Local Protocals... Do You Ever Break Them?

[THE_DITCH_DOCTOR]

Sorry USAF, I was never the diplomat

Your name wouldn't happen to be John Bolton would it? :wink:

[cchief66]

The problem with breaking or bending protocols is, that when it works you cant tell any one, when it goes wrong even if you have done the same thing a hundred times they will hang you. Someone will document that you broke protocol. Although some are just stupid for instance I was reprimanded for giving a pt a bottle of water to drink after we were in transit. I guess that some where it says that "when transporting a pt you are to give them no oral intake but if the person has their own fluid you shall / cannot prevent them from ingesting said fluid" :?

[tinman694]

no, its amonkey skill, a trained monkey could essentially do it(not literally)

Guess that is why they made us do our advanced airway rotations for medic school at the animal clinic rather than at the hospital...

[MedicShannon]

Did you guys hear about the two medics in FL (I think) that arrived on an MVA and the Fire Dept was performing CPR on a full term OB and they decided to perform a C-Section on scene.....YIKES

They saved the mother but the newborn died.

Mother died, was dead when they got there... baby survived... medic lost license for practicing outside his scope... not just his protocols... can understand why, but I don't recall c-sections in medic school.

[Asysin2leads]

I found the original text on what Shannon was talking about. Here it is if anyone is interested.

N.J. Paramedics Face Inquiry Over Emergency C-Section

By DAVID W. CHEN

9/27/97 The New York Times

New Jersey health officials are investigating the actions of two paramedics

who performed an emergency Caesarean section on Thursday to deliver the baby of a woman in North Bergen who was in cardiac arrest and could not be revived.

The paramedics acted while consulting by radio with emergency room doctors at Jersey City Medical Center, officials said, but state health regulations forbid paramedics to perform surgical operations. The emergency workers said they believed the procedure was their only hope of saving the baby.

The full-term baby girl survived but is in critical condition; the mother,

who was 37, died.

The two paramedics were placed on desk duty, with pay, pending the outcome of the state investigation, which officials said should be completed next week.

"This was so unusual," said Dr. Leah Ziskin, the deputy commissioner of the state's Department of Health and Senior Services. "Our review is not

complete."

But to hospital and volunteer officials, the only thing clear was that the

two paramedics were heroes, in spite of the rules.

"These two people, a man and a woman, they've gone through probably the most traumatic situation of their professional career, so light duty is more than appropriate," said Bill Dauster, a spokesman for Jersey City Medical Center. "We probably didn't need the state to tell us to do that."

The events, according to spokesmen from the Jersey City Medical Center and the North Bergen Volunteer First Aid Squad, unfolded as follows:

At 5:30 a.m. Thursday, the North Bergen squad received a 911 call from

someone in a residential neighborhood in the uptown section of North Bergen, saying that a woman was not breathing. Two volunteers, who were on the midnight-to-7 a.m. shift, arrived a few minutes later, finding the woman in cardiac arrest, with no heartbeat and no sign of breathing. They tried to revive her, said Mary Ellen Cleveland, the president of the first aid squad.

A few minutes later, two paramedics from the staff of Jersey City Medical

Center arrived at a house in the neighborhood from their base in Weehawken. The woman had still not been resuscitated; the baby was lodged in the birth canal.

"They made a determination that she was dead," Dauster said. "And then they said, 'Oh my God, we have to do this."'

In a telephone consultation with doctors at Jersey City Medical Center, the

paramedics and the doctors made a "joint decision" to try a Caesarean

section, he said. The two paramedics, both of whom were described by Dausteras seasoned, delivered the baby just after 6 a.m.

The baby had no pulse at birth but was revived by the paramedics.

Another ambulance from West New York then came to assist, and the woman and the baby were taken separately to Palisades Medical Center in North Bergen. The woman was pronounced dead at the hospital. The baby was later taken to Jersey City Medical Center.

Officials said they had not yet determined what caused the woman's heart

attack.

Friday, a woman who answered the phone at Palisades Medical Center said the hospital had no comment on the incident. Dauster and Ms. Cleveland declined to give the names of the family, the paramedics or the volunteer emergency medical technicians from the North Bergen squad.

It was the first time anyone at Jersey City Medical Center could recall

such a case, Dauster said. But he added that everyone was proud of the

paramedics.

"What they did was step over what regulators have outlined for them into

the moral arena," he said. "Most people are going to view this as an act of

heroic endeavor; that's how we're viewing it."

The baby, he added, was named Davida by the nurses at Jersey City Medical

Center. She weighed about 10 pounds.

[Ridryder 911]

Actually, there have been several cases of where mother was in full arrest & emergency C-section was performed. I am glad it was successful, it took large gonads to do so. If the outcome was not as bright, we might be reading a different report.

This does remind of a call where a Paramedic called to do a C-section on a traumatic arrest.. after lengthy debate.. & unable to detect fetal heart tones.. was denied... fortunately.. the woman was NOT pregnant, just obese....oops!

Be safe,

Ridryder 911

[EMT9903]

You know, i would like to believe that for most of us that saving someones life would be more important than some piece of paper. as an 18D in the military, (Special Forces Medical Sergent). I learned how to do simple surgical procedure, and other skill that a paramedic could never perform in a hundred years. If it came down to saving a life especially that of a child, i would have to say that that child is more important that this piece of paper in my back pocket.