Paramedics - A heart attack...

[vs-eh?]

Has this been posted here before?

I know it is likely 10+ years old and I know there are numerous "points of concern" people may have with this video.

My question is this...

Was it/is it a normal procedure to give a POST ARREST patient SL nitro prehospital? Regardless of presentation/vitals/whatever?

I know...there are a lot of things that are "wrong" with this video...

[mediccjh]

First off, as you said, 10 years ago. ACLS has changed how many times since then?

He still having CP? Maybe it was before they put ASA on the trucks in Nashville.

And why are we discussing a video from 10 years ago???!!!

[vs-eh?]

He still having CP? Maybe it was before they put ASA on the trucks in Nashville.

Dude, think about that for one second....

This is a post-cardiac arrest pre-hospital...

You would feel comfortable administering NTG to a patient given this scenerio (regardless of "vitals") that is post CPR and defib in your care....they are experiencing "chest pain"?

THEY ARE? NO WAY...

Maybe it's just me...

[Ridryder 911]

It is not unusual to still administer NTG post arrest. Coronary arteries are still occluded and ischemia can still occur. Of course now, we would rule out the possibility of inferior wall involvement. I still see it used on post arrest until cathed or those that are not eligible to be fibro or cathed.

Actually, I do not see any major "problems" with this video rather I see poor editing. Editing can be seen from the oxygen mask then BVM then back to oxygen mask which can be misleading. I have been on Paramedics and other similar shows, which can paint a poor presentation. ASA might have been given, but not displayed such as the I.V. and possible other med.'s

R/r 911

[chbare]

I am with Ridryder911. No major problems with what I saw. Could have had him on the monitor a little sooner. I am not sure they had the ability to do 12 lead ECG's.

Take care,

chbare.

[mediccjh]

It is not unusual to still administer NTG post arrest. Coronary arteries are still occluded and ischemia can still occur. Of course now, we would rule out the possibility of inferior wall involvement. I still see it used on post arrest until cathed or those that are not eligible to be fibro or cathed.

Actually, I do not see any major "problems" with this video rather I see poor editing. Editing can be seen from the oxygen mask then BVM then back to oxygen mask which can be misleading. I have been on Paramedics and other similar shows, which can paint a poor presentation. ASA might have been given, but not displayed such as the I.V. and possible other med.'s

R/r 911

Thank you bro!!

Which goes back to my original question...vs, why are you bugging on a video made 10 years ago? If you're that bored, I'm sure there are other things you can look at on the Internet. Like porn.

[DwayneEMTP]

From the peanut gallery...

What makes this older video less interesting then one made yesterday? The nitro question was still valid and interesting.

I thought they might as well have not bothered with the compressions...they were so shallow as to be useless...might as well have spent time on something else...

Just picking at it for the sake of argument...waiting to run scenarios... :wink:

Have a great day all....

Dwayne

[Ridryder 911]

The main point I guess we have to concur is; whatever they did.. worked. The patient went into an arrest and then was successfully resuscitated. I have to admit, Murphy's law would had never allowed such on my shift.. especially being filmed for coverage.

I have never heard or even thought of any contraindications regarding NTG in post-arrest. What makes the difference? If the hemodynamics are stable enough and if they do not present an inferior wall (which in itself is a debatable topic) then why not give NTG ? Especially if the indicator might had been caused by coronary spasm, occlusion or obstruction.

I have routinely have placed patients on NTG drips post AMI. Still contiunously do, especially those that do not meet fibro requirements or unable to be cath. Yes, there are now alternatives (in -hospital) but very few services still have any other choices.

Again, we are only able to see a "snippet" of what treatment occurred. They might had bolus the patient with Lido as well. Which is now controversial and was not then.

Again, I wished I would have such results....

R/r 911

[CBEMT]

The medic outright says his post-arrest BP was 160/100. It ain't like they were holding onto his pulse with their fingernails.

Some of the people commenting at the YouTube page seriously need to get a grip.

[Dustdevil]

Chest pain after having CPR done on you?

Who'd a thunk it? :roll:

Nitro ain't a gonna cure that!