the 100% directionless thread

[Jim37F]

Just had my first Full Arrest. Pt down for approximately 10 min prior to our arrival, no bystander CPR , immediately started compressions, Pt was in V-Fib, got one shock, was otherwise in Asystole pretty much the whole time.

Continued CPR and ACLS for 20 min. Medics pushed 2 rounds of Epi, and a round of Atropine (base contact orders) although I was a bit too busy with compressions to tell you what all was/wasn't pushed. Medics made one attempt at intubation, then went straight for a King Airway (placement confirmed with EtCO2 and lung and gastric sounds), compressions were not interrupted for airway attempts.

But at 20 min of Asystole and no other responses they called base to pronounce. We just got off the phone with the doctor who DID pronounce, stopped CPR, and all of a sudden, there's a pulse on the monitor. Well then.

Code 3 to the hospital, no crash, no compressions enroute, maybe 5-10min drive to hospital with a full cardiac cath lab. By the time we got there, sustained palpable femoral pulse and a blood pressure. (It was like 70/40 on NIBP) Still alive when we finished deconing and cleared the hospital.

I'll try to follow up next shift day after tomorrow, but last word I had was that he was alive with a better BP lol. Now I just need to figure out what flavor ice cream everyone at the station likes haha

(Edited: Originally posted via phone, edited on laptop for readability)

 

[Chewy20]

That's an awesome call, looking forward to the update!

 

[Jon]

Just had my first Full Arrest.

...there's a pulse on the monitor. Well then...

2 Comments:
First - Whats a "Full Arrest" - Is there such a thing as a partial arrest?
Second - The monitor doesn't show a PULSE, it shows electrical activity. Pulse is something you can only sense.

 

[DesertMedic66]

2 Comments:
First - Whats a "Full Arrest" - Is there such a thing as a partial arrest?
Second - The monitor doesn't show a PULSE, it shows electrical activity. Pulse is something you can only sense.

If you want to nitpick things, respiratory arrest could be a partial arrest whereas cardiac arrest includes respiratory arrest

 

[STXmedic]

Jon, weren't you just talking about how rusty your ban hammer was? :lol:

 

[Rin]

Ugh... I sent them CEs, money, my refresher cert, copies of all my cards, and it was received before March 31... I will call them tomorrow I guess

Same here. I believe I read somewhere on the NREMT site that if you need your cert as a condition of your employment, you should send it in two weeks ahead of time. I took that to mean that they may need two weeks to process the paperwork. Everything else says mail by March 31 and you're good.

Also if you have all your requirements met by the deadline, but don't turn your application in on time, you're supposed to be able to reinstate your cert for a $50 fee. I think that's only an option if you're expired less than a month though.

 

[Handsome Robb]

So this new part time job I have acquired is superior to my full time job in every way... Except pay.

The equipment is better, the trucks, nice stations, no system status, and awesome education opportunities. I'm so torn as what to do. I do not think I could afford a 3 dollar an hour pay cut :-/

What about full time at the new one and PRN at the old one? It's a pay cut and you'd be working more hours for the same pay but what's happiness worth? 3 dollars an hour is a huge cut though, around 10k a year, depending on how the schedules work. If you're on 24s and they're doing it as a 56 hour work week you'd probably make close to the same if not more.

Example:
20/hr on a 48 hour work week
40hrsx20=800 base
20x1.5=30 for OT rate
30x8=240 built in OT
800+240=1040/week
1040x52 weeks in a year = $54,080/year

17/hr on 56 hour work week, 24s on a rotating schedule A, B, C shift
40x17=680
17x1.5=25.50
25.5x16=408
680+408=1088/week
1088x52= $56,576/year

Just had my first Full Arrest. Pt down for approximately 10 min prior to our arrival, no bystander CPR , immediately started compressions, Pt was in V-Fib, got one shock, was otherwise in Asystole pretty much the whole time.

Continued CPR and ACLS for 20 min. Medics pushed 2 rounds of Epi, and a round of Atropine (base contact orders) although I was a bit too busy with compressions to tell you what all was/wasn't pushed. Medics made one attempt at intubation, then went straight for a King Airway (placement confirmed with EtCO2 and lung and gastric sounds), compressions were not interrupted for airway attempts.

But at 20 min of Asystole and no other responses they called base to pronounce. We just got off the phone with the doctor who DID pronounce, stopped CPR, and all of a sudden, there's a pulse on the monitor. Well then.

Code 3 to the hospital, no crash, no compressions enroute, maybe 5-10min drive to hospital with a full cardiac cath lab. By the time we got there, sustained palpable femoral pulse and a blood pressure. (It was like 70/40 on NIBP) Still alive when we finished deconing and cleared the hospital.

I'll try to follow up next shift day after tomorrow, but last word I had was that he was alive with a better BP lol. Now I just need to figure out what flavor ice cream everyone at the station likes haha

(Edited: Originally posted via phone, edited on laptop for readability)

That's an interesting one. I was wondering if with the new emphasis on short peri-shock and pre-shock pauses is causing patients with a bradycardic perfusing rhythm to get an extra round or two of CPR before the rate speeds up enough to be detected in the short pauses or in this case when efforts are terminated. More and more agencies are starting to look at and record peri-shock and pre-shock pauses, along with other parameters like average compression rate and depth, and give the crews feedback on those specific parameters. In the second episode of Code STEMI, Wake County the arrest they're talking about had an average of 3.5 second peri-shock pauses and I want to say 5 second pre-shock pauses and they were saying that's about what the goal is.

If you want to nitpick things, respiratory arrest could be a partial arrest whereas cardiac arrest includes respiratory arrest

I was thinking the same thing. not a huge fan of full arrest and I've never heard of someone calling a respiratory arrest a 'partial arrest' but if you really wanted to get technical you could argue that point. respiratory collapse vs. respiratory and circulatory collapse.

 

[exodus]

Annnnnd, we're moving on sunday. Yay for gated communities and HOA's.

 

[Aprz]

Argh, I hate it when I try to do something, and I almost always perfectly screw up another plan. I usually do NOTHING Friday afternoons, and managed to volunteer myself for something at 10 am, and then remembered that there is another thing that goes from 9 am - 11 am that I have to do. 24 hours in why day, why did the two things have to happen at the same time? <_<

Thankfully the thing that happens from 9 am - 11 am I can do again on another date, but I hope they aren't mad that I got to reschedule one day prior.

 

[TransportJockey]

Argh, I hate it when I try to do something, and I almost always perfectly screw up another plan. I usually do NOTHING Friday afternoons, and managed to volunteer myself for something at 10 am, and then remembered that there is another thing that goes from 9 am - 11 am that I have to do. 24 hours in why day, why did the two things have to happen at the same time? <_<

Thankfully the thing that happens from 9 am - 11 am I can do again on another date, but I hope they aren't mad that I got to reschedule one day prior.

I know that feeling... I'm scheduled to report to my new job on April 14th... My last day of work is April 13th... from 1900-0700 on the 14th. Now to figure out what to do.

 

[Chewy20]

IED supposedly confirmed right outside FT. HOOD in Killeen.

 

[MrJones]

IED supposedly confirmed right outside FT. HOOD in Killeen.

How 'bout getting back with us when you can make that statement without the word 'supposedly'. Spreading rumors, theories and suppositions hurts more than it helps.

 

[Chewy20]

Only put supposedly because I had not looked into it myself. Got a text from a buddy on base.

It was a confirmed IED and they did a controlled detonation of the device.

 

[Tigger]

It appears to be spring in Colorado.

 

[MrJones]

Only put supposedly because I had not looked into it myself. Got a text from a buddy on base.

It was a confirmed IED and they did a controlled detonation of the device.

Actually, they did a controlled detonation of something that turned out to not be an IED

Suspicious device found on truck in Killeen neighborhood turns out to be fake. Killeen PD confirms that the threat was a hoax. The device was not a real explosive.

source

 

[Carlos Danger]

It appears to be spring in Colorado.

Spring looks a little different here in SC.

 

[TransportJockey]

We had snow for a bit yesterday

 

[Handsome Robb]

Still haven't heard about the dog...and my better half hasn't talked to me in two days...

Surgery on wednesday, ready to be done with this :censored::censored::censored::censored:. Not stoked to be stuck one handed again.

 

[TransportJockey]

Ugh Registry taking forever is not making me happy. I need that registry card asap so Texas can finish processing my application and my new job won't let me start till I have registry on hand

 

[NomadicMedic]

I took a whole tour off. Sooooo nice to have a full week of no paramedic BS.

...aside from this place.