Flatline

Today I had the exam for my Advanced Cardiovascular Life Support (ACLS) class. I was tested with a group of five other med students and interns. I was chosen to go first. Each person had to "run a code," i.e. oversee a team of people attempting to resuscitate a patient. My case was commotio cordis, in which a blow to the chest causes a disturbance of the heart rhythm. In this case the scenario was a 15-year-old pitcher who got hit square in the chest by a line drive and went down, unresponsive.

Although only a simulation, it's both exhilarating and nerve-wracking for someone like me who has had relatively little experience with emergency medicine so far; there's a lot to keep track of. I can only imagine what it would be like to have a real 15-year-old on the ground with no heartbeat. I was wracking my brain for things to do (and asking the rest of the team), but in these cases death is the most common outcome and this was no exception. Even in a simulation it's unpleasant to lose a patient.

At the end the instructor gave me a good evaluation, saying that I stayed calm and directed everybody through the resuscitation algorithms clearly. (We "did all we could.") I'm not sure it felt so smooth from my point of view. I have to admit that I'm both anticipating and dreading the first time I do this for real.