When I was a First Responder some 7 years ago, one of the first cardiac arrests that I worked on was a surfer at a place we call The Cove. It’s a popular place in Oregon to surf, but also very dangerous since the shoreline is large, boulderous rock, large drift wood, and smaller, wave worn stones. This surfer had been found by others in the water to be floating face down, being tossed by the waves. They paddled her to shore, to a spot at the edge of the surf line and called for help. A few off-duty EMTs were nearby, working on remodeling a beach home, when they heard the shouts. They rushed to help, scrambling over the rocks, and when I arrived with the rescue, I could see them at the surf line performing CPR. She was packaged to a scoop, then brought up to the ambulance waiting in the parking lot and taken to the local ER. Sadly, she passed. She was in her 60s.
She was well known to the local surfing population, mainly teens and college age guys, though there are a fair amount of middle-aged men in the mix. The Cove is a territorial place for surfing, but she belonged there; she’d been surfing all of her life. She was gray haired, but slim and athletic, with very few health problems that her fellow surfers knew of. But she passed in the ocean, where she wanted to be, and among those that knew her.*****
A week ago, I was working an extra shift with an EMT whom I’d rarely worked with. We were posting, covering the south end of the county, and waiting for the Medic 4 crew to return to service. The tones sounded, our pagers chirped, and the dispatcher told us to respond to the Sunset Beach approach for a cardiac arrest, CPR in progress. Our post was less than a mile from the beach approach, and as we pulled into the graveled parking lot, we were far ahead of the closet fire department unit of county sheriff. I told my partner to keep the ambulance on the hard pack and we drove onto the beach.
The patient was another mile from the approach and we drove past over 100 cars and trucks, parked on the beach while their owners were out clam digging. Their owner were all along the surf line, hip waders on and clam shovels in hand. We pulled up next to a red Dodge pickup with its 4-ways on and looked down towards the surf where the driver was pointing. At the edge of the breaking surf, we could see a huddle of men, performing CPR on another clammer. Working a code on the beach is a difficult chore, nothing like Baywatch. You can’t shock on wet sand, sand gets all over the equipment, there’s an audience, the wind is always blowing at you, and it’s just plain tiring to be moving back in forth in the sand. I told my partner that our only immediate priority was to get him up from the surf line and into the ambulance where we could work on him properly.
He was in his mid-sixties and had a true beer-belly. Witnesses say that he just fell face forward onto the sand—he didn’t even try to stop his fall. He had a hematoma over the bridge of the nose, and blood streaking in his eye. A retired paramedic was there, supervising other bystanders as they gave mouth-to-mouth and did compressions. I asked about history, but he was alone on the beach. No friends, no family, no wallet in his pockets, no name that we knew of.
We worked the arrest for 45 minutes on the way to the hospital. He received all 3 doses of atropine, 5 of epinephrine, 2mg of narcan, 1000ml of saline, and 50 mlEq of sodium bicarb. He had two IVs in and a combitube placed after my unsuccessful intubation attempts. We established quantitative ETCO2 monitoring and were able to adjust our CPR and other treatments accordingly. But despite all of this, he started in asystole and stayed in asystole.
After a few hours, after hard work by the state troopers, he was identified. He was from the valley, here at the beach alone for a day of clam digging. And here at the beach is where his life ended. But I like to believe that it was peaceful for him, I hope that he was doing what he wanted and had good memories before he passed.
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