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Paying Attention To The Details When Assisting Patients in Shock
Last Tuesday morning, an elderly woman, with a history of multiple chronic medical issues, collapsed and hit her head in her home located in the city of Ramla. When the woman’s son came home, he arrived to find his mother on the ground and quickly called his sister for help. The sister, who had medical training arrived and began CPR on her motionless mother. After a few tiresome minutes, the two siblings realized their mother had passed away. Avraham Bitkin, a member of the Psychotrauma and Crisis Response Unit (PCRU), as well as an ambucycle EMT in Rehovot, was alerted and dispatched to the scene.
Avraham was in synagogue at the time, praying quickly before heading out to work in Lod, Ramla’s neighboring city. He had just begun his morning prayers when he received the alert. He quickly packed up his prayer shawl and phylacteries as he would have to finish praying later, and responded to the call.
A few minutes later Avraham arrived at the given location and found a situation of utter chaos. The woman’s family members were at the house alongside medical personnel who had been dispatched to the scene and had arrived before Avraham. Avraham, being the only member of the PCRU there, spotted the 45-year-old daughter who attempted CPR lying on the ground with her feet resting on a chair. She was conscious and breathing, but not responding to the requests or questions of the other first responders. Avraham tended to her and began convincing her to get up, he used a psychological technique that helps activate a person physically in order to eventually activate the person cognitively as well.
The woman refused and insisted that she would faint if she moved. Her hands were shaking, her voice was cracking and her breaths were short. Avraham noticed these signs and knew that she required assistance. He turned to other people in the room and asked them to help encourage the woman and urge her to stand up as well. After a number of attempts, Avraham’s efforts met with no success, as the woman was in the process of shutting down emotionally. Finally, the woman’s husband lifted his wife and helped her stand on her own.
Avraham noticed that the minute the woman stood on her feet, her thoughts began to stir and her mind slowly began to return to functioning normally. She then insisted on seeing her mother’s body, and although many objected, Avraham told them that if it was what she wanted to do, she should not be denied it. The woman was now forming sentences and speaking clearer, showing that she was on the road to recovering from her state of emotional shock. Avraham accompanied her and made sure that she remained calm and in a state where she could process what was happening when she saw the body.
Avraham then approached the eldest brother, who seemed fairly calm in comparison to his other siblings, and discussed proper burial plans. After tending to all family members and helping them all relax enough to be able to begin processing their loss, Avraham realized his job was done. Before leaving, Avraham checked on the family members present and made sure that no other family members were due to arrive at the apartment, and possibly start up another emotional episode, which could rekindle the fire that he had just put out. After receiving a negative answer, Avraham made sure that the family knew who to contact for further assistance and then he parted from the family and went on his way.
“In my daily job, I am an active social worker, and unfortunately, I am exposed to many dark situations. I always learn from these experiences and stories. That day in Ramla I learned something new,” said Avraham. “Normally, when a person refuses any psychological help, it is our duty to stand back and obey their wishes. That Tuesday, I saw the state the woman was in and decided not to stand back. Because I pushed for her to stand, the woman’s attitude changed completely and therefore caused the mood in the apartment to change vastly. I could have moved on to treat another sibling in order to lower the tension in the apartment, but I decided to stay with the woman on the floor as I saw she needed my intervention the most. Later, I noticed that she was the key figure in the room. She was the one whom the rest of the siblings looked to at that moment and who they were taking their cue from. In almost every family there is a person like that, someone who all the others turn to in times of stress and emergencies. By helping her, I in essence helped everyone. This is one of the tactics we teach in the PCRU training and it is a life lesson as well. I use this in all aspects of my life, as an EMT, a social worker, a father, and a husband. One must always notice the small details. At times, they are what counts most.”
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