An ambulance call came to the ER stating that a 75 year old man with shortness of breath was expected to arrive in the ER in 5 minutess. As this was a normal complaint to be seen in the emergency department, LTJG Javar Childress and his assigned Corpsman quickly readied the bed, and prepared to assume responsibility of the patient. When the patient arrived, he was on 15 L of oxygen on a non-rebreather. The patient was transferred to the ER bed, and while trying to change his oxygen to the bedside tank, the patient literally started “freaking out”. As the patient’s anxiety worsened, the attending called for the RSI kit and the airway cart to be brought to the bedside. LTJG Childress, however, quickly got the patient’s attention and told him we were going to take great care of him, but we needed him to calm down. As the patient realized that his oxygen was flowing, he started relaxing enough and his oxygen sats started rising.
LTJG Childress, being one step ahead of the doctor, initiated respiratory being called and BIPAP being set up. Within fifteen minutes, 2 IV’s were placed, EKG done, labs drawn, and patient was satting well on BIPAP. Because of his quick thinking, patient advocating, and initiating the goal for the least invasive procedures, LTJG Childress prevented the patient from having to be intubated. The patient was transferred to the ICU, but not without continually thanking the ER staff for always being there to help him.