SIDS whats your school of thought?

[triemal04]

so we're arguing about agreeing with eachother?

Well hell yeah! Is there any other way to do it?:beerchug:

 

[Hastings]

The fact that Hasting's believed/believes that it is acceptable to say something like that, let alone actually do something along those lines is inexscusable.

Rather, what Hastings believes is that it's acceptable to blow off members of this forum occasionally because they'll get after you over anything until you start kissing their *** and telling them that their way is the only acceptable way to do a job that is known for it's critical thinking, different methods, unique situations, and improv.

This isn't a situation where dangerous treatment is being provided that can be medically proven as wrong. This is something that certain people feel one way about and others feel one way about, and neither - I apologize to the old grumpy men of this forum - are wrong in the end. This is one topic where medics can rightfully disagree on which treatment is more appropriate (and factor in individual circumstances and situation), and neither will be wrong.

Sorry, but you heard me. I'm not wrong, and neither are you. You have your way of doing things and I have mine. I was taught one way, you were taught another. Such situations exist in EMS. This IS one of them.

 

[Hastings]

I'm going to break this down really simple and put it to rest in regards to me.

If I get called to a home where the family is huddled over the child, crying, mourning the loss, knowing it was a hopeless situation, I'd check the infant for any signs of life, and then I'd join them, put my arm around them, and attempt to comfort them as they mourn. I'm not going to make a theater show out of that.

But that's not the case 99% of the time. 99% of the time, it's a frantic mother that meets you at the door and throws the kid in your arms, begging you to do something; anything. You are welcome to call me a bad medic. Do it. But at this moment, I am not going to give the baby back and tell the mother that it's hopeless. There is an expectation there. There is an expectation that you're going to come, and you are going to do EVERYTHING you can do to "fix" the problem. Argue that there is nothing you can do, that's fair. But there are lists of things that a paramedic can do to bring people back from the dead. No matter how hopeless you may think it is, there is that expectation from the parents to do everything you can. And there are things you can do. And it's my job to meet those expectations, in my opinion. I'm going to take the baby, tell the mother that "I'm going to do everything I can, but I'm afraid s/he may have died of natural causes in his/her sleep. It may be too late. I'm going to do everything I can though." And I am going to work that child as the mother expects from the paramedic that she called for, and because it's my job.

It's my job to do everything I can. It's the expectation when I'm called for. It is what I feel is the right thing to do.



Emotionally damaging to the family? It is regardless. I've never heard of a parent blaming a medic for working a hopeless case on their child. They were thankful they did everything they could. I have however seen several instances where a medic told a family it was hopeless and refused to work it. Guess how that went over.

 

[KEVD18]

I'm sure it didn't go over all that well at all. as medical practitioners we are sometimes called upon to inform people that things have gone bad. if someone cant handle it, they are in the wrong business.

apparently you're one of the people not willing to examine your practices from an objective standpoint. that's fine. I'm not fundamentally concerned with how you handle your patients. if you can sleep at night then so be it.

 

[Hastings]

I'm sure it didn't go over all that well at all. as medical practitioners we are sometimes called upon to inform people that things have gone bad. if someone cant handle it, they are in the wrong business.

apparently you're one of the people not willing to examine your practices from an objective standpoint. that's fine. I'm not fundamentally concerned with how you handle your patients. if you can sleep at night then so be it.

Again, if it were something that were harmful to the patient, or if it were something with a true right answer, you'd find me more than willing to re-evaluate. This is not one of those cases.

Ironically, YOU are the one being close-minded. Not me.

 

[KEVD18]

Again, if it were something that were harmful to the patient, or if it were something with a true right answer, you'd find me more than willing to re-evaluate. This is not one of those cases.

Ironically, YOU are the one being close-minded. Not me.

i was hoping you would phrase your response juts like that.

the baby is dead and will remain so. your patient is no longer the baby, but the parent(s)/family and giving them false hope and raising their spirits only to crush them again is exceedingly harmful. this is without a shadow of a doubt one of the cases you seem to think it isn't.

 

[Ridryder911]

But that's not the case 99% of the time. 99% of the time, it's a frantic mother that meets you at the door and throws the kid in your arms, begging you to do something; anything. You are welcome to call me a bad medic. Do it. But at this moment, I am not going to give the baby back and tell the mother that it's hopeless. There is an expectation there. There is an expectation that you're going to come, and you are going to do EVERYTHING you can do to "fix" the problem. Argue that there is nothing you can do, that's fair. But there are lists of things that a paramedic can do to bring people back from the dead. No matter how hopeless you may think it is, there is that expectation from the parents to do everything you can. And there are things you can do. And it's my job to meet those expectations, in my opinion. I'm going to take the baby, tell the mother that "I'm going to do everything I can, but I'm afraid s/he may have died of natural causes in his/her sleep. It may be too late. I'm going to do everything I can though." And I am going to work that child as the mother expects from the paramedic that she called for, and because it's my job.

It's my job to do everything I can. It's the expectation when I'm called for. It is what I feel is the right thing to do.



Emotionally damaging to the family? It is regardless. I've never heard of a parent blaming a medic for working a hopeless case on their child. They were thankful they did everything they could. I have however seen several instances where a medic told a family it was hopeless and refused to work it. Guess how that went over.

Wow! Someone been watching too much Rescue Me! Kinda filled up with the hero syndrome huh?

Now let's discuss facts.. not a television series .. nor a dream vision, okay? Unless, you are one in the hundredth thousand that has ever seen an infant resuscitated from SIDS then I suggest you notify ,JEMS, American Academy of Pediatrics, The National SIDS Foundation because they will want a picture of you and your story!...

Let's look at the real facts, according to one study (Phila. JAMA; 2008) there is < than a 0.06% chance of sucessful resucitation with infants that was found in aystole. Again, remember that we are the medical professionals (or supposed to be) and again people call us BECAUSE THEY DO NOT KNOW WHAT TO DO! be it to resucititate or not. Again, if the infant is DEAD (signs of levidity, pooling, rigor mortis) it is OUR JOB to inform them that the infant has died. Tragic as it be, that is what your job is. PERIOD. Let's quit the "Cowboy medicine" ...

I believe many need a good reality check. Paramedics very, very seldom bring people back from the dead. Does ACLS work, yes, but is very seldom and the rarity of it especially in a pediatric arrest is more uncommon. That is not anectedotal wishing or "emotional thinking" that is cold hard facts, no matter where you are.

Now, let me see if I can break this down where you might be able to understand it. Your informing others you practice your way regardless of the studies, modalities of treatment, etc., not the national or proven ways. I really do doubt that you were taught such, if so; your school and instructors are lacking.

No one desribed not to attempt treat an infant that has became apneic or went into an arrest; however those that have SIDS are usually found past the point. It has been greater than 15-30 minutes since the infant was last seen. Usually pooling (levidity) has occurred and death had occured past the agreed time limits.

Stating "regardless" upon how this is going to effect the family goes to my point that you are doing for yourself, not the patient. You are not a hero, nor a life saver, your a just a Paramedic with a job to do (be it calling the code or working one).


R/r 911

 

[triemal04]

This has become (as happens many, many times) a pointless thread; someone has decided that what they do is the appropriate course of action (despite what the FACTS and EVIDENCE say) and decides that they will continue to do what they want no matter what.

But as a final comment, Hasting's, I gotta know...does this mean that you work ALL codes? And I do mean ALL of them (trauma, elderly with/without rigor/lividity, decomp, decapitation, etc etc) because in each case, since we are paramedics there is an expectation that "you are going to come and you are going to do everything you can to fix the problem?" I'm betting the answer is no, and, as you admit, you will only work pediatric codes that shouldn't be worked because of personal reasons.

I hope you can see the problem with that. For someone who seems to like increased education for EMS, who seems to want EMS to move forward, it's odd that instead you would adopt the attitude and actions that are holding EMS back.

When the original patient is dead and beyond help, they are dead and no longer need your attention. The ones who do, and are now your patients are the survivors, be it a 90 year old husband/wife, are a 20-something set of parent's.

Why do so many new paramedics think that they know best and know so much more than anyone else!?

 

[Hastings]

Why do so many new paramedics think that they know best and know so much more than anyone else!?

Lol.

+10 Lolz.

 

[volparamedic]

SIDS Calls

I found every situation is different. Most of the time it is possible to explain to the parents it's too late. When your life is in grave danger you bls to the truck and call it there. I haven't had to do the bls thing. I usually explain that even if we did everything medically there would be 0% chance they could be revived. You'll know if there's something fishy going on. A true SIDS case the family will be destraut. I usually let the mother hold the infant wrapped in a blanket if it feaseable. Being a mother of 3 and what I've seen on SIDS calls the best medicine for the mother you can give her is allowing her to hold her baby one more time at home. You'll have to gain some experience in feeling each call and making a judgement call when it occurs on how to handle it.

 

[triemal04]

Lol.

+10 Lolz.

Absolutely, I agree, very funny. (but you didn't address any of the points in my previous post...why?) But I'm thinking it's also very true (if it's not then you'll get the fastest apology ever and as an added bonus I'll do 5 laps around my house while naked) based on many comment's that you've posted and your refusal to ever say how long you've been a paramedic for, both here and elsewhere (I'm gonna say around a year on one side or the other). Of course, this isn't neccasarily a problem; everybody started out fresh once. But it can be.

It's not just people who have been doing something for 20 years that become set in doing something a certain way and are a problem; it's also people who have been doing something for 20 days and won't listen to someone else's opinion on how something should be done. Based on your responces here and in other threads, that does sort of describe you; when you are told that what you are doing is wrong, or could be done differently, or better, or such, you immedietly go on the defensce and refuse to even consider doing it differently. Why? There are thousands of paramedics who have been doing this for decades...do you really think there is nothing that you can learn from them, or that you know better in every case? Being so close-minded that you refuse to listen to another's idea of why and immedietly discount it as wrong will only create problems for you, especially in medicine, which can change at a rapid rate. This situation is a perfect example: you are doing something not because it is medically appropriate, or because it is the best thing for the family, but because you want to, because it's for YOU. So inappropriate. The reasons why are listed, but apparenty, you know better. So be it.

Good luck with your career.

 

[Ridryder911]

Lol.

+10 Lolz.

Personally, I didn't see anything funny or humorous...

R/r 911

 

[Hastings]

It's not just people who have been doing something for 20 years that become set in doing something a certain way and are a problem

Let's take a moment to address that problem then.

it's also people who have been doing something for 20 years and won't listen to someone else's opinion on how something should be done.

Fixed.

 

[Hastings]

And even though you've turned me off completely from responding in a serious manner, I can agree that I would not be working an infant in rigor under any circumstances. But at that point, most families already know what's going on.

Any other situation, and I will try everything I can. And you're right. Infants are no different than anyone else. I'd work anyone else not in rigor too.

But Rigor, you have my agreement. Thankfully - and surprisingly - of the three I've been called for, neither was at that point. All three were worked. Zero survived.

 

[KEVD18]

hastings, are you running for president?

 

[Hastings]

It's called being a Paramedic and taking the initiative to do research, learn.

Afterall, is that not what you were trying (and failing) to promote?

Granted, none of you helped to promote anything besides locking up and becoming unresponsive to the posts here with more attacks (see above post). But again, as a paramedic, I felt it was necessary to go out and seek the articles that the others neglected to post here. I read, I re-evaluated, and I - well on my own - have gained more information that may alter my treatment plans.

 

[karaya]

It's called being a Paramedic and taking the initiative to do research, learn.

Afterall, is that not what you were trying (and failing) to promote?

Granted, none of you helped to promote anything besides locking up and becoming unresponsive to the posts here with more attacks (see above post). But again, as a paramedic, I felt it was necessary to go out and seek the articles that the others neglected to post here. I read, I re-evaluated, and I - well on my own - have gained more information that may alter my treatment plans.

Can you provide us with some articles that support this?

Ray

 

[Hastings]

Which part? To do CPR unless infant is in rigor?

 

[karaya]

Which part? To do CPR unless infant is in rigor?

I'm sure regional protocols would define "obvious death" in differing aspects. I'm curious as to what you may be referring to when you state unless they are in rigor you will begin CPR.

Also, there are numerous articles that pooh pooh the concept of doing CPR for the sake of the family. All you're doing is dragging out an already highly emotional and physiological event in which statistically the survival rate is 0%. I agree with other posters here that better training for EMS personnel to communicate with families in such crises is a much better solution than carrying on a futile theatrical effort.

Ray

 

[Hastings]

I'm sure regional protocols would define "obvious death" in differing aspects. I'm curious as to what you may be referring to when you state unless they are in rigor you will begin CPR.

Also, there are numerous articles that pooh pooh the concept of doing CPR for the sake of the family. All you're doing is dragging out an already highly emotional and physiological event in which statistically the survival rate is 0%. I agree with other posters here that better training for EMS personnel to communicate with families in such crises is a much better solution than carrying on a futile theatrical effort.

Ray

Many articles referenced, none linked.

Edit: But at least you're wildly more polite than the others about it.