DOA?

[JPINFV]

To answer your question, the reason you give the drugs to a patient who needs them when the hospital will give them the same is so they will get them quicker. In some aspects, you are right, I'd like to also see a person who is 98 years old in arrest be left alone as well, but we can't just stop working everybody.

How about this for a traumatic arrest protocol?

I think you misread my post. I'm not arguing against prehospital ALS. I'm arguing against transporting patients who are still pulseless and apneic. ALS still works the patient, but without improvement, all you are doing is toting around a corpse code 3. Unlike fine wine, cardiac arrests don't get better with age.

[Dustdevil]

Ah, I better understand now. Thanks for the clarification.

I tend to generally agree with the theory of working and calling on the scene. And the primary reason for that is to prevent screaming runs to the hospital which put the crew and the public at unnecessary risk. However, there is also a legitimate argument to be made that if you DO happen to revive your victim, they will then probably need hospital level definitive care, and the sooner the better. Therefore, it is better to have revived them on the road, minutes from the hospital, than on a scene across town or out in the sticks.

I think a reasonable solution is -- dependent upon your proximity to the hospital -- to transport those who have a chance of survival while continuing ALS resuscitation measures enroute. But notice that I said to TRANSPORT them. I did NOT say to race them at top speed, lights and siren blaring, busting intersections, jumping medians, and leaving tire marks all over the city. Unfortunately, that is a hard mentality to break in EMS because let's face it, driving like an arsehole is why the majority of EMTs got into this business in the first place.

Well... either that, or else because they were too fat/stupid to get hired by the fire department.

[Asysin2leads]

Dust, I fully agree with you, but this still doesn't address the issue of communities with long transport times and negligible or absent ALS interception/response. As much as I'd like to see everybody be paid ALS, until that happens, I really think there needs to be reevalution of arrest procedures in the field.

My brother who did his rotations in a hospital which serves a rural area in the Northeast told me the stories of time and time again seeing volunteer ambulance crews come in, exhausted, having done CPR on someone for the past 40+ minutes. Even if the driver drove like Morgan Freeman in driving Miss Daisy, it still takes a toll on the crew, and still places them at risk by being unbelted in the rear of the ambulance, probably standing up, for the duration.

As someone said before, however, increasing the lienency for a presumptive DOA at the Basic level can be dangerous territory we are treading given the low demands of the EMT-Basic course. This is why I think there should be a national push to change the requirements for EMS. While I am a big fan of Dust's RN first, medic second provider model, I think in the mean time a more feasible model would to make the EMT-B curriculum a standard only for First Responders or a course for people wishing to work in the transport field.

Anyone who responds to medical or traumatic emergencies, volunteer or paid, should be at the EMT-I level at least. Then we put more lienient standards in for calling dead people in the field, and benefit the profession and the public by not having to engage in rescusitation efforts on unsalvagable patients.

[iMac]

Dead people are just sick... 8)

[Ridryder 911]

Dead people are just sick... 8)

Nope their dead!...

R/r911

[Oilersfan1]

Your protocals will dictate the course of action.

Cheers :occasion5:

[1EMT-P]

Always check your patient's ABC's & listen with a scope for a full minute!

[iMac]

...dead people are just disgusting...

[EmergencyMedicalTigger]

...dead people are just disgusting...

Sometimes they're less disgusting than the live ones.

[JPINFV]

...dead people are just disgusting...

She would disagree...