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I haven't posted in awhile and I am hesitant to jump back in...but here goes my thoughts. Take them with a grain of salt but realize they come directly from my heart~~ First off, ask yourself "why". Why do you want to be in EMS? If it's because you rode with an ambulance crew one night and got to see some cool things like dramatic car accidents and maybe a real rescue of one sort or another where the person 'almost died' but they saved him/her then that reason isn't good enough... The majority of EMS calls are not the high adrenaline, high stress calls that we see on TV. Sure, those type of calls are mixed in there and occasionally we do get the one person that maybe wouldn't have lived had we not done what we did....but the majority of our calls roll into a ball of the same call presenting in various degree's over and over again~~the drug addicts, the alcoholics, the chronically ill who can't or won't take their medications (diabetics, psych patients, liver failure, etc.), the nursing home that refuses to let a resident die in privacy in their own room and calls for them to be transferred out hours before death, the chronically ill patient on multiple medications with multiple doctors whose history is more like a rubik's cube or a puzzle.... If it's because you love medicine and enjoy a rubik's cube or puzzle now and then... Great!! We need more people like you!! People who will realize that everything they are taught in their certification classes is the least amount of information they will ever need to hopefully not kill someone and that from the moment they step outside that door with that shiny patch in their hand, their responsibility is to keep learning, seeking and even asking the 'dumb' questions from time to time. Another thing I always talk to my new students about now is their mental health. Are they ready to possibly see some of the worst things that mankind can do to one another and are they willing to accept that 'those' stories may or may not become a permanent part of their life? I make it clear to my students that reading about something in a book and looking at 'gory' pictures is nothing like they will face in the streets where they are going to get the full blown 3D effect. Is that something they are mentally prepared for and do they have the proper safety net set up in advance? Do they have the resiliency and coping mechanisms they are going to need if they want to be a part of this world for any amount of time without becoming a zombie needing assistance themselves? Do they want to put the time in to building a strong foundation for themselves before they become a safety net for John Q Public? If they still do at that point then I stand behind and beside them every step of the way from there on out....if they don't, I still stand beside them and support whatever decision they make~~I just want them to know ahead of time some of the things that I never knew.....whether it would have kept me out of EMS or not, I doubt it, but I may have been more prepared had someone sat down with me and explained some of those things....

Try Activity - Unread Content. The latest update changed the button to a menu item I think.

There definitely seems to be some increased activity now. I'll admit, I haven't been here in a while but it's good to see things picking up. Admin, is there any way to add a button just to see the new content in the forums? There used to be a button like that previously.

Once you have discussed with medical Director, the ball is officially out of your hands. I'd leave it there until you get a note back from the medical director. You never know who else is a member on this forum, it could be one of your colleagues who reads this and then all hell breaks loose, or we do have families sometimes come here for fishing expeditions. You just never know. And GOD FORBID, don't post anything about the call on Facebook, even to a EMS related facebook site.

Sounds like some bad calls were made. Would the outcome have been any different? There is no way to know. One thing you will learn in the medical field is that no one will publicly discuss mistakes/bad decisions. Doing so, opens up everyone on the call (yourself included) to a lawsuit. As others have said, discuss it with the medical director but I wouldn't say anything more about it in a public forum.

Off label has apparantly in this case has it right, sounds like pissing match. Sad case if you ask me.

I think this is one of those situations where it was an on-scene judgement call. Depending on exactly what was going on at the time might change one's answer. 10 minutes is too long to go without CPR but what exactly was happening when the arrest occurred? Was the pt on a stairchair in between flights? Were they in bed? That would make a huge difference in how quickly you could start compressions. OP, being that you almost chanted BLS before ALS, it makes me wonder about your experience level. You may not understand why some things are done the way they are. You say that there were other meds that the ALS crew could have given. What were they and what were the indications? We don't just push meds to be pushing meds. If the pt lost his pulse in a place where it would be reasonable to start working the code, then it should have been worked. Once the pt codes, there is very little that the ER can do that a properly trained and equipped ALS unit can't do. Too much missing to make an informed decision at this point.

Yes there is a phenom called pissing matches but when it directly affects your patient's well being, there's a time to speak up. I know I know, some people don't feel comfortable in doing so but there are ways to do so that aren't done on scene. I get wehre you are coming from Offlabel but with more to this story, it sounds like the medics got tunnel vision and focused on one thing when another thing came back and bit them in the butt. As an armchair quarterback, if the patient began to crash to the point of coding, CPR should have been started earlier. Either in the house or in the ambulance as quickly as possible but 10 minutes is a really really long time to go without CPR when we of all people know that Early CPR means a better outcome (sometimes). Jenjas, you sound like a good person, I would at least let your medical director know about this call. they can review it and if needed, contact the ALS services medical director. Good luck in whatever you decide to do.