Cardiac Arrest

[whit72]

Maybe a PE blue from the nipple line up? oh did someone say that already. Oh I thought we didnt work arrest pts anymore. I dont believe it paramedics made the wrong call How about the fact that he asked if he could stop CPR because the pt was now in asystole.

[ERDoc]

Maybe a PE blue from the nipple line up? oh did someone say that already. Oh I thought we didnt work arrest pts anymore. I dont believe it paramedics made the wrong call How about the fact that he asked if he could stop CPR because the pt was now in asystole.

These were NOT paramedics, it was an EMT-CC. In NYS there is a big difference.

[whit72]

What is the difference?

[vs-eh?]

Maybe a PE blue from the nipple line up? oh did someone say that already. Oh I thought we didnt work arrest pts anymore. I dont believe it paramedics made the wrong call How about the fact that he asked if he could stop CPR because the pt was now in asystole.

Huh?

So where you work just because the patient is asystolic, it equals termination of the arrest without doing anything? No ACLS, just BCLS and call?

You walk in, attach the monitor and go "Oh, aysystole, I don't care if this is witnessed/he is still warm and not obviously dead, give me the phone".

Ummm, we still work asystolic arrests as long as they aren't obviously dead/DNR or something...

These people should be fired on multiple things...

- Witnessed arrest by a health care professional with immediate CPR. The crew does nothing besides CPR, and doesn't even have the monitor on before calling for pronouncement. Let alone little things like ACLS, proper BCLS, etc...I don't care what rhythm they are in...

- Even removing the witnessed arrest thing and CPR...They thought this patient had lividty. You don't do CPR on people that have signs of being "obviously dead". You don't need too call a doctor if the patient is "obviously dead". We have had this discussion before...MAAAYYYBE your service requires a strip (why I don't know) but that is it...

They are obviously incompetent and should be fired.

[whit72]

I think you are missing the sarcasm. Some people on this board do not agree with working arrests I am an advocate for working them.

thak you.

[Scaramedic]

Lots of issues being brought up here, so let me take them one at a time.

#1 The crew are morons, revoke their field status, shave off their pubic hair and send them home to mommy. They have no place working in the field.

#2 The issue here isn't whether or not we work asystole arrests. The issue is the above mentioned fact that this crew are morons. If anything this proves what we have said on other posts, termination of efforts is viable alternative with medical control. In this case ERDoc denied calling the patient, and the patient was transported, if the patient was truly not viable maybe ERDoc would have responded differently. I do not believe anyone on the other thread said med control should not be contacted for termination of efforts. Those efforts should include a couple rounds of the usual ACLS drugs, Airway management (ETI), CPR and a proper assessment, not just "he's blue can we stop now?"

#3 I strongly agree we should have a Paramedic standard for every urban area/city in the nation. The Basic level should be reserved for First Responders, not transport. Except for, let me phrase a new term here, "extreme rural areas." The problem here might be geography, what you consider rural in New York or other states is not what we consider rural on the West coast or the Mountain states. There are towns out here with pops of 20-30 people, 1 1/2hrs from the nearest ALS service, and 30 minutes beyond them is another town of 20 people. These little mountain towns do have volly services that transport to an ALS intercept, but that intercept might take 30-60 minutes. These rural areas are in my opinion, the only exceptions to ALS transport, and then only to get a patient some basic level of treatment before they can meet up with an ALS transport unit.

#4 Did I mention the crew in question was not all that bright? :sign3:

Peace,

Marty

:joker:

[whit72]

So the use of emt would be what. So cities like Boston and NY have it all wrong, The facts in urban areas you dont need Als trucks on every corner, BLS works fine. you have a hospital on every corner, and the BLS rate is through the roof, That leaves the medics to respond to true ALS calls and their skill can be maintaned. So lets use emts for transports of up to and hour and a half. I think you have reversed the problem. BLS works fine in urban areas, weather you believe it or not, and I believe the paramedic was introduced for the fact that sometimes you have over and hour transport times in some states.

[Asysin2leads]

Whit, listen to me. The BLS wars on this site of been ranging for a long time, and you're new to the battlefield, so I'll be gentle and just give a few points here.

1. Cities like Boston and NYC do not utilize BLS crews because they are more effective. They do it because its cheaper.

2. Your general BLS provider is woefully undereducated and undertrained to be performing assessments and treatments on critically ill or injured people.

3. The notion that ALS can't do anything for trauma is crap. Next time you see a BLS crew doing a scoop and run on a seizing head injury patient, remember, there is no airway, and the lack of ALS intervention is causing brain death.

4. Actually, you have it ass backwards on the creation of EMT and paramedic. Very simply speaking, in the beginning there were paramedics and there were firemen. The paramedics were few and far between, and needed assistance on calls, and the firemen tried to help out best they could, but they really didn't know what they were doing, so a level was created to help the paramedic and also do simple interventions prior to their response. This was the EMT-B level.

5. Once upon a time, I was a trauma victim myself. Lucky for me, I had a very well trained and competent EMT-B crew respond, and I was only about 10 minutes away from a hospital. My injury was in no way life threatening. I didn't need cardioversion, I didn't need airway management, I didn't have any holes in me and I wasn't going to die. However, I was in some of the most excrutiating pain of my life, and the 10 minute hospital ride seemed to go on forever. I can remember every bump, jolt, etc. on the way in, out, and around to the ER. Once I was there they gave me medications that are all commonly carried on ALS ambulances. This is why I am also convinced that ALS has its place even on 'minor' injuries, because with holding medication from people in pain because its cheaper to pay a lower level provider is not good medicine.

[ERDoc]

Wait, it gets better. On their post-call the CC states, "Yeah it was a waste of time, he didn't make it." So, the medic working the console takes the times the meds were given. The pt got 2 rounds of epi and atropine. Then there is a 20 minute gap until arrival at the hospital. The excuse it that the CC was working on getting a line (and failed). :shock: :shock: :shock:

[Asysin2leads]

Ahhhh, Long Island, making New Jersey's EMS system look "not so bad!"