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Unconcious Male At Bus Stop


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I would not intubate the patient until after ROSC is achieved

If he stays in asystole I'm going to work him for maybe five to ten minutes and then call it then and there

There is no role for transporting this patient unless ROSC is achieved

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Had an 88 year old witnessed arrest at a nursing home, family in the room, full code. Daughter screaming to save him save him. Protocols insist we worked him. We had been toned out for altered level

Called to bus stop for approximately 50 year-old male sitting up, but slumped back on bus stop bench. You show up. Bus driver who called tells you he found him like that 5 minutes prior. No one else w

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Aren't we just running an ACLS Mega code.

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I agree, When I got Anthony's text, he said it was something different, but since anthony hasn't returned since his last message we are left to run this as a megacode until his return.

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If I can't find a clear non-cardiac cause for his arrest then it's for all intents and purposes a primary cardiac arrest

I'm happy working him for 20-30 minutes and if he doesn't get ROSC I'm going to terminate resuscitation

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I just texted Anthony again. This guys primarily a cardiac arrest as well. I think we're going to have to put this scenario in suspended animation until Anthony comes back.

He just texted me back and said he was going to try to get online after he got done with what his current call.

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Hey guys. There's not going to be any magical zebra in this one, but I do want to see how you manage the code and how far you'll go with it.

So, now after your third round of EPI, you get a wide complex rhythm...looks close to V-Tach, but only at 105. No pulse..

Just seeing if anyone has any thoughts at this point....then I'll come back with next phase.

And yes, this is a mega code scenario really...

honestly it's for my own education as well to see different ideas that might pop up...I'm compressing a scenario in which there was much debate about what should have been done while the code was going...

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If I can't find a clear non-cardiac cause for his arrest then it's for all intents and purposes a primary cardiac arrest

I'm happy working him for 20-30 minutes and if he doesn't get ROSC I'm going to terminate resuscitation

You mean the attending would terminate resuscitation, right?

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You mean the attending would terminate resuscitation, right?

No D, in many countries, including the US (certain areas) you are allowed to initiate CPR/ACLS then terminate based on your local guildleines/protocols. For example when I became a paramedic in 1994, I rode wtih NY EMS (before it as FDNY), and the arrest alogo was cpr, intubate, defib if nec, EPI, IV Isuprel then if no ROSC... end attempts. Pull IV and ETT and leave patient. (I cant remember if medical control was contacted or not, sorry was a long time ago) This makes sense based on the pure volume of arrests that they probably work in a 24 hour period, the taxing of your ED(s) would be immense.

Edited by flightmedic608
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No D, in many countries, including the US (certain areas) you are allowed to initiate CPR/ACLS then terminate based on your local guildleines/protocols. For example when I became a paramedic in 1994, I rode wtih NY EMS (before it as FDNY), and the arrest alogo was cpr, intubate, defib if nec, EPI, IV Isuprel then if no ROSC... end attempts. Pull IV and ETT and leave patient. (I cant remember if medical control was contacted or not, sorry was a long time ago) This makes sense based on the pure volume of arrests that they probably work in a 24 hour period, the taxing of your ED(s) would be immense.

I understand, but one would have to have some sort of certification to be obligated to protocols. This guy is a civilian, not an EMS worker, kind of a make believe ciber-medic in the forums so to speak.

Edited by DFIB
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