My first save

[Just Plain Ruff]

Lady, this shows some guts to come back and reply after the beating that I hope you didn't misconstrue

There are some really bad reasons for a ped to seize and even worse for that patient to go cyanotic. The first thing that I'd have looked at was how his head was positioned on the cot or for that matter in his moms' arms. Was he in his mom's arms or on the cot.

When kids go cyanotic there is usually a reason and many times it's as simple as re-positioning the head and ensuring an open airway.

I had a 5 year old one night sitting on a couch. he was nearly in an arrest state. His sat was 63%, his heart rate was 40 and he was grey in color. I was able to move him flat onto our cot, open his airway and give him some breaths via the BVM and wham bam, color improves, heart rate increased and LOC increases.

Your original post sure did make it sound like you just thought of this as a basic level call and nothing more and I'm sorry we assumed that but that's what it sounded like.

I as a basic would have never ever have gotten a cardiac tracing because that is beyond my scope and I can do nothing with it. It makes not an iota of difference in my care and could eventually have hurt you because the parents could have come back and said, "she put him on a monitor, why didn't she treat what she saw"

I am also glad you clarified the no als available - that makes more sense.

This is the call that many many many providers dread, having a critical child in your ambulance and having the parents along for the joyride. If this was me I would not have allowed them to accompany us but your decision is yours to make and you have to justify why you allowed them in. I can't criticise that.

I hope that this kind of case makes you into a better provider because these experiences add to your knowledge base and I hope that this one call prods you to go to medic school as I think you are destined for better things than just being a basic.

I am also offering condolences to you for your loss of your husband, never a good thing.

I strongly urge you to hit medic school and get that licensure, think of all the good that you can do with a medic license. It would benefit you, your service and the patients you provide for.

Keep up the good fight.

**note, now sing the chorus to Kum-by-Yah!**

[Mateo_1387]

Although I understood the reply posts, were not meant to beat me up, they sounded harsh.

I do not think the posts were meaning to be harsh. If you go back and read the post as being inquisitive instead of bashing you, they may seem better.

By the way, welcome to the city !

On this site, questions are going to be asked. When you got done with the call, you realized some new things about how you will handle the call in the future. For example, you learned how parental placement is key to delivering proper patient care. Just as much as you should reflect on calls when you are finished, the people on EMTCity reflecting on your call is only helping you to get better, as well as satisfy our inquisitive nature. All questions asked were the same question many other people wondered about.

Take the comments as positive. Hope you stick around, and pick up all the knowledge we have to offer. Be open-minded.

Good Luck !

Mateo

[BEorP]

I do not think the posts were meaning to be harsh. If you go back and read the post as being inquisitive instead of bashing you, they may seem better.

I agree... email tone and internet tone is 90% how you read what is written and only 10% what is actually written.

[911lady]

Thanks for the come back guys. I do understand the questions and the inquisituve nature of those of you out there. I do want to say that I did have the child on the cot and did repositioned him. I believe this made a big difference in bringing the child back around to us. As far as the monitor; the child had stopped twitching and I only wanted to get a READING FOR THE DOCTOR. We are allowed to print but not read the strips on our service. And I do welcome the help. I think we are all here to do the same kind of job for our communities. Pardon me for not putting in all the details at first. I was merely trying to make a short post. Didnt think it would turn out like it has. No hard feelings taken, just didnt expect the immediate come backs as I had interpreted them at first. I put my heart and soul into my volunteer work, with both the EMS and the Fire Department. Both of whom I am a volunteer. I have learned that when I make another post of this nature in the future; I need to state details, details, details for all to try and understand. Thanks again for the input.

Lady, this shows some guts to come back and reply after the beating that I hope you didn't misconstrue

There are some really bad reasons for a ped to seize and even worse for that patient to go cyanotic. The first thing that I'd have looked at was how his head was positioned on the cot or for that matter in his moms' arms. Was he in his mom's arms or on the cot.

When kids go cyanotic there is usually a reason and many times it's as simple as re-positioning the head and ensuring an open airway.

I had a 5 year old one night sitting on a couch. he was nearly in an arrest state. His sat was 63%, his heart rate was 40 and he was grey in color. I was able to move him flat onto our cot, open his airway and give him some breaths via the BVM and wham bam, color improves, heart rate increased and LOC increases.

Your original post sure did make it sound like you just thought of this as a basic level call and nothing more and I'm sorry we assumed that but that's what it sounded like.

I as a basic would have never ever have gotten a cardiac tracing because that is beyond my scope and I can do nothing with it. It makes not an iota of difference in my care and could eventually have hurt you because the parents could have come back and said, "she put him on a monitor, why didn't she treat what she saw"

I am also glad you clarified the no als available - that makes more sense.

This is the call that many many many providers dread, having a critical child in your ambulance and having the parents along for the joyride. If this was me I would not have allowed them to accompany us but your decision is yours to make and you have to justify why you allowed them in. I can't criticise that.

I hope that this kind of case makes you into a better provider because these experiences add to your knowledge base and I hope that this one call prods you to go to medic school as I think you are destined for better things than just being a basic.

I am also offering condolences to you for your loss of your husband, never a good thing.

I strongly urge you to hit medic school and get that licensure, think of all the good that you can do with a medic license. It would benefit you, your service and the patients you provide for.

Keep up the good fight.

**note, now sing the chorus to Kum-by-Yah!**

[katbemeEMT-B]

Congrats on your first save. I also volunteer on a BLS service with the closest ALS intercept fifteen minutes by air. Ground ALS is more than thrity minutes. I definitely understand how sometimes as a BLS provider, one can feel helpless. Staying composed is a must. Pediatric calls especially scare the crap out of me, regardless of the seriousness of the call. It seems as though even what starts out as a minor situation, goes south in a hurry. I would say that any seizure, and especially a ped. seizure should always be considered serious and ALS.

I can also understand your excitement on the save. I experienced my first official save two weeks ago. We were called out for difficulty breathing. When we pulled into the driveway, we were met by a teenager crying, "she's blue, she's blue". I assumed it was her sister but she quickly corrected me and told me it was her mom. I know the family well and my heart sank. Her mom is only 43. We got to the patient, turned her over and immediately started CPR. As soon as the Heart Start got to us, I placed the pads but no shock was advised. This really scared the hell out of me as she had no pulse or respirations. We did another round of CPR and this time we were able to shock her. There was still no pulse so we continued with CPR, loaded her up, and headed towards the hosptial. We had a local deputy drive and had him radio the hospital. About two mile out she was attempting to breathe, although I had inserted a combitube, she had a pulse, and even a decent pressure. It was short lived. We lost it all again five blocks from the hospital. What upset me was that the hospital didn't immediately call for a bird to meet us their. Next time I will have our dispatcher contact air care. One thing to keep in mind is that this is a small hospital with VERY limited capabilities. I was really concerned about her outcome, but I guess all that matters now is that she survived with zero deficits. I really wish we had ALS closer to us. I am trying to convince our director to sign a mutual aide agreement with the ALS service that I work for. We'll see how that goes.

[medicwithabullitt]

Good Job and it sounds like you handled yourself well. You maintained the airway and thats the most important thing you could have done.

[zzyzx]

Good job on a very scary call.

I'm gonna disagree with some of the others about not taking parents along. I nearly always take family members if they want to go, and usually let them go in the back with me.

[Asysin2leads]

911, first let me say that I think you performed very well in what sounds to be an emotionally charged situation. In addition, it is commendable that you focused on aggressive airway management in the pediatric patient. I'm not sure if this child ever truly was apneic or lost their pulse, it sounds like the child may have simply been postictal for a prolonged period... kids do a lot of strange stuff when they're posticital, turn blue, mauve, etc, but in any pediatric patient aggressive airway management and breathing support is key. Another tip for success in EMS: Don't say frothing at the mouth. Only rabid dogs to that. This is known as excessive secretions which you handled appropriately. Secretions. Not frothing.

Kat, the reason the hospital probably didn't call for air support is that generally speaking, cardiac arrests don't get flown. They get pronounced. Many if not most air services will not fly in if its a confirmed cardiac arrest.

[Just Plain Ruff]

911, first let me say that I think you performed very well in what sounds to be an emotionally charged situation. In addition, it is commendable that you focused on aggressive airway management in the pediatric patient. I'm not sure if this child ever truly was apneic or lost their pulse, it sounds like the child may have simply been postictal for a prolonged period... kids do a lot of strange stuff when they're posticital, turn blue, mauve, etc, but in any pediatric patient aggressive airway management and breathing support is key. Another tip for success in EMS: Don't say frothing at the mouth. Only rabid dogs to that. This is known as excessive secretions which you handled appropriately. Secretions. Not frothing.

Kat, the reason the hospital probably didn't call for air support is that generally speaking, cardiac arrests don't get flown. They get pronounced. Many if not most air services will not fly in if its a confirmed cardiac arrest.

I second Asys's statement on the cardiac arrest and the no fly - Every helicopter service I've had a chance to use have never responded to a cardiac arrest. Now if it's a post code then yes they will come but not an active arrest. If the patient arrests in the helicopter then that's a different story.

[firedoc5]

Good job, Lady. Sounds like between the call itself and what has been said here, it is a good learning experience. Take what you've learned and build on it. Don't get discouraged and not go for becoming a Medic. We've all been there. We had to start somewhere.

For no more experience than you had in a peds. seizure patient, you did well. Airway and breathing, and you caught the cyanosis. Some will get tunnel vision or side tracked and miss it. As a basic, O2 and keeping the airway clear is most of the battle. I'd been running "Code 3" (what was our "Code 1") from the start. I see your reasoning to run a strip for the ER doc, but unless it is a suspected MI don't bother with it.

As far as the parents. I myself would have had mom ride up front and dad follow. Ideally you could have had both parents follow, but I know that's not always acceptable to worried parents.

Keep up the good work.