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Your patient arrests as you pull up to the ER


akroeze

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So where do you draw the line? If you are at a residence right next door to the ER do you work it on scene and call it or do you load and go? How far away do you have to be?

I'm not questioning if you work it or not, I'm questioning HOW you would work it.

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If the house is next to the ER then I'll work it shortly at the house and then move to the ambulance continue the code and then go to the ER.

But if they do arrest in the ambulance in the ER garage or near the door I'll work it a short time, let the ER staff know and have them come out to the ambulance for the extra hands.

Either or, since it's a witnessed arrest I'll do what can be done in the ambulance, shock, cpr, intubate, first line of drugs and pace if needed and then move to the er room.

but you need to do 2 minutes of cpr regardless so Maybe some would just do cpr into the ER and go from there.

There is no wrong answer and many right answers. It all depends on the situation.

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The etiology of the arrest makes all the difference. The VF/VT arrest? No brainer, shock the patient, cpr, go in to the hospital. Obstructed airway? Secure it quickly, go in to hospital. Trauma? Go in to the hospital. OB? Go in to the hospital. If it is something that we can IMMEDIATELY correct, do so, otherwise we are at the hospital, provide BLS airway management, cpr and go in.

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The etiology of the arrest makes all the difference. The VF/VT arrest? No brainer, shock the patient, cpr, go in to the hospital. Obstructed airway? Secure it quickly, go in to hospital. Trauma? Go in to the hospital. OB? Go in to the hospital. If it is something that we can IMMEDIATELY correct, do so, otherwise we are at the hospital, provide BLS airway management, cpr and go in.

Word... 8)

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I've had this happen a number of times. If they are in a shockable rythm, we'd defib X's 3 if needed in the back and rush them into the cardiac room. It was a relatively short distance. At that time we had some cots that had a bar between the wheels where someone could stand and be able to do CPR while rolling.

Get them inside, you have more room, more personel, more resources. I can't see where staying in the rig sitting in the middle of the drive way and running the entire code there.

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Someone is apparently wandering through a woman's hair...

Never heard of walking into a forest and being lost for the TRESS before.

When offering a grammar p3wn, it really helps if you edit for your own grammar/spelling/usage mistakes first...

Just sayin'.

Wendy

CO EMT-B

(EMTCity Apprentice Grammar-Nazi)

As I said I often amuse myself. And indeed I have here with your hair reference.

As I stated before, once is a typo. I have NEVER claimed to be immune from them and even commented I make them all the time. However when I spell TREES incorrectly three times, as genAric (sic) was, well then I would agree you have a point. It wasn't the typo / spelling I was pointing out though. It was the repetitive mistake that was still not corrected despite being GIVEN the correct spelling.

Having said that though Wendy I certainly do hope that your 1356 messages to date contain PERFECT spelling and grammar. It's going to take a while for me to search them though. I hope they are certainly all clinically correct too!!! But that is another time.

For now, I'm going back to walking through a woman's hair. - :lol:

Stay safe,

Curse :evil:

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The etiology of the arrest makes all the difference.

THANK YOU!!!!!!!!! Someone finally gets it. :D

Give me the scenario and I'll tell you what I would do.

Certainly does not subscribe to the theory that "an arrest is an arrest, is an arrest"

Stay safe,

Curse :evil:

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Sure, grammar and spelling are not the focus of this thread. Simply pointing out that those who wish to slam others for spelling or grammar errors should first examine their own writing carefully. Presentation is everything, and a misspelled word can be so distracting that one can literally become completely sidetracked from an argument that is otherwise well constructed and thought out.

Wendy

CO EMT-B

On that note could you please explain what a RAPPOR is? (Read below from another thread)

Unfortunately, expressing that SI is not a valid mechanism or a good mechanism may alienate your rappor with your patient and not do anyone any good... but at the same time, you can't say "good, sure, cut your wrists instead of taking that overdose" because it's positively reinforcing a behavior that is less negative than the alternative but surely still a negative.

Touche!!!

Anyway this is boring me now and I am happy to move on. None of us can spell , myself included. So let's engage in our illiterate debates on here with true typo freedom and get back to the clinical issues at hand.

Stay safe,

Curse :evil:

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If the house is next to the ER then I'll work it shortly at the house and then move to the ambulance continue the code and then go to the ER.

What happened to the concept that it is more appropriate for us to work a patient on scene?

It seems you did not see my last post. Give me your own examples of things that would make a difference.

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Holy Crap....

Some of the smartest people on the forum locked in what seems like a never ending penis measureing contest.

C'mon guys. This is an awesome thread, great ideas and many things I may not have thought of before...Perhaps it's time to move on?

Dwayne

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