think) the kisses he thought I was giving at each CPR breath. Their mother, Zoe, led the paramedics to us.
Doctors expect a complete recovery, though they are still unable to determine the cause of the event. This was her second silent heart attack. We never knew about the first. Vigilance will be key in making sure she continues to get the timely treatment she will need in case it happens again.
I dispatch for a large consolidated 911 center, and I am also an office manager and instructor for a small fire department. I tell responders where to go, how to properly fill out reports, and keep their training up-to-date. I do not run calls. My job is getting them to the call and making sure they have the information and training they need. I never envied their role. Now I know why. I could not do it and certainly not in a small town like Eutawville where everyone is related or grew up knowing each other.
I have post-traumatic stress disorder from that night. Each time I see a heart-related call on my screen or hear one of my calltakers going through those questions, it is all I can do to not break down at my console. My mind keeps going back and remembering, seeing as I mentally go through those same questions about her. If I lost her, I would be lost, too. I know she has never been prouder of her first responder children, especially after she learned the whole story.
The last thing she said to me that night was, “Today was so much fun! Can we do it all again tomorrow?”
No, Momma. We are not doing that last bit again, ever.
Shannon Shuler is a Fire/EMS Dispatcher for Charleston County Consolidated 9-1-1 Center in North Charleston, S.C. She has been dispatching for 8 years and, in addition to her time at dispatch, she also volunteers for her local fire department where her brother is the chief. Shannon is pursuing a degree in Emergency Management with hopes of furthering her career to include Public Health.