The Emergency was real, the System was not!
A few hours into the night shift, I identified a patient with refractory hypoxia despite receiving 15L/min via NRBM. I initiated an ICU referral; however, the ambulance crew ( 1 driver, 2 EMT personnel) was hesitant to transport due to the patient’s critical status. They requested a clinician escort from the ER to facilitate the transfer. I agreed to go. We are taught that the line between life and death is thin, but tonight I learned that in our healthcare system, that line is held together by nothing more than Scotch tape and whatever I can scramble to fit into my pockets before an ICU transfer. Before we set off, I had the gut feeling to slip an ampule of adrenaline, a few syringes, and gloves into my pockets “just in case.” I didn’t know I was packing for a war our system had already surrendered.