Full Arrest

[DBieniek]

When you say nurses, do you mean RNs? If this is the case, WHY were there no advanced interventions taking place BEFORE you arrived on scene?

I also noticed that in your original post it stated that they requested an ALS response, when did they show up?

 

[KEVD18]

When you say nurses, do you mean RNs? If this is the case, WHY were there no advanced interventions taking place BEFORE you arrived on scene?

I also noticed that in your original post it stated that they requested an ALS response, when did they show up?

simple: not all nurses are acls prepared. some(most) nurses only hold a bcls card

 

[Jeremy89]

Having worked in a nursing home, I can tell you nurses are VERY ill prepared for these types of emergencies. Most are just LPN's with 1 Charge RN and they are all CPR certified (even Nurse Asst's are required to be). I have never seen an arrest in my 14 mo's there, but there have been many transports to the hospital.

 

[VentMedic]

Vent, I may have read it wrong but their post gave me the impression that they had absolutely no medical training (no cpr/first aid, etc). I'm talking about the people who would stare at you if you asked them to grab the BVM.

:lol:
That would be a very strange land for me since the FFs in many regions of Florida have EMT-P somewhere in their history even if they are retired to a nice engine in the suburbs.

 

[FFPARAMEDIC08]

I see what he means, but in general firefighters are required to have some level of medical experience and/or certification.

In the future the OP should specifiy

 

[hitechredneckemt]

Rid I agree with you to some extent about needing ALS. But if nursing staff cant do good CPR then it makes Pt. care even harder for the best of squad crews. I cant stand nurses that believe they are better than EMS. At my company we call all emergencies at nursing homes rescues because the staff knows nothing about emergency care. It sounds to me like that crew responded to a bad call that just got worse.

 

[Ridryder911]

I understand, but remember nurses are NOT taught on how to handle emergencies. Again, nursing core curriculum DOES NOT TEACH CRITICAL CARE or EMERGENCIES ! This is why, I do not understand so many that want to run to nursing school, when in real life in comparison emergency and critical care areas, are considered in the same opinion as we do for nursing home nurses. No where in the curriculum do they describe "running a cardiac arrest". That is why they call EMS. Realistically, how many long term type nurses have ACLS or even should have ACLS? People are usually in a nursing home for a reason.

It is the job of the EMS (paid or volunteer) to know what they are doing, albeit in a nursing home or if this call was at a residential area. The same outcome would had occurred, maybe even worse, since there was at least some other to assist.

Sorry, no excuses. Get your feces together and do what is right for the patient, the system and the profession.

R/r 911

 

[mikeylikesit]

"full cardiac arrests" thats what the dispachers say around here what do you call it?

Around here we call it "F@#K i just made this sandwich".

 

[piranah]

here its code 99

 

[DBieniek]

Here, we use either "Code 99" or "10-99" when describing a cardiac or respiratory arrest.

 

[Medstudent1983]

Here We Call 911

 

[wolfie23b]

ok the pt was getting air regardless if it is abd or not. and I have seen and can verify that copious amounts of vomitus can spew from said victim depending on how much they had eaten, or drank. Here at where I work in Oklahoma if I went to the scene like that with just me (the Basic), a FF, and a "Used" to be emt, well I would've already had the bird on standby just in case or found a Mutual Aid Paramedic service, grab and go.
Remeber time is muscle.

 

[firemedic7982]

Here at where I work in Oklahoma if I went to the scene like that with just me (the Basic), a FF, and a "Used" to be emt, well I would've already had the bird on standby just in case or found a Mutual Aid Paramedic service, grab and go.
Remeber time is muscle.

A Couple things Im curious about.

I work for several large 911 agencies, and am affiliated with a large air medical provider. None of the Air medical providers that I know of will transport an active arrest. If the pt arrests in the air, thats a different story, but don't know of one that will transport one that started on the ground.

The second thing is the time is muscle comment. In the case of the BLS code... Time is NOT muscle ... AIR is LIFE. If you are in a "BLS Only" situation, and are a transport unit, the odds are stacked against you to begin with. Bag the best you can, do compressions, defribulate if nessessary, utilize your protocols to their full extent, and transport to the closest appropriate facility. Dont wait for ALS to arrive (unless they are like around the corner) scoop and go. Haull butt to the hospital How much time are you wasting on scene working a BLS arrest waiting on someone to come help.

Ive only worked 1 BLS only arrest once in my career the rest have all been ALS, it's not ideal circumstance. But given that death was probably not on the pt's daily agenda either,you just have to work with what you have.


~All the Best !~

 

[firemedic7982]

Vent, I may have read it wrong but their post gave me the impression that they had absolutely no medical training (no cpr/first aid, etc). I'm talking about the people who would stare at you if you asked them to grab the BVM.

Kev, that holds very true around here. Everyone seems far more concerned with numbers than actual patient care.

Wolf, if they have no medical training they may not understand what exactly you are asking for. Besides, typically you should have what you need BEFORE entering the scene.

Firefighters have their place in emergency services, without a doubt. However, unless they are certified MFR's I do not feel they belong on an ambulance - just as I, acting in the capacity of an EMT-B, do not belong inside of a fire. My point being that if I need help lifting a patient I will call another ambulance staffed with emergency medical personnel who are trained on the proper techniques of moving patients.

Please note that this does not cover those fireman who do have medical training. This is mainly directed towards your second-day volly with absolutely no experience who decides to jump on the ambulance to feel like they are part of the call. In reality, these people clutter up scenes and get in the way of emergency personnel.

Sorry , Im just in a mood.

Firefighters are NEVER useless. Almost all of them are willing to help. In the land that you live in, all of your calls might go perfectly, but Ive yet to see an arrest (in ten years) that hasnt required SOMETHING extra out of the truck. Bad code? What if your giving your second round of AMIO, and the medication is comprimised in some way? what do you do ? Ooops oh well, we just wont give that drug, that way we dont have to go out to the truck. Send the Fireman out there to get it. They follow instructions really well.

As to the comment about "In reality, these people clutter up scenes and get in the way of emergency personnel". Theyre not emergency personnell? What are they then? They clutter up scenes? I bet you never had a cluster of a scne before have you?

"My point being that if I need help lifting a patient I will call another ambulance staffed with emergency medical personnel who are trained on the proper techniques of moving patients." .... WOW, you are going to take a second ambulance out of service to help you lift a pt? Really? Seriously? The ratio of ambulances to fire trucks leans WAAAY in the fire truck favor. So go ahead, and put a strain on the ems system thats already overloaded. Instead of using a fire truck that has morethan likely ran a few less calls that shift than the ambulance. Good thinkin there ace.

Lastly... If they have no training... train them. HELP them, show them how to do CPR, show them the ambulance and where common stuff is located. You were untrained at one time, someone had to take the time to train you. You had to do student time on the truck when you didnt know anythiing. I bet you werent a pain in the butt either.


Bad attitudes here.

********The above rants were nothing more than my personal opinion against the words expressed herein this web post. Not an attack against any individual who may or may not be knownst to me **********

 

[KEVD18]

....defribulate.....

sorry but that was actually physically painful to read.

 

[firemedic7982]

sorry. i got on a rant,

 

[BEorP]

sorry but that was actually physically painful to read.

I died a bit inside when I read it.

 

[BEorP]

The second thing is the time is muscle comment. In the case of the BLS code... Time is NOT muscle ... AIR is LIFE. If you are in a "BLS Only" situation, and are a transport unit, the odds are stacked against you to begin with. Bag the best you can, do compressions, defribulate if nessessary, utilize your protocols to their full extent, and transport to the closest appropriate facility. Dont wait for ALS to arrive (unless they are like around the corner) scoop and go. Haull butt to the hospital How much time are you wasting on scene working a BLS arrest waiting on someone to come help.

So how much more likely is a patient to live when they get ALS rather than BLS treatment for their cardiac arrest?

 

[KEVD18]

So how much more likely is a patient to live when they get ALS rather than BLS treatment for their cardiac arrest?

the odds are better with early advanced care but even then, the overall stats for cardiac arrest are rather dismal. R/r can quote them from memory.

 

[Jon]

the odds are better with early advanced care but even then, the overall stats for cardiac arrest are rather dismal. R/r can quote them from memory.

Well... they need BLS-level care ASAP... and ALS care ASAP. CPR helps... and you might get lucky with an AED... but it is a good bet you will need drugs and perhaps pacing... and an airway wouldn't be such a bad thing, either - and I can't do any of that.

However, if you can be to the hospital in less time than it will take for a medic to get to you... get to the hospital. Hospitals are ALS, too

It really ticks me off when BLS crews don't know what to do without a medic onscene, and they don't see "high flow diesel" as a treatment option instead of sitting around waiting for the ALS intercept that is 15 minutes out.

Of course... "high flow diesel" doesn't mean that you do stupid :censored::censored::censored::censored: in the truck... it just means that you get the patient to the hospital in an expedient manner.