spenac Posted December 18, 2008 Share Posted December 18, 2008 Maybe Matty, But I've never heard of it. And Google was no help, at least with the meager info I supplied it. My issue, yeah, is with the CPR. That's why I would have no issues having my partner give PPV while I get with medcon. There is no way that I can see that this pt can survive CPR, and it is almost certainly not going to save her. So I'm opposed to damaging her when the ends are all negative with no realistic hint of a positive. If there is an option that allows for sufficient CPR without causing her physical damage, and I have some reason to believe that my above assumptions are incorrect, then I might be up for that...Though it's late, so I'll need to let it percolate for a bit.... Dwayne Sounds like maybe he's offering to allow you to crack her chest and use internal heart massage to attempt to revive her. :shock: Link to comment Share on other sites More sharing options...
Mateo_1387 Posted December 18, 2008 Share Posted December 18, 2008 Maybe Matty, But I've never heard of it. And Google was no help, at least with the meager info I supplied it. My issue, yeah, is with the CPR. That's why I would have no issues having my partner give PPV while I get with medcon. There is no way that I can see that this pt can survive CPR, and it is almost certainly not going to save her. So I'm opposed to damaging her when the ends are all negative with no realistic hint of a positive. If there is an option that allows for sufficient CPR without causing her physical damage, and I have some reason to believe that my above assumptions are incorrect, then I might be up for that...Though it's late, so I'll need to let it percolate for a bit.... Dwayne I asked the question because I was curious if you still thought the age of the patient should be criteria for CPR. As far as the device, I am not sure where to find one. I may be imagining it, but it seems that I remember a device where the practitioner could insert it into the chest abvoe the heart, and it would be used to provide compression to the heart internally, but from external forces. I have no clue what it is called, but I suspect the idea of the device is to have less damage with better compressions. Link to comment Share on other sites More sharing options...
Mateo_1387 Posted December 18, 2008 Share Posted December 18, 2008 Sounds like maybe he's offering to allow you to crack her chest and use internal heart massage to attempt to revive her. :shock: One day bro, one day. Link to comment Share on other sites More sharing options...
firedoc5 Posted December 18, 2008 Share Posted December 18, 2008 Sounds like maybe he's offering to allow you to crack her chest and use internal heart massage to attempt to revive her. :shock: One day bro, one day. Link to comment Share on other sites More sharing options...
Richard B the EMT Posted December 18, 2008 Share Posted December 18, 2008 Any time your treatment course is in doubt It's to the OLMC you should reach out! (Richard B, the EMT, a sometimes poet, who darn well knows it!) Link to comment Share on other sites More sharing options...
ambodriver Posted December 18, 2008 Share Posted December 18, 2008 Unless she is super cold/a little rigored we'd work 3 rounds of epi/atro Confirm the tube then call it in if no ROSC to terminate. Not my decision to work it or not. I am paid to do it even if I don't think its the right thing to do morally. "She was talking 5 minutes ago"--how many times have we heard that? ha. Link to comment Share on other sites More sharing options...
Richard B the EMT Posted December 18, 2008 Share Posted December 18, 2008 "She was talking 5 minutes ago"--how many times have we heard that? ha.So many times, possibly as recently as 5 minutes ago, too! Link to comment Share on other sites More sharing options...
crotchitymedic1986 Posted December 18, 2008 Author Share Posted December 18, 2008 Great answers, but no one has answered the question that was brought about by Kaisus first response: I agree with not working an 89 year old, for all the reasons stated, and yes, "quality of life was part of my decision" (gasps heard all across the forum). But if it were a severely deformed, bedridden four year old with Cerebral Palsey, a feeding tube, a shunt in its brain, maybe on a ventilator at home, I hate to say it, but i would probably work the child, just cause thats the way it has always been. But if you look at it from a humanitarian point of view, you shouldnt work the child either. Do you agree ? If not, what justifies not working one, and working the other ? Link to comment Share on other sites More sharing options...
spenac Posted December 18, 2008 Share Posted December 18, 2008 Great answers, but no one has answered the question that was brought about by Kaisus first response: I agree with not working an 89 year old, for all the reasons stated, and yes, "quality of life was part of my decision" (gasps heard all across the forum). But if it were a severely deformed, bedridden four year old with Cerebral Palsey, a feeding tube, a shunt in its brain, maybe on a ventilator at home, I hate to say it, but i would probably work the child, just cause thats the way it has always been. But if you look at it from a humanitarian point of view, you shouldnt work the child either. Do you agree ? If not, what justifies not working one, and working the other ? I answered I would work the little old lady. So guess what I also would work the kid. Link to comment Share on other sites More sharing options...
DwayneEMTP Posted December 19, 2008 Share Posted December 19, 2008 Yeah, I think I see what you want, but the two situations don't really equate. What are the likely reasons for an arrest in a child vs 90 y/o? Right, much different and most often less permanent for the child. What are the odds of successful ROSC? Much more likely with a much better long term prognosis, again, for the child. Does the family (Who's present) wish a full code? Also, I can work the child, and if successful have a prognosis that isn't negatively defined by my interventions. But again, I hope you'll notice that none of this for me, or that I can see for the others that chose not to work it, revolves around their current quality of life. They are decisions based on science based medicine that simply says that in certain situations the odds of providing a positive outcome, even if ROSC is obtained, is so small that it makes no sense to attempt it. You seem to want to get people to compare the value of the child to the value of the elderly woman, and that comparison has no place in this equation. This is about who has the most viable body, not who has the more precious soul. Dwayne Link to comment Share on other sites More sharing options...
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