Asysin2leads Posted June 9, 2006 Share Posted June 9, 2006 You think that's bad, try combining the arrogance, competitveness, and infalliability held over from the medical profession combined with the paramilitary mindset held over from a large scale fire department for some laughs. We didn't kill the patient. We saved the patient. Now stop asking questions. Link to comment Share on other sites More sharing options...
Ridryder 911 Posted June 9, 2006 Share Posted June 9, 2006 Good example, was called to ER .. medics was about to explode. Crew brought "respiratory arrest" in. The usual yadda.. yadda... good lung sounds, no abdominal distention, excellent wave forms on the Et C02 monitor with good levels for a bad patient. Crew prints out strip as per new protocol just before moving patient. ER physician looks at patient, listens says " sounds great".. makes about 10 steps.. stops and says "We need to re-intubate, that is in the belly".. WTF ? Crews reemphasize that there was good wave form, good lung sounds.. etc.. he then attempts to reintubate, and takes > 20 minutes, meanwhile patient codes and patient dies. Had to go diffuse the situation... We requesting the medics write a formal complaint and incidence, as well as we will show proper documentation of proper ET placement. Wonder if these type of incidences ever make the journal?..... R/r 911 Link to comment Share on other sites More sharing options...
chbare Posted June 9, 2006 Share Posted June 9, 2006 Ridryder 911, :shock: WTF :?:. With a printed out strip of the wave form and good Et CO2 values? Take care, chbare. Link to comment Share on other sites More sharing options...
Ridryder 911 Posted June 9, 2006 Share Posted June 9, 2006 Yeah, bad situation. Very experienced ER Doc; however, I think he just wanted to practice. Although, each of 20 ER Cardiac rooms has EtCo2 (even with sideline) most of the Doc's are not real familiar with waveform interpretation. I do believe after this event they will be. :wink: Will see how much caa....caaa will proceed after this. No one is blaming the medics or making such reference. In fact it has now been one of those hushed things..... R/r 911 Link to comment Share on other sites More sharing options...
Punisher Posted June 9, 2006 Share Posted June 9, 2006 Good example, was called to ER .. medics was about to explode. Crew brought "respiratory arrest" in. The usual yadda.. yadda... good lung sounds, no abdominal distention, excellent wave forms on the Et C02 monitor with good levels for a bad patient. Crew prints out strip as per new protocol just before moving patient. ER physician looks at patient, listens says " sounds great".. makes about 10 steps.. stops and says "We need to re-intubate, that is in the belly".. WTF ? Crews reemphasize that there was good wave form, good lung sounds.. etc.. he then attempts to reintubate, and takes > 20 minutes, meanwhile patient codes and patient dies. Had to go diffuse the situation... We requesting the medics write a formal complaint and incidence, as well as we will show proper documentation of proper ET placement. Wonder if these type of incidences ever make the journal?..... R/r 911 Want to write it up Rid? I'd be happy to help. PM me if you're interested. Link to comment Share on other sites More sharing options...
Ace844 Posted June 21, 2006 Share Posted June 21, 2006 (Haemodynamics of cardiac arrest and resuscitation. Cardiopulmonary resuscitation Current Opinion in Critical Care. 12(3):198-203 @ June 2006. Andreka, Peter a; Frenneaux, Michael P Abstract: Purpose of review: This review will summarize the available data regarding the haemodynamic changes occurring following cardiac arrest in humans and animal models. Recent findings: Following cardiac arrest due to ventricular fibrillation without cardiopulmonary resuscitation, blood flow exponentially falls but continues for approximately 5 min until the pressure gradient between the aorta and the right heart is completely dissipated. During cardiopulmonary resuscitation forward flow occurs into the aorta during the compression phase. Coronary blood flow is retrograde during the compression phase and antegrade during the decompression phase. Carotid blood flow takes over a minute to reach plateau levels following the initiation of chest compressions, and even brief interruptions of compressions result in a dramatic reduction in carotid blood flow which takes a minute or so to recover to plateau levels when compressions are reinstituted. Coronary perfusion pressure during the release phase of cardiopulmonary resuscitation has been shown to be a powerful predictor of the likelihood of recovery of spontaneous circulation following restoration of electrical activity. Summary: Recent studies have provided important insights into the haemodynamics of cardiac arrest and of cardiopulmonary resuscitation which may inform more effective strategies for the management of cardiac arrest in the future. Link to comment Share on other sites More sharing options...
Ace844 Posted June 21, 2006 Share Posted June 21, 2006 (doi:10.1016/j.resuscitation.2005.11.016 Copyright © 2005 Elsevier Ireland Ltd All rights reserved. Clinical paper A meta-analysis of cardiopulmonary resuscitation with and without the administration of thrombolytic agents Xin Lia @ Qing-ling Fub, Xiao-li Jinga, Yu-jie Lia, Hong Zhana, Zhong-fu Maa and Xiao-xing Liaoa, , aDepartment of Emergency, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong 510080, PR China bDepartment of Anatomy, The University of Hong Kong, 21 Sassoon Road, Hong Kong, PR China Received 18 March 2005; revised 21 November 2005; accepted 26 November 2005. Available online 9 June 2006.) Summary Objective To pool data on the role of thrombolytic agents in cardiopulmonary resuscitation (CPR) and evaluate the efficacy and safety of thrombolysis. Materials and methods The clinical studies in MEDLINE database from 1966 to August 2004 that studied the efficacy and safety in CPR with and without treatment with thrombolytic agents were assessed by a meta-analysis performed to evaluate the effect of the treatment. Results A total of eight papers evaluating the effect of thrombolysis in CPR were identified. This meta-analysis showed that thrombolytic agents significantly improved the rate of return of spontaneous circulation, 24 h survival rate, survival to discharge and long-term neurological function in patients treated with CPR (p < 0.01). However, the patients receiving thrombolysis had a risk of severe bleeding (p < 0.01). Conclusion Thrombolytic agents during CPR can improve the survival rate to discharge and neurological. Link to comment Share on other sites More sharing options...
Ace844 Posted June 21, 2006 Share Posted June 21, 2006 (doi:10.1016/j.resuscitation.2005.11.016 Copyright © 2005 Elsevier Ireland Ltd All rights reserved. Clinical paper A meta-analysis of cardiopulmonary resuscitation with and without the administration of thrombolytic agents Xin Lia @ Qing-ling Fub, Xiao-li Jinga, Yu-jie Lia, Hong Zhana, Zhong-fu Maa and Xiao-xing Liaoa, , aDepartment of Emergency, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong 510080, PR China bDepartment of Anatomy, The University of Hong Kong, 21 Sassoon Road, Hong Kong, PR China Received 18 March 2005; revised 21 November 2005; accepted 26 November 2005. Available online 9 June 2006.) Summary Objective To pool data on the role of thrombolytic agents in cardiopulmonary resuscitation (CPR) and evaluate the efficacy and safety of thrombolysis. Materials and methods The clinical studies in MEDLINE database from 1966 to August 2004 that studied the efficacy and safety in CPR with and without treatment with thrombolytic agents were assessed by a meta-analysis performed to evaluate the effect of the treatment. Results A total of eight papers evaluating the effect of thrombolysis in CPR were identified. This meta-analysis showed that thrombolytic agents significantly improved the rate of return of spontaneous circulation, 24 h survival rate, survival to discharge and long-term neurological function in patients treated with CPR (p < 0.01). However, the patients receiving thrombolysis had a risk of severe bleeding (p < 0.01). Conclusion Thrombolytic agents during CPR can improve the survival rate to discharge and neurological. Link to comment Share on other sites More sharing options...
AZCEP Posted June 24, 2006 Share Posted June 24, 2006 I could be wrong, but aren't fibrinolytics contraindicated for patients that have had prolonged CPR performed? How exactly this is supposed to help the treatment of a progressive problem, like say, asthma or hypovolemia, I'd like to know. I'm willing to try anything once, but this one just doesn't make too much sense to me. :oops: Link to comment Share on other sites More sharing options...
Ace844 Posted June 24, 2006 Share Posted June 24, 2006 I could be wrong, but aren't fibrinolytics contraindicated for patients that have had prolonged CPR performed? How exactly this is supposed to help the treatment of a progressive problem, like say, asthma or hypovolemia, I'd like to know. I'm willing to try anything once, but this one just doesn't make too much sense to me. :oops: "AZcep," I'd like to point out the following things for you about this studyt which may change your perspective abit on this. Also, yes, prolonged CPR is a contraindication to thrombolysis... 1.) It was done in China, and often the rest of the world does things differently and in soem places in Europe and elsewhere they use thrombolyitics in Cardiac Arrest. 2.) The study was merely, a 'Meta-Analysis' using medline, and not an original and or un-biased evidence based study. Hope this helps, ACE844 Link to comment Share on other sites More sharing options...
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