What is a code sucess outcome?????????

[Chrisclark]

Some people really need that period of goodbye.

[akflightmedic]

Some people really need that period of goodbye.

How do you know?

You can only validate that statement by putting them in an exactly similar situation and comparing the two which is vitrually impossible to do as we feel and react differently to the dead person depending on what relationship we had with them.

Prolonging their agony and giving false hope does nothing to help them begin the grieving process. It is only when they know the end has come that they start to cope. Delaying the inevitable does nothing for them.

I am speaking strictly about the familiy emotional side. If you want to jump on the logical side, is giving them false hope and delaying the inevitable worth wasting numerous personel resources, endangering other people that are not dead during a rapid drive to the ER, tying up a bed in the ER and again wasting resources, and giving the family a final bill to settle all so they could have extra time?

You would be surprised what an average human can cope with, especially when not given an option.

However, I bet you would be surprised if on the scene of a futile cardiac arrest you asked the family what they thought. Give them full disclosure. Tell them, he is dead but I will go ahead and work him just to give you time to accept all of this. See what they say then.

[Chrisclark]

^ I was not talking about your case. In general, it helps some people cope. It is kind of like how all of my grandparents are crazy about veiwings at funerals. Personaly, I dont want to look at wax faces, it is freaky to me, not comforting. But some people need that.

Honestly, I am an organ donor. If I am brain dead. Keep me alive and use my organs. Organs can only last about 24 hours after the heart stops beating. If ROSC can be acheived, won't the organs last longer?

[aussiephil]

This sounds like another excuse really chris. Sorry. EMS on scene have to make a call, & unless u have ORGAN DONER tattooed on yr forhead, how the hell would we know?????????? Sounds like more avoidance to me. We better work it, just in case they r an organ doner?????

Come on, I was taught to provide dignity to all patients, alive or dead, and sometimes that is better served by calling the case on scene & providing support to the family.

Phil

[Dustdevil]

Come on, I was taught to provide dignity to all patients, alive or dead, and sometimes that is better served by calling the case on scene & providing support to the family.

Dignity is a lot to ask from a medic in America.

For the most part, you are talking about people who don't even have any self-respect.

[aussiephil]

Dignity is a lot to ask from a medic in America.

For the most part, you are talking about people who don't even have any self-respect.

Or do they feel that they need to be overly self serving & trying to impress others by overstating their 'sucesses' to try to increase their standing n the eyes of ther peers?

[dzmohr]

The only codes that I consider success are the ones who walk out of the hospital. Those that I get to the ER witha pulse but still die are not successful codes - they are dead dead dead.

I had one lady who arrested in our ambulance, 2 shocks later , cpr and meds in the er and then flown to a cardiac center and she went home a week later. That in my book is a success.

Ventillator dependent vegetable is not a success.

So many contradictory thoughts on this in my OWN mind! I agree 100% with Ruffems and others who have posted this line....however, I am working with a family in Indiana now who's 16 year old son experienced SCA while playing a High School basketball game 3 weeks ago. An AED was used, they got pulses and respirations back. He lived in CCU 11 days, last 5 on a vent. The Father called me and said he and his family were so grateful for those 11 days. They felt ( rightly or wrongly, it is not relevant which) that even though he was not conscious he was aware of his family being there with him. HE viewed the AED as resulting in a "save" and wanted to raise money to provide AEDs to the other schools that did not have them in the County.

I had a young teen who had rigor in his fingers and was long flatline, we could have, and I normally would have, called the code at the scene, I do NOT believe on giving the family false hopes. But in THIS case in THESE circumstances because of how his Father was responding to his death ( there is a "rest of the story" but now is not the time) I worked the kid, had Dad hold the IV bag to "help" see if we could "get him back" but told him it was a long shot at BEST... I got a 17 page letter from the guy and his wife saying that the Father knew he "had killed" his son, and he could not have lived with that had it been "too late" when we arrived...that he had considered suicide but the fact that he had been able to "help try" to get him back ( by being a human IV pole) made him change his mind.... on the other hand I have seen TOO many times the anguish of parents that had accepted the SIDS death when police or somebody overruled my decision not to resuscitate and transported "for the family" ... they were fine with the fact that it was SIDS and if it happened in the ER nobody could have saved the child, only to be given false hope and have it dashed AGAIN!

I don't know that there IS a correct answer for this ... to me "saving" a brain dead former person is the polar opposite of a "save". Short term" saves" go both ways, depending on the circumstances and family needs... everybody wants a neurologically intact walk out of the hospital save BUT....

The bottom line is we can only do our best with what we have to work with. EVERY ONE of them is going to die ( but then so are WE) eventually. In fact, every one we code HAS died, and ,as so many have observed in other threads, you can not get deader then dead... but with a little skill and a LOT of good fortune we can revive some that have died. To what extent is usually TOTALLY out of our control, we just have to use our heads, hands and hearts to the best of our abilities!

An interesting aside ... one large city that was touting itself as "safest place in the world to have a heart attack" reportedly was considering ANY change in rhythm to be a save ( VF to Asystole ..hmm) Don't know if that is true or not, never bothered to check, but their save rates were SO much higher then anywhere else and later dropped back to the real world..( but has in recent weeks been reported at 48% survive to discharge!!) One would hope the do not count those discharged to the medical examiner ( I kid the City, they really DO have a great EMS system, please don't be mad at me if you are from there!)