Cardiac Arrest

[medic001918]

I am sick of hearing about studies WHAT DO YOUR PROTOCOLS STATE.I am saying my protocols state you work arrest pt's, without obvious signs of injuries non compatible with life. Why is this such a big problem for people to understand it has nothing to do with being aggressive. It has nothing to do with my emotions. Until the protocols change thats how they are handled regardless of my own personal opinions. The facts about intubation are true medics suck at it because they never perform the skill. If the rate for intubation was higher you would have more succesful tubes. I had to take and intubation class in a another state that I worked in, lets face it its not rocket science. But wouldnt you be more proficent at it if you did three a day rather then one a month.

What do my protocols state? My protocols state to not initiate efforts on a patient with obvious death to start. And they also state that I don't have to transport an asystolic arrest after intubation, IV access, 3 rounds of meds and 20 minutues of effort without change. Dead people are dead and stay that way. It's a risk to the safety of the crew to transport someone who isn't a viable patient. It simply prolongs the death process. And it's a poor use of resources since that's an ambulance out of service for no real valid reason.

And your logic about paramedic "sucking" at intubation are hardly validated. Great strides have been made to help assure that misplaced/displaced tubes are properly detected in the way of end tidal CO2 monitoring. My particular service actually maintains a very high sucess rate with intubation and we have the option of requesting OR time if we want it though our medical control. The skill of intubation itself isn't rocket science at all. In fact, it's a pretty straight forward and easy skill. The knowledge of when and why to perform it is more important. Some patients are better off not being intubated or intubated after other meaures have been exhausted. There is a considerable thought process in intubating someone, the least of which is the skill itself.

Shane

NREMT-P

[Scaramedic]

WHAT DO YOUR PROTOCOLS STATE

Denver Metro Protocols from 1994.

Current Multnomah County EMS Protocols (Portland, OR)

Did that answer your question?

Peace,

Marty

:joker:

[Asysin2leads]

First of all, Whit, I'm not exactly sure where you get off throwing your opinion around as too why paramedics 'suck' at anything. It's obviously apparent you've never read a study, or even have the foggiest notion of advanced airway management, other than "paramedics use that tubey thing and miss sometimes cause they don't practice enough"

You know why misplaced tubes are common in the prehospital setting? Well, for one, yes, some it does have to do with lack of skill. But also, the fact that most intubations are done in a well lit operating room or even emergency room, and we medics get to do it in the ditch. Ever tried auscultation lung sounds in an ambulance with the sirens going? It isn't easy, sometimes mistakes are made.

But to use that to justify giving people a lower level of care is really just asinine. You sound like the type of person who complains about the medic "playing doctor" or "playing around on scene", which usually lays bear the complete ignorance many BLS providers have of higher levels of training. Don't use factoids to justify your frustration with your position.

[Ace844]

First of all, Whit, I'm not exactly sure where you get off throwing your opinion around as too why paramedics 'suck' at anything. It's obviously apparent you've never read a study, or even have the foggiest notion of advanced airway management, other than "paramedics use that tubey thing and miss sometimes cause they don't practice enough"

You know why misplaced tubes are common in the prehospital setting? Well, for one, yes, some it does have to do with lack of skill. But also, the fact that most intubations are done in a well lit operating room or even emergency room, and we medics get to do it in the ditch. Ever tried auscultation lung sounds in an ambulance with the sirens going? It isn't easy, sometimes mistakes are made.

But to use that to justify giving people a lower level of care is really just asinine. You sound like the type of person who complains about the medic "playing doctor" or "playing around on scene", which usually lays bear the complete ignorance many BLS providers have of higher levels of training. Don't use factoids to justify your frustration with your position.

"Asys,"

My Esteemed Colleague from the NYC has hit the proverbial Nail on the Head yet again..Your right on the mark with your post. HERE..HERE... :occasion5: !! The 1st rounds on me..!

Peace out,

ACE844

[Asysin2leads]

ooopsy, wrong thread. Hee hee.

[whit72]

I work in an area we work very closely with medics, most of them our the shit, their the best of the best do I necc. like all of them personally No, Do I respect them absolutely, they carry them self in a manner that commands respect because of what they have accomplished in pre hospital medicine.

They are confident but humble. they dont walk aound with shiney patches or telling everyone how good they are, they let their actions speak for themselves they are not constantley rattling off their qualifications to anyone who will listen. They dont bitch and complain when they have to get up to transport and old lady that stubbed her toe, they dont think their above that. they dont belittle emts to make themselves feel more important. They understand we are all in this together, dosent really matter what it says on your patch. I could nock on any of their bunk doors at 3am to ask a question. Those are paramedics, those are the people I work with. I am not anti-paramedic, I am anti paragod

[Ace844]

I work in an area we work very closely with medics, most of them our the Ca Ca, their the best of the best do I necc. like all of them personally No, Do I respect them absolutely, they carry them self in a manner that commands respect because of what they have accomplished in pre hospital medicine.

They are confident but humble. they dont walk aound with shiney patches or telling everyone how good they are, they let their actions speak for themselves they are not constantley rattling off their qualifications to anyone who will listen. They dont bitch and complain when they have to get up to transport and old lady that stubbed her toe, they dont think their above that. they dont belittle emts to make themselves feel more important. They understand we are all in this together, dosent really matter what it says on your patch. I could nock on any of their bunk doors at 3am to ask a question. Those are paramedics, those are the people I work with. I am not anti-paramedic, I am anti paragod

This post is in response to whom/what exactly? I.E.: So what's your point?

Ace

[medic001918]

I work in an area we work very closely with medics, most of them our the Ca Ca, their the best of the best do I necc. like all of them personally No, Do I respect them absolutely, they carry them self in a manner that commands respect because of what they have accomplished in pre hospital medicine.

They are confident but humble. they dont walk aound with shiney patches or telling everyone how good they are, they let their actions speak for themselves they are not constantley rattling off their qualifications to anyone who will listen. They dont bitch and complain when they have to get up to transport and old lady that stubbed her toe, they dont think their above that. they dont belittle emts to make themselves feel more important. They understand we are all in this together, dosent really matter what it says on your patch. I could nock on any of their bunk doors at 3am to ask a question. Those are paramedics, those are the people I work with. I am not anti-paramedic, I am anti paragod

Your post is poorly written(at best) and difficult to follow and really doesn't contribute anything to the topic. So let's just clarify something, you work with paramedics but you're not one yourself? Just trying to get a feel for the level of care YOU provide. That tends to lend itself rather well to understanding where someone is coming from in their views. As a paramedic, I probably look at calls and situations differently than an EMT simply do to training and the higher thought process involved. It's not a bash, just tryng to understand.

Noone here has claimed or acted like a paragod. This scenario turned into a discussion of weather to work certain cardiac arrests. You've asked what our protocols state and that has been answered by many experienced paramedics here. Their answers have not been study based, rather protocol based...as per your request.

Please, explain your last post and where you going with it...I'm left confused by where it came from as I'm sure others most likely are too.

Shane

NREMT-P

[whit72]

It might be poorly written but I can use the word weather in its proper context. Some stated earlier that I was EMT dissatisfied with my position as an EMT, so I knocked paramedics that's untrue. Where I work the pay difference is not abundant enough for me to become a paramedic. I have other financial responsibilities at this time. I was just stating that I am not against paramedics I am against bashing other people because they are not one.

[Ace844]

It might be poorly written but I can use the word weather in its proper context. Some stated earlier that I was EMT dissatisfied with my position as an EMT, so I knocked paramedics that's untrue. Where I work the pay difference is not abundant enough for me to become a paramedic. I have other financial responsibilities at this time. I was just stating that I am not against paramedics I am against bashing other people because they are not one.

This has anything to do with the topic how?????

ACE