JennaEMT

Since all I've ever known is the Zoll monitor and HeartStart AED, I must say pads. They work just fine, but just once I wanna look cool using paddles (even if just for a quick look)!!

If the moon can move the ocean, then why can't it affect our brains? We are mostly water, after all. I think someone rigged the research :wink:

Maybe I read the article differently, but I disagree... The current ischemic stroke guidelines, put out by the American Stroke Association, recommend a CT scan to rule out hemorrhagic stroke, followed by tPA, within a window of three hours from the onset of symptoms. They also say that CT should be available 24/7 for stroke evaluation; if a pt arrives who is suspected to be having a CVA and CT is not available then the pt should be transferred. In the article, they say, "Kent Shoji, an emergency-room doctor at Centinela Freeman who handled Ms. Shelton's case, says, "She was a possible candidate for tPA," but a CT scan was required first. "The order was put in for a CT scan," Dr. Shoji says. "I can't answer why it took so long." A Centinela Freeman spokeswoman says, "We did not have 24/7 coverage with our CT scan, and we had to call a technician to come in. That's pretty common with a community hospital." So it sounds like the doctor did follow the protocols; the hospital just wasn't set up to follow the time-line for tPA. I'd have to agree with the writer of the article, this pt should have been taken to a hospital that had a CT available - like the stroke center 17 miles away, instead of the community hospital 13 miles away. Paramedics & EMTs need to be allowed to take pts where they will receive appropriate care - and I say we are well-trained to make that determination in the field. You wouldn't take a woman in labor to a hospital that had no L&D; you wouldn't take a major trauma to a hospital that had no trauma services. I'd back mcad's decision ("Interesting article, Brings up the question of taking Pt's to the closest appropriate facility. I had a AMI "the widow maker" I had a choice a small ER 4 beds that would have to fly the pt or a Hospital that has Cardiac Cath, I chose the ER with the Cardiac Cath"). So, if the hospital that is fully prepared to manage CVA in the 3-hour window is only a few more miles, we should go there. But don't get overly excited about this article; it has some spin in it. For example, it says, "For example, a survey published in 2000 in the journal Stroke showed that 66 percent of hospitals in North Carolina lacked any protocol for treating stroke. About 82 percent couldn't rapidly identify patients with acute stroke." What the hospitals lack is a written "stroke plan," a document that goes in the pt's chart and that all disciplines, from ED to rehab, use to plan for and to chart the pt's progress. It does NOT mean that 66% of NC hospitals can't treat CVAs. And the 82% they refer to was a poll of lay people - 82% of the general public couldn't identify stroke sxs. The way it was written, you'd think that 82% of NC hospitals couldn't identify a stroke. Reporters :evil: Some days that rank right up there with lawyers.