BEorP

[sub:156987e22a]Bold added by me.[/sub:156987e22a] So the truth is that your protocols are written to require drug administration and not leave you with any judgment?

Wow...

[sub:4fe51aaa2d]Bold added by me.[/sub:4fe51aaa2d] Required to give? No judgement is allowed? (And before Dust says it, you're not a BLS provider if you're giving drugs :wink: )

You are correct. The ITD will not allow air to passively enter during compressions. This may conflict with the ideas of compression only CPR, but we will see what survival rates look like and it may be worth it. I would not be surprised that if the ITD proves itself, intubation may be re-emphasized in cardiac arrest due to the difficulty of maintaining the tight seal that is required with just a mask. This also allows continuos compressions and breaths (although from my understanding, giving the breaths then gets rid of any negative pressure build up).

After calming down about the whole "heart attack" thing I have one more comment about the video. As great as it is to parade cardiac arrest survivors on the local news and say "yay we need Res-Q-Pods," it does not provide the whole story. A few things to consider: - Great, two people survived. Who says that they would not have survived without the ITD being used? - Great, the manager says that survival is increasing. That means nothing. Let us consider a few of the other things that could be going on in a community during the year that would increase cardiac arrest survival: implementation of new CPR guidelines [*]providing medics with CPR quality feedback to improve their CPR [*]increased bystander CPR [*]implementation of a PAD program [*]getting all medics to obtain a two year degree/diploma - Why is this news? Is it because this community actually cares what are in the bags of their medics or could it somehow be that Zoll is trying to convince the public that the ITD is a required piece of equipment? I'm not saying that Zoll would do this, but it is worth considering since it would mean huge profits for them.

Ugghh... again with the media using "heart attack" to refer to cardiac arrest.

Although you brought back quite an old thread that is a good question. This is why ROC PRIMED (a clinical trial being conducted across North America) is evaluating the benefits of the ITD in increasing survival to hospital discharge.

Just wondering if anyone here works for or is familiar with Perth EMS in Ontario. If you are, please PM me.

I'll be honest and admit that I did not read all of BVESBC's posts since it is frustrating to see one member ruining a good thread, but did he ever state him formal education?

That is great to hear. What defibs are you guys using?

There are actually many more than just three agencies participating in PRIMED. Off the top of my head, there are: Toronto EMS Toronto Fire Peel EMS Most Peel Region fire departments Durham EMS Most Durham Region fire departments Muskoka EMS In addition, Thames EMS in London, Ontario is participating through the Ottawa site I believe. ROC HS (hypertonic saline) is also being trialed through a number of different agencies including Orgne (Ontario Air Ambulance). Rock shoes, do you know if BC ambulance has launched PRIMED yet or is it yet to be implemented?

[sub:21d49bc9d4]http://www.emtlife.com/showthread.php?t=6721[/sub:21d49bc9d4] All I have to say is that someone needs a new hobby. I sure hope this was a joke, but I can't say I bothered to read any more of this thread.

Speaking of accuracy, they hit on one of my pet peeves in the video. They mentioned that he had a "heart attack" but they said nothing about "cardiac arrest." The distinction is important and not that complicated, but with the media using "heart attack" for both, it causes confusion with the public. (This confusion shows when you try to teach first aid and CPR to people who think you do CPR for a heart attack).

There is actually a research forum on this site. I work full time in research on a prehospital cardiac arrest study (ROC PRIMED) that is being run at sites across North America. Prehospital research is difficult. Times are so important yet so difficult to obtain accurately with so many different sources (e.g. CAD, defib, watch). There is also the issue of just trying to get the medics to participate if it is an interventional study and not required by their medical directives. PM me if you want to discuss more.

I'm not sure. If I find out, I will post it.

His decision was not based entirely on the 12 lead, but he seemed to weight it very strongly. I kept the information vague because I was looking for more general answers, rather than a critique of this specific call since I wasn't there and don't have all the info. Apparently, the patient had had at least one MI with the new heart, and this is what if felt like. In this specific case, the pain did also change to some degree after their arrival and may have began to feel more like indigestion to the patient (I only spoke a bit about this call with my friend so I do not have all the information.) Thanks to everyone for the input!

:oops: I did not see that thread in my search. If anyone has it I would love to look at it.

I was recently speaking with a friend (Primary Care Paramedic) who had a patient with a history of more than five MIs and a heart transplant who was suffering from chest pain like his past MIs. After a variety of assessments, my friend decided that the pain was most likely non-cardiac and did not treat it with ASA or nitro. Given all assessments performed, he may have been right to call the pain non-cardiac, but my concern is the weight that was put on the 12 lead being normal. As much as having a 12 lead showing STEMI could possibly improve care by decreasing the time in the ED, couldn't it be a risky thing if it makes medics think non-cardiac without considering the possibility of a non-STEMI? It seems to me like 12 leads should be used more to call a unique presentation as cardiac rather than what seems like a typical presentation non-cardiac (since I think that I have heard that about half of MIs are non-STEMI). Thoughts?

I would respectfully disagree with you on two points. All people in cardiac arrest will be also be unresponsive. Saying that someone is "unresponsive" does not mean that they are alive. Also, even though the patient is in cardiac arrest, paramedics (at least in Ontario) often document the GCS of 3.

I'm not too sure what you're trying to say here... this was not any type of test question. There was no info missing for the question I was answering.

You are very wise. I'm glad that none of our members are any of those people though.

What would you give the following patient as a GCS? The patient is found lying in bed with their eyes open, not responding to verbal or pain. The patient is in cardiac arrest. I know this may seem like a joke, but please just humour me.

Although I'm not offended by your initial post, I'm not a big fan of this comment. It is your right to feel that way, but I see many medics who have no sympathy for people who attempt or successfully commit suicide without thinking about the depression that often lies behind it.

Doesn't "doing everything possible" end when the resuscitation attempt becomes futile? This seems to say we should go through a normal arrest algorithm on people who are obviously dead just so we can tell the family that we tired everything possible even though we know that there is literally no chance of the patient surviving.

Exactly the point I was trying to mrmeaner. This attitude of "this is how we do it and have always done it so it must be the best" is too prevalent in EMS and is an obstacle when conducting research in EMS.