# Medstar Flipping Off Sirens for Cardiac Arrest Patients



## MMiz (Apr 17, 2010)

*Medstar Flipping Off Sirens for Cardiac Arrest  Patients*

Ambulances in Fort Worth will no longer race to the hospital with lights and sirens while transporting people in cardiac arrest.

*Watch the video*


----------



## TransportJockey (Apr 17, 2010)

It's weird to me to hear about transporting L/S with a dead body... The way I was taught is that you work it on scene, not transport the arrest.


----------



## medicdan (Apr 17, 2010)

Some medical control physicians will not authorize death in the field... 
and on a much more logistical level, the ambulance service can't bill if they don't transport...


----------



## rescue99 (Apr 17, 2010)

MMiz said:


> *Medstar Flipping Off Sirens for Cardiac Arrest  Patients*
> 
> Ambulances in Fort Worth will no longer race to the hospital with lights and sirens while transporting people in cardiac arrest.
> 
> *Watch the video*



We've had the protocol here for at least a decade. Now, if people would only listen, especially the Fd's! I agree whole heartedly...dead is dead.


----------



## MrBrown (Apr 17, 2010)

jtpaintball70 said:


> It's weird to me to hear about transporting L/S with a dead body... The way I was taught is that you work it on scene, not transport the arrest.



+ 1 to you sir, I don't think we have *ever* transported a working cardiac arrest.


----------



## piranah (Apr 17, 2010)

Here we transport every arrest unless livid,rigor, or injury incapable of life....every single one


----------



## WolfmanHarris (Apr 17, 2010)

Here if only a PCP crew is on scene, we still have to transport. But that's been more of an "in theory" protocol as we never seem to have trouble getting an ACP to the call before reaching the end of our protocol. (Came close once) 

ACP's usually have no issue getting a TOR, though I've had to drive one in where the ACP didn't even request a TOR. Pt. had an awful A/W such that he didn't even attempt the intubation and I just dropped the king. Couldn't get a line that would stay patent anywhere. Pt. freshly dead in PEA. We were two blocks from the hospital so we loaded and went and called ahead for RT.

We also transport pediatric arrests and penetrating trauma VSA's.


----------



## MrBrown (Apr 17, 2010)

Can you manually defibrillate/analyse as a PCP or do you take directions from the talking box? Our Ambulance Technician (90% of an NOCP PCP skills wise with 1/4 of the education) can interpret VF/VT on an ECG but not manually zap it.

Secondary arrest is a bit of a grey area things like certian tricyclics or other cardiotoxic medications, PEA from pericardial tamponade that can be relieved etc are examples where you should transport.

Primary arrests really shouldn't go to the hospital.


----------



## Shishkabob (Apr 17, 2010)

emt.dan said:


> Some medical control physicians will not authorize death in the field...
> and on a much more logistical level, the ambulance service can't bill if they don't transport...



MedStar actually works most of their arrest in the field, and try to keep it in the field if they can, and can do field termination.  This is more for the patient that crashes while in transport or for a traumatic arrest, which they try to get to JPS asap.


Trust me, MedStar is pretty progressive in their protocols, and Dr Griswell is always trying for more.


----------



## MrBrown (Apr 17, 2010)

Wonder how long it takes for this to pass over to the fireys next door in the BioTel system ... paging Dr Pepe, Dr Pepe please


----------



## Shishkabob (Apr 17, 2010)

Quite a while considering they just came out with their 2010 protocols when I was doing my internship, and we still transported my CPR l/s 10 miles.


----------



## Stephanie. (Apr 17, 2010)

*Careflite*

Careflite, in Dallas, Johnson County & Hill County Texas, has adopted this as well..Makes for a hellatious call when you have to sit for 15 minutes at stop lights thru Burleson & F.W...


----------



## WolfmanHarris (Apr 17, 2010)

Stephanie. said:


> Careflite, in Dallas, Johnson County & Hill County Texas, has adopted this as well..Makes for a hellatious call when you have to sit for 15 minutes at stop lights thru Burleson & F.W...



Do the crews still have discretion to use L&S to clear traffic? Here I can use them on even lower priority calls if I need to enter or exit traffic or if it's that congested.


----------



## FLEMTP (Apr 17, 2010)

emt.dan said:


> Some medical control physicians will not authorize death in the field...
> and on a much more logistical level, the ambulance service can't bill if they don't transport...



Sure they can.. medicare/medicaid and private insurance will pay EMS for a treat no transport.... 

And even if they stopped doing that there is nothing to prevent them from still sending the patient a bill. They used EMS time and resources, they should get a bill unless its something simple like a lift assist or a no treatment no transport. 

Codes, diabetes, etc, should all get billed for our services


----------



## CAOX3 (Apr 17, 2010)

Lights and sirens here are at provider discretion as is transporting cardiac arrests.  I hate blanket policies.  

Not everything is black and white.


----------



## Stephanie. (Apr 17, 2010)

*No L&S*



WolfmanHarris said:


> Do the crews still have discretion to use L&S to clear traffic? Here I can use them on even lower priority calls if I need to enter or exit traffic or if it's that congested.



On Priorty 1 calls they run L&S's but now full arrests are considered Priority 1... You don't run code.


----------

