I can't beleive this happened.....

[MikeRi24]

I'm currently in a paid EMT-B training program, and I did a ride along today with an EMT-B and a Paramedic. although I have virtually no experience, my jaw was on the floor after I watched this unfold.

we get dispatched to a "elderly male with chest pains and shortness of breath." we get on scene, and the guy is in a chair, slumped over, unresponsive, and not looking so good. we hook him up to the monitor, and its clearly obvious thats we now have a full cardiac arrest on our hands. We shock him and start CPR, and in the middle of all this, we gather enough information for figure out that we are to take him to the local Veterans Affairs Hospital. Just so happens that the VA is LITERALLY less than 2 minutes away. we decide to "load and go." EMT-B drves, medic is in the back doing chest compressions and shocked him a second time, and i'm bagging. we get to the VA and as we are unloading, a nurse walks outside and demands to know whats going on. we give her the long and short of it, and she is like "well why didn't you call ahead? we had no idea you were brining this here, we heard the sirens from inside" so we explain to her that we were literally around the corner, and were doing what we needed to do to bring this guy back, sow e kinda didnt have time to call, and if we did by the time we got through and explained the situation, we would have been there anyway. Oh, and mind you we are now standing outside the ER doors, because this nurse won't let us in.

So they finally let us in, and we get the guy on a bed, and we are STILL doing chest compressions and bagging. WE are working the guy in the ER by ourselves before the nurse comes back and tries to get information on him, and says they cant look at him until they know his info. the nurse tells us that they will take over and we are relieved.

well, we basically watched the guy die, because the nurse made us stop resuscitating the guy, and no doctor or even another nurse came to look at the guy. the nurse then starts *****ing US out because she said we didnt start a line on him and didnt call ahead so they couldnt prepare. there was no one else in the ER, and we never saw anyone except for this nurse in the whole ED. so basically this guy died because they were lazy....


ok im done /rant

 

[JPINFV]

and this is why there should be prehospital termination of resuscitation. Why transport when any medic worth their pay could have worked the patient on scene with 2 other providers doing compressions and ventilation?

 

[MikeRi24]

and this is why there should be prehospital termination of resuscitation. Why transport when any medic worth their pay could have worked the patient on scene with 2 other providers doing compressions and ventilation?

we were, and dont get me wrong, we would have worked the patient more on scene, but since we were SOOOO close to the ED, we decided we might as well transport and get them somewhere thats better equipped then we were.

 

[triemal04]

Wow. You're right. I can't believe that either. Why would you decide to transport someone to the ER instead of working the code on scene? I don't give a rat's a$$ how close the ER is, the care given will be the same. (sometimes may even be better in the field) Add in that good, sustained compressions make a huge difference in patient outcome, and it's rather difficult to perform them satisfactorily while loading someone and then while in transport, and I have to ask...why?

Sorry. I know this wasn't your call and you aren't in a position to make those type of decisions, so nothing personall. But, at least take something away from this, even if it is an understanding of what should NOT be done.

1. 2 minutes of CPR BEFORE defibrillation, unless it's a witnessed arrest.
2. ACLS is ACLS, in or out of a hospital. Unless you're a BLS (or piss poor service) then the hospital isn't "better equipped" for the intial stages of a code.
3. Good CPR is extremely important, especially in the initial 8-15 minutes of a code.
4. Not notifiying the hospital...when coming in with a code...that's just plain stupid. And lazy. And stupid. Tends to annoy the people in the ER.

Live and learn.

 

[Ridryder911]

Sorry, but I have read this story before in another EMS forum a while back, unless it is an ironic re-current identical situation.

Personally, I can't believe that an EMT misspelled believe twice.....

Also, V.A. are a government private hospital and do NOT have to allow just anyone to be entered. They ARE exempt from EMTALA, COBRA, etc...
If you are with a Paramedic unit, why did they not pursue the medical care they were supposed to.

Why do you say they are "more prepared and better equipped"? Does your EMS unit NOT have ALS equipment or Paramedic not able to provide ALS? Sorry, a code is a code. Remember, I am responsible that they did NOT have an advanced care. (negligent). Sorry, that was piss poor treatment and care, of not even attempting an airway, IV/I/O medication. Your Paramedic can be reviewed for negligent care, since they did not perform according to standards. Don't blame the ER, almost anyone with EMS experience will tell you VA hospitals rarely are prepared for true emergencies or will accept most codes. As well, you contradicted yourself, you described that there were only the nurse, then stated " they will take over and we are relieved". So she relieved you and left her by herself?


R/r 911

 

[Emt /b/]

Personally, I can't believe that an EMT misspelled believe twice.....

Ha. Do you not realize that most of your posts are riddled with grammatical and spelling errors?

 

[Meursault]

As far as the original story, he could just have cross-posted it.
VA hospital + no notification? I can most definitely believe that they were unhappy and unprepared. I doubt it was laziness on their part.

Ooh, and somebody's challenging Rid. The fireworks should be most interesting. If you're lucky, VentMedic and Flight-LP will show up too, giving you the full forum teaching experience.
/me grabs aluminized suit and runs for cover.

 

[milhouse]

let the beatings begin....... lol this is gonna be interesting

 

[Ridryder911]

Ha. Do you not realize that most of your posts are riddled with grammatical and spelling errors?

Oh, I am sure of the grammatical errors (most on purpose). As we have numerously discussed upon this forum. I and many others utilize the common usage of grammar and style for posting on forums. If you would like, I could utilize the APA, MLA, formats and styles, etc. On the point of spelling, doubt it would be numerous, one of my few talents. I also do perform spell check twice before posting as a courtesy for those that care to be able to interpret postings.

I just thought it was ironic to post and criticize others on how poorly educated and stupid they were, when your title was misspelled and rarely capitalized the beginning of a sentence. Also, I have read a very similar to near exact same post on another EMS forum a few months ago. So I still ask did your crew leave the patient with the one nurse or did others assume care?

I also ask what is this "special equipment" that ED's have that EMS units do not have to work upon cardiac arrests?

Oh, by the way it is respiratory or cardiac arrest in lieu of the common slang .."full arrest".. which most never heard of a half-arrest..

Have fun continuing learning....

R/r 911

 

[RichmondMedik]

Damn !!!

I miss reading your replies Rid !!!!

All is well here after a few harrowing months of self doubt.

New job and back in school for more edumacation(spelled wrong on purpose)

stay safe

Paul

 

[MikeRi24]

when we got there, city fire had been there for a good 5 minutes (we had a REALLY long response time because we were dispatched from the other end of the city...not sure why) and doing CPR. they continued CPR until the point where we shocked, then our guys took over to try and get the FD out of the way (the room we were working in was maybe 4x6 if that (it was like a walk in closet that this guy had made into a very small sitting room for whatever reason) and the rest of the house was really really cluttered with stuff. so we didnt really NOT do CPR first, as the fire dpt had been doing that for about 5 minutes prior to our arrival.

like i said, you maybe would have needed to see the house we had to work in and what the conditions were an every other variable involved, but I was just doing what the medic told me. to be honest, there were a few things the medic did that kind of made me raise an eyebrow, and I think the EMT-B we were with (who happens to be a friend of mine...never met the medic before) agreed with me on most of them, but didnt say anything. By no means am I in any position to take charge over anything, so I just did what they told me and tried to take in as much as possible.

FIY, I dont think anyone realizes how close we actually were, so the blue dot is where the ED is, and the gray one is where the scene was.

 

[piranah]

Iagree...you should have worked that code especially with a medic on board...and not calling ahead...one of the bigges thingsthey teach you in Basic school is ALWAYS call medical control and tell them (age,sex,vitals, ETA, any interventions, current condition,also any special indications,) thats just baseline knowlege. just arriving at the hospital is like catching them with their pants down. thats why so many hospitals don't care for EMS is because people dont do their jobs correctly.

 

[Jolt]

we get on scene, and the guy is in a chair, slumped over, unresponsive, and not looking so good.

when we got there, city fire had been there for a good 5 minutes (we had a REALLY long response time because we were dispatched from the other end of the city...not sure why) and doing CPR.

Wow... you're a really bad liar.

 

[milhouse]

makes you wonder what really happened now!?!?!?!?!!

 

[JPINFV]

one of the bigges thingsthey teach you in Basic school is ALWAYS call medical control

Of course you can tell people that all the time, but not everyplace had online medical control at the EMT-B level (hospital notifications were done through dispatch and as age, sex, CC, and ETA plus anything else the crew wanted to throw in).

 

[JPINFV]

FIY, I dont think anyone realizes how close we actually were, so the blue dot is where the ED is, and the gray one is where the scene was.

It's immaterial actually. CPR is never of decent quality while moving and there is no significant differences between prehospital arrest treatment and ER arrest treatment.

That said, I don't think anyone's blaming you, it is the medic's patient.

 

[MikeRi24]

Wow... you're a really bad liar.

ok excuse me, thats how the FD found him, he was still in the same "area" as when they found him. u get the idea though....

I have to schedule my next ride along on Monday, I am definitely going to do it with another medic..like i said i didn't really 100% agree with some of the things that were going on, but oh well I can only learn from the better ones i guess.

 

[Jolt]

ok excuse me, thats how the FD found him, he was still in the same "area" as when they found him. u get the idea though....

Sorry, I still don't believe you for two reasons. (1) You would have said it that way if that's what you meant, and (2) Rid already said that he saw the same post on another site.

 

[Ridryder911]

Mike, since you are a student, what I would had liked to seen presented is maybe what you would had done? We realize, that you were not in charged, but learn off the call.. good or bad.

Maybe the scene or situation did make the Paramedic want to just transport with just doing the essentials. I don't know, I was not there. Again, what we do has to be justified. Performing the entirety of the code just outside the driveway or the opposite of transporting. Again, attempt to justify their action(s) or disagree with what occurred.

I do NOT want my students to be mindless sheep and be followers. What might be right one time, may not be the next. This is why medicine is gray, not black & white, as well we are trying to install critical thinking skills. To judge each situation separately, independently based upon its merit. Is there general guidelines, you bet.. but, how you apply and adapt to them is what counts.

This is what clinicals are for. To expose you to the real working environment after you have learned the basics of patient care. Take those skills that you have mastered and now apply them into a clinical setting.

I wish you luck!

R/r 911

 

[KEVD18]

im throwing the bs flag:

story just doesnt add up.