# First Call by Myself



## NetMatrix

Well Sunday night Monday morning at 00:10 the pager for the fire department I'm with toned for a 56 year old female that had a seizure and was not breathing.  Now I'm not done with the EMT class yet and have not gotten my EMT license yet through the state.  The final exam is tomorrow night in class.  Well I had called the fire chief and asked him if he wanted me to go straight to the scene to assess the PT and start CPR if needed and he told me to hear over there asap.  I only lived a 30 second walk from the PT's house.  I got my truck grabbed a few of my medical supplies that I have and went to the house to assess the PT and start CPR on her.  I got there knocked on the door the PT's boyfriend told me to come in and I introduced myself to him and told him I was with the fire department.  I was EXTREMELY nervous cause I was there by myself with no assistance from anyone else.  I asked him what had happened and he told me as I was walking over to the PT.  I started to do a very rapid assessment of the PT checked her breathing which she was not breathing, check to see if she had a pulse which was absent.  Her skin was very cool to the touch and pail in color.  I cut her upper garments off and started to administer CPR to her.  I knew right from the get go that she was to far gone and there was maybe a 5% chance of bring her back.  There was about a 10 minute response time for the rescue unit at the fire department and a 20 minute response time for the ambulance due to their locations and road conditions.  When the rescue unit arrived on scene one of our fire fighters/EMT jumped over me and applied the pads to the PT's check for the diffubilater.  Another one of our fire fighters/EMT had the suction machine to suction the PT's mouth.  We continued to perform CPR on the PT and was able to get 1 shock.  The ambulance arrived at the scene so we got her on the long board strapped her down, and got her to the ambulance.  We kept doing CPR the whole time we just had to change persons doing compressions due to the terrain.  Anyhow the ambulance took her to the hospital and at the hospital she was pronounced dead.  

It was rather nerve racking for this being my first time out on my own assisting a PT waiting for the rescue unit and the ambulance to arrive.  After the call when the 2 EMT's that are also our fire fighters got back the the department (they rode with the ambulance to assist them) they told me I did a great job and stated that the PT was to far gone to really do anything for her.  I feel good that I was able to do what I could do and what I have been trained to do.  I'm really enjoying taking the class to become a EMT and I do look forward to working with more PT's in the future.  It really sucks that she died, and sadly this PT won't be the last one.


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## rwik123

NetMatrix said:


> Well Sunday night Monday morning at 00:10 the pager for the fire department I'm with toned for a 56 year old female that had a seizure and was not breathing.  Now I'm not done with the EMT class yet and have not gotten my EMT license yet through the state.  The final exam is tomorrow night in class.  Well I had called the fire chief and asked him if he wanted me to go straight to the scene to assess the PT and start CPR if needed and he told me to hear over there asap.  I only lived a 30 second walk from the PT's house.  I got my truck grabbed a few of my medical supplies that I have and went to the house to assess the PT and start CPR on her.  I got there knocked on the door the PT's boyfriend told me to come in and I introduced myself to him and told him I was with the fire department.  I was EXTREMELY nervous cause I was there by myself with no assistance from anyone else.  I asked him what had happened and he told me as I was walking over to the PT.  I started to do a very rapid assessment of the PT checked her breathing which she was not breathing, check to see if she had a pulse which was absent.  Her skin was very cool to the touch and pail in color.  I cut her upper garments off and started to administer CPR to her.  I knew right from the get go that she was to far gone and there was maybe a 5% chance of bring her back.  There was about a 10 minute response time for the rescue unit at the fire department and a 20 minute response time for the ambulance due to their locations and road conditions.  When the rescue unit arrived on scene one of our fire fighters/EMT jumped over me and applied the pads to the PT's check for the diffubilater.  Another one of our fire fighters/EMT had the suction machine to suction the PT's mouth.  We continued to perform CPR on the PT and was able to get 1 shock.  The ambulance arrived at the scene so we got her on the long board strapped her down, and got her to the ambulance.  We kept doing CPR the whole time we just had to change persons doing compressions due to the terrain.  Anyhow the ambulance took her to the hospital and at the hospital she was pronounced dead.
> 
> It was rather nerve racking for this being my first time out on my own assisting a PT waiting for the rescue unit and the ambulance to arrive.  After the call when the 2 EMT's that are also our fire fighters got back the the department (they rode with the ambulance to assist them) they told me I did a great job and stated that the PT was to far gone to really do anything for her.  I feel good that I was able to do what I could do and what I have been trained to do.  I'm really enjoying taking the class to become a EMT and I do look forward to working with more PT's in the future.  It really sucks that she died, and sadly this PT won't be the last one.



That's great experience. Good job. But one question... You have no cert/license depending on your state. Granted, you did nothing past first aid.. Anyone can do CPR, but why were you on call and with a pager If you have no cert? Are you a FF? Departments I know would not have their personal respond without a cert or at least a preceptor at scene or on route with them.


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## Minnick27

I would assume the op has at least his CPR cert. I passed a scene before I was an EMT, was actually getting ready to go in the pizza place when a code was dispatched for that location. Of course I went in and started to work, ad let my ems chief know I was there.


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## NetMatrix

The pager is what we have for both the fire department and ambulance service.  Not everyone has a actual radio issued to them.  The chief wanted me to respond to the call cause I'm certified to perform CPR, and it would take them a while to get to the scene cause of the distance and weather.  The whole CPR deal is why he had me go there and with only being a few seconds away from the house.  Also with the ride along time I had to do for the EMT class all of the EMT's we have with the fire department rode with me and was able to see how I act and manage PT's on the scene.  Yes it was kind of one of those calls that can be questioned on them having me go, but with general first aid with cuts, burns, and other things I have been trained on with the fire department and CPR is one of them.


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## firetender

*I guess we start here...*

Essentially, your Dept. Head dispatched you to a scene. If you had done something fatal and you weren't "quite" covered by your training then his butt would be in a sling.

Given that you didn't arrive in an "Official" capacity, accompanied by real Fire Trucks and Ambulances and the like, I question the sanity of choosing to cut the woman's clothes off before CPR, like, "WHO THE HELL ARE YOU???" might come up and slow your delivery of care.

(Unless, of course you're a whacker and showed up in turnouts!)


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## rwik123

firetender said:


> Essentially, your Dept. Head dispatched you to a scene. If you had done something fatal and you weren't "quite" covered by your training then his butt would be in a sling.
> 
> Given that you didn't arrive in an "Official" capacity, accompanied by real Fire Trucks and Ambulances and the like, I question the sanity of choosing to cut the woman's clothes off before CPR, like, "WHO THE HELL ARE YOU???" might come up and slow your delivery of care.
> 
> (Unless, of course you're a whacker and showed up in turnouts!)



i'd prob shear em off.. better landmarks and its gunna hafta come off sometime in the future for the defib.. than again, landmarks can be established with clothes on. just a matter of preference


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## jjesusfreak01

firetender said:


> (Unless, of course you're a whacker and showed up in turnouts!)



I ran all my calls today in turnouts...granted, it didn't get above freezing the whole day, but that's beside the point, isn't it?


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## NetMatrix

When I arrived at the PT's house I told the boyfriend who I was and let him know that I was with the fire department.  Also he knows who I am and he knows I'm with the fire department.  He sees me all the time responding to calls.  But I still did the proper introduction when I arrived at the house.  Before I cut the upper garments off his girlfriend I did tell him that I was cutting them off to expose the chest for compressions that it helps to keep from other injuries caused by garments.  Then went to do CPR.  Everything was explained to the gentlemen as I was doing it.  On a legal stand point I'm certified to do CPR,a nd there is documents of other rescue calls that I was in the rescue unit and had to perform CPR, and those PT's did live, and them and their spouse sent me thank you cards for saving the life.  The big part of it isn't because I haven't taken my state test yet.  It's I'm certified to perform CPR which is all I did.  Nothing else happened till rescue/ambulance arrived on scene.  

rwik with our protocol shearing of upper garments are required due to a female that CPR was done on that had a push up bra with the under wire and that wire went into her chest as the compressions were being done.
Look at it this way your walking down the street you are certified to do CPR, but not a first responder or EMT (and never had training in those 2 areas.)  Would you stop and do the CPR and tell someone to call 911 or what would you do.  I didn't realize doing this post would cause a debate like this.  I'm trained in some first aid situations, but I'm done posting on this thread.


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## rwik123

NetMatrix said:


> When I arrived at the PT's house I told the boyfriend who I was and let him know that I was with the fire department.  Also he knows who I am and he knows I'm with the fire department.  He sees me all the time responding to calls.  But I still did the proper introduction when I arrived at the house.  Before I cut the upper garments off his girlfriend I did tell him that I was cutting them off to expose the chest for compressions that it helps to keep from other injuries caused by garments.  Then went to do CPR.  Everything was explained to the gentlemen as I was doing it.  On a legal stand point I'm certified to do CPR,a nd there is documents of other rescue calls that I was in the rescue unit and had to perform CPR, and those PT's did live, and them and their spouse sent me thank you cards for saving the life.  The big part of it isn't because I haven't taken my state test yet.  It's I'm certified to perform CPR which is all I did.  Nothing else happened till rescue/ambulance arrived on scene.
> 
> rwik with our protocol shearing of upper garments are required due to a female that CPR was done on that had a push up bra with the under wire and that wire went into her chest as the compressions were being done.
> Look at it this way your walking down the street you are certified to do CPR, but not a first responder or EMT (and never had training in those 2 areas.)  Would you stop and do the CPR and tell someone to call 911 or what would you do.  I didn't realize doing this post would cause a debate like this.  I'm trained in some first aid situations, but I'm done posting on this thread.



I'm not chastising you in anyway or criticizing you for responding. You've got to understand that debates like this happen all the time in this forum, and you shouldn't take any criticisms personally. Around me its different than say where you live. I think people could see what you do in many different ways; a) you do have a cpr cert and the experience helped you gain more confidence, and its the judgment of the chief, whoever to decide wether or not to have you respond. B.) some people on this forum will see what you did as irresponsible on the side of the chief and being you had no EMT certification, had no right to respond to a call without a supervising individual 

although having a CPR card and running into a cardiac incident at the mall and doing compression until ems arrives is much different than responding on behalf of an agency with a CPR card.. not the best analogy. Im not aware of the Good Samaritan law in your state, and whatever it covers... much in the situation where you did compressions, say broke a rib and punctured a lung, you could be able to get in trouble. Yes, she is pretty much dead whatever, coding, but a lawyer could see fault in a non-certified person responding to a call.


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## JJR512

NetMatrix said:


> ...When the rescue unit arrived on scene one of our fire fighters/EMT jumped over me and applied the pads to the PT's check for the *diffubilater*.  Another one of our fire fighters/EMT had the suction machine to suction the PT's mouth.  We continued to perform CPR on the PT and was able to get 1 shock.  The ambulance arrived at the scene so we got her on the *long board* strapped her down, and got her to the ambulance...



I have two comments, both based on the parts of your quote that I highlighted.

1. "diffubilater" This has got to be the bestest misspelling of _defibrillator_ that I've ever seen. 

2. Why was the patient put on a long board? Doesn't seem indicated to me.


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## Shishkabob

JJR512 said:


> 2. Why was the patient put on a long board? Doesn't seem indicated to me.



Easier to move the patient rather than an arm/leg carry.


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## Aidey

The long board is for movement and so you are doing compressions against something hard.


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## NetMatrix

JJR512 said:


> I have two comments, both based on the parts of your quote that I highlighted.
> 
> 1. "diffubilater" This has got to be the bestest misspelling of _defibrillator_ that I've ever seen.
> 
> 2. Why was the patient put on a long board? Doesn't seem indicated to me.



I have a hard time spelling that word.  She was put on the long board to get her on the cot and to continue CPR.  The pad on the cot is really thick and soft.  Thick meaning it has a lot of padding in it.  Also with where the patient was located at the the structure of the house.  It was impossible to get the cot in there, and the paramedic wanted her on a cot.  Plus with being on the back board (long board) able to do the compressions without the body being pushed down into the padding on the pad on the cot.  That's also more protocol for our region.  If they are trauma they go on the back board and she was trauma.

One of these days I'll learn how to spell defibrillator correctly.  Our abbreviation for that in which we can put on the report is defib.


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## NetMatrix

Ok I found my mistake.  I forgot to put in that she was put on the cot then loaded into the ambulance.  Well at least I didn't make that mistake on the report for the fire department.  Sorry about that one was in a little hurry when I was typing the starting post.


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## mc400

What made the patient a trauma? I understand the board for movement and compressions but how was the sz a trauma?


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## medicdan

1. What would have changed, for us, if the OP was a representative of the volunteer Fire Department, responding as a First Responder (which does not require state certification, only the completion of a class)? He was dispatched as a fire person, arrived (and identified) himself as a fire person, and acted well within the SOP of an FR. Let's forget the (absent) EMT credential...

2. OP, Can I teach you the Enter and Tab buttons, please... to create paragraph breaks, or even indent?

3. If you were putting the patient on a board for trauma (which I think we disagree with), did you apply a collar and blocks? Strap the patient down?


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## NetMatrix

emt.dan said:


> 1. What would have changed, for us, if the OP was a representative of the volunteer Fire Department, responding as a First Responder (which does not require state certification, only the completion of a class)? He was dispatched as a fire person, arrived (and identified) himself as a fire person, and acted well within the SOP of an FR. Let's forget the (absent) EMT credential...
> 
> 2. OP, Can I teach you the Enter and Tab buttons, please... to create paragraph breaks, or even indent?
> 
> 3. If you were putting the patient on a board for trauma (which I think we disagree with), did you apply a collar and blocks? Strap the patient down?



Ok I'm seriously starting to get tired.  Don't ask about the trauma part.  I've been studying that part of the EMT book all night, and trauma is really stuck in my head right now.


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## JJR512

emt.dan said:


> 3. If you were putting the patient on a board for trauma (which I think we disagree with), did you apply a collar and blocks? Strap the patient down?



I can sort of understand using the long board to move an unresponsive patient out of an area if you can't get the stretcher into that area. In this situation, I don't think the collar and blocks would really be necessary.

I can sort of understand using the long board to be a hard surface for CPR, but I have to wonder what kind of stretcher mattresses they're using that are so different from standard stretcher mattresses, which in my admittedly limited experience (and always seeing, never doing), have always seemed fine for CPR. In this situation, just as the previous one, I don't see that the collar and blocks would really be necessary.

What I don't understand at all is the new claim that the patient was a trauma. I can understand that a patient, during seizures, might physically injure herself, whether from falling down or from striking something while seizing. But I don't think that kind of injury would be a significant enough mechanism to warrant a long board. Of course, I wasn't there, and perhaps there are additional details of which we have not yet been made aware.


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## Aidey

The long board does make a difference with CPR. As someone who has done compressions with and without the LSB on the gurney, you can feel the difference, mainly in smaller patients IMO.

I have a feeling this is a trauma per protocol situation. You would be amazed how many simple fall-from-standing patients get back boarded because they are a "trauma".

By simple I mean people who just fell down. No boucing off of dressers or concrete steps or whatever.


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## NetMatrix

Aidey said:


> The long board does make a difference with CPR. As someone who has done compressions with and without the LSB on the gurney, you can feel the difference, mainly in smaller patients IMO.
> 
> I have a feeling this is a trauma per protocol situation. You would be amazed how many simple fall-from-standing patients get back boarded because they are a "trauma".
> 
> By simple I mean people who just fell down. No boucing off of dressers or concrete steps or whatever.



With the different protocols not all trauma requires a c-collar.  On a technicality with some protocols just a simple abrasion to the knee just from falling off a bicycle.  That type of injury is considered to be soft tissue trauma.  With this lady yes there could have been trauma caused when she fell.

With our protocols when a patient is unresponsive with no pulse and no breathing that patient is considered to be a trauma patient, because there is a life threatening situation.  

With our stretchers we have the automatic style (I don't remember exactly what they are called) they have a up and a down button on them.  It's all electric.  It does have a thicker pad on it than standard cots have that I have personally seen, but they are also brand new.  The brand new pad since there has not been enough patients to wear it down yet is 3 inches thick.

With the first responder there is a certificate that you do receive once you complete the class for it.  I'm not a first responder, but I am a medical technician.  I went to college for that 3 years ago; I just never got a job at a hospital for that training.  So I do have the basic first aid training.  Plus all the training we are required to have with the fire department in regards to first aid.  

Yes some people will question the chief sending me over there to assess the patient and perform CPR.  I called and asked because of the ice on the roads I knew for a fact the response time for them to arrive was doubled because of the snow and ice that was on the roads.  The area that me and the patient live at is a little village out in the country.  Roads aren't taken care of very well.  To me making that phone call and the chief telling me to go over there with the short amount of time I got there I was hoping would save her life.  Sadly her life was not able to be saved...


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## NetMatrix

Aidey said:


> The long board does make a difference with CPR. As someone who has done compressions with and without the LSB on the gurney, you can feel the difference, mainly in smaller patients IMO.
> 
> I have a feeling this is a trauma per protocol situation. You would be amazed how many simple fall-from-standing patients get back boarded because they are a "trauma".
> 
> By simple I mean people who just fell down. No boucing off of dressers or concrete steps or whatever.



Ok I'm editing this cause it posted twice.  I have no idea why. lol


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## Aidey

So if someone was found in cardiac arrest in bed at 6am they would be considered a trauma patient?


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## NetMatrix

Aidey said:


> So if someone was found in cardiac arrest in bed at 6am they would be considered a trauma patient?



Yep it's a life threatening situation.  It would be documented on the paperwork as a trauma.


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## NetMatrix

Ok I just had to double check on what I just posted no on that one it would be a medical call.  This call was documented as a trauma due to patient falling while having the seizure.

I'm still learning this stuff, but trauma depends on the situation.


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## Aidey

So, in short I was right. It was a trauma per protocol rather than a trauma because the patient had any actual injuries. That is assuming you didn't neglect to mention she had some sort of injury.


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## clibb

JJR512 said:


> I can sort of understand using the long board to move an unresponsive patient out of an area if you can't get the stretcher into that area. In this situation, I don't think the collar and blocks would really be necessary.
> 
> I can sort of understand using the long board to be a hard surface for CPR, but I have to wonder what kind of stretcher mattresses they're using that are so different from standard stretcher mattresses, which in my admittedly limited experience (and always seeing, never doing), have always seemed fine for CPR. In this situation, just as the previous one, I don't see that the collar and blocks would really be necessary.
> 
> What I don't understand at all is the new claim that the patient was a trauma. I can understand that a patient, during seizures, might physically injure herself, whether from falling down or from striking something while seizing. But I don't think that kind of injury would be a significant enough mechanism to warrant a long board. Of course, I wasn't there, and perhaps there are additional details of which we have not yet been made aware.




I have had two patients that we have had to have a full trauma team activated for this week and the place we found them were in their living room. I treat the patient's symptoms and complaints, not their surroundings. One did have a seizure and had a bad fall. Another one fell down the stairs. All protocols are different for a full trauma team activation. These two patients did meet my full trauma team criteria. One had Flail Chest. Have absolutely no idea how she got it since she wasn't responsive.
My protocols state that if a patient has fallen and is bleeding from their head, I have to c-spine. If they aren't Alert and Oriented x 4 after their fall, c-spine. If they have Osteoporosis and have suffered a fall, c-spine. So I do not disagree with the decision to back board or c-spine at all.
I would have to see the patient and know her history before the decision for a trauma team to be activated or what not.

Here's a thought for you.
What if the patient went into a seizure and while falling hit her C2 or C3 and injured them. What would be one of the outcomes?
Inability to breathe using chest muscles or diaphragm. Therefore, she would not be breathing. Could this cause cardiac arrest? Yes. Would C-spine stability help this patient? Most likely. 


There are so many factors that our new (almost) EMT haven't given us to really judge the situation.






JJR512 said:


> 2. Why was the patient put on a long board? Doesn't seem indicated to me.



Because they were doing CPR? You put the patient on a back board so that you get proficient compressions. As you're taught to do in EMT class.


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## jjesusfreak01

JJR512 said:


> "diffubilater" This has got to be the bestest misspelling of _defibrillator_ that I've ever seen.



My instructor always called it a defibulator. I think that is a fairly common mispronunciation.


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## JJR512

clibb said:


> I have had two patients that we have had to have a full trauma team activated for this week and the place we found them were in their living room. I treat the patient's symptoms and complaints, not their surroundings. One did have a seizure and had a bad fall. Another one fell down the stairs. All protocols are different for a full trauma team activation. These two patients did meet my full trauma team criteria. One had Flail Chest. Have absolutely no idea how she got it since she wasn't responsive.
> My protocols state that if a patient has fallen and is bleeding from their head, I have to c-spine. If they aren't Alert and Oriented x 4 after their fall, c-spine. If they have Osteoporosis and have suffered a fall, c-spine. So I do not disagree with the decision to back board or c-spine at all.
> I would have to see the patient and know her history before the decision for a trauma team to be activated or what not.


That's nice for you and your trauma team, but I've never suggested treating a patient's surrounds instead of the patient. Nor have I ever said that you can't have a trauma in a living room.

I also never disagreed with the decision to use a long board. So I'm not sure why you're picking on me as if I have. There wasn't enough information in the original post for me to see that there was a need, that's why I _questioned_ the need. Questioning something is not the same as disagreeing with it.



> There are so many factors that our new (almost) EMT haven't given us to really judge the situation.


Exactly—that's why I was _questioning_, not _disagreeing_.



> Because they were doing CPR? You put the patient on a back board so that you get proficient compressions. As you're taught to do in EMT class.


I wasn't taught to automatically put every CPR patient on a long board. I was taught that if a patient is on a couch or bed, or other soft or unstable surface, to put the patient on the floor for better CPR. I was _never_ taught that a stretcher isn't good enough. On the other hand, in my jurisdiction, we're also supposed to get CPR patients on an AutoPulse as soon as possible, and that comes with its own CPR board, so perhaps its a moot point for me.


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## JJR512

JJR512 said:


> I wasn't taught to automatically put every CPR patient on a long board. I was taught that if a patient is on a couch or bed, or other soft or unstable surface, to put the patient on the floor for better CPR. I was _never_ taught that a stretcher isn't good enough. On the other hand, in my jurisdiction, we're also supposed to get CPR patients on an AutoPulse as soon as possible, and that comes with its own CPR board, so perhaps its a moot point for me.



To follow up with some new info...As I said earlier, I do not recall my primary instructor ever saying that a stretcher wasn't acceptable for CPR. I do remember that couches and beds were specifically mentioned, and I understand the problem is soft surfaces. I guess I never considered a stretcher to be a "soft surface". Now, as I mentioned earlier, my primary instructor has made a big point about getting the patient on the AutoPulse as soon as possible, so that makes whether a stretcher is too soft or not a moot point. But to get a definitive answer, I wanted to ask the question directly, but was unable to ask my primary instructor tonight due to him being out sick. So I asked the backup instructor, and she said that although it isn't specifically taught, she doesn't feel a stretcher would be acceptable for CPR.

That being said, I know I've seen CPR done on a stretcher numerous times. That doesn't mean it's right, of course, but it does illustrate the gap between classroom teachings and real-word doings.


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## medic2be823

JJR512 said:


> I have two comments, both based on the parts of your quote that I highlighted.
> 
> 1. "diffubilater" This has got to be the bestest misspelling of _defibrillator_ that I've ever seen.
> 
> 2. Why was the patient put on a long board? Doesn't seem indicated to me.


In NY, its in our protocols to put a pt on a long board so that there is a hard stable surface under the pt.  It makes chest compressions more accurate and has led to more saves state wide.


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## JJR512

medic2be823 said:


> In NY, its in our protocols to put a pt on a long board so that there is a hard stable surface under the pt.  It makes chest compressions more accurate and has led to more saves state wide.



Oh? It's better for chest compressions, you say? Really? Wow, I never heard that before. Certainly not five times already in this thread alone. Thanks for the amazingly new piece of information!


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## medic2be823

Wellll.....excuse me....but I only read the first page of this post as I got toned out....so excuse me for not being as well read as you!!!


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## jjesusfreak01

Lets be nice now...


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## Fox800

Backboards are SOP for cardiac arrests that we transport, too. Our advanced airway patients are also typically backboarded, it helps prevent the tube from becoming dislodged.


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## clibb

medic2be823 said:


> Wellll.....excuse me....but I only read the first page of this post as I got toned out....so excuse me for not being as well read as you!!!



Oh it's alright. The guy is just now figuring out that he shouldn't had skipped over the CPR chapter in his EMT book.


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## JJR512

clibb said:


> Oh it's alright. The guy is just now figuring out that he shouldn't had skipped over the CPR chapter in his EMT book.



LOL—In the national curriculum, CPR is considered to be a prerequisite for the EMT-B class, not part of it. Therefore, there is no chapter for it in _my_ EMT book. That being said, CPR is actually taught in Maryland as part of the EMT class in one of the class sessions. However, there is still no chapter for it in the EMT book. Just an appendix. You want to try to be a smartass without even knowing what you're talking about...LOL.

And I CHALLENGE you to tell me where in _my_ protocols it says to not do CPR on a stretcher. Luckily for you, Maryland only has one set of protocols for the entire state, so you don't even need to try to figure out which local or agency-specific protocols apply to me. Here, I'll even make it easy for you by giving you a link to MD's protocols. It's the very first link on this page: http://www.miemss.org/home/EMSProviders/EMSproviderProtocols/tabid/106/Default.aspx

Finally, I think you ought to go back and review some of the things I've said and find some of the details you've missed. Details like the one that it's a local SOP to get the patient on the AutoPulse ASAP. If you don't know what that is, look it up. Part of the AutoPulse is a hard surface for the patient's upper body to rest on, which provides a firm surface for compressions. Gee, I wonder why I wasn't taught that a stretcher wasn't good enough? As I've said at LEAST _twice_ already, it's a MOOT POINT for my jurisdiction.

So don't tell me what I'm being taught in _my_ class. If you want to mention it at all, you may _ask_ if that's taught in my class. And don't _ever_ tell me, or anyone else, what's going on in _my_ mind. Period.


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## clibb

JJR512 said:


> LOL—In the national curriculum, CPR is considered to be a prerequisite for the EMT-B class, not part of it. Therefore, there is no chapter for it in _my_ EMT book. That being said, CPR is actually taught in Maryland as part of the EMT class in one of the class sessions. However, there is still no chapter for it in the EMT book. Just an appendix. You want to try to be a smartass without even knowing what you're talking about...LOL.
> 
> And I CHALLENGE you to tell me where in _my_ protocols it says to not do CPR on a stretcher. Luckily for you, Maryland only has one set of protocols for the entire state, so you don't even need to try to figure out which local or agency-specific protocols apply to me. Here, I'll even make it easy for you by giving you a link to MD's protocols. It's the very first link on this page: http://www.miemss.org/home/EMSProviders/EMSproviderProtocols/tabid/106/Default.aspx
> 
> Finally, I think you ought to go back and review some of the things I've said and find some of the details you've missed. Details like the one that it's a local SOP to get the patient on the AutoPulse ASAP. If you don't know what that is, look it up. Part of the AutoPulse is a hard surface for the patient's upper body to rest on, which provides a firm surface for compressions. Gee, I wonder why I wasn't taught that a stretcher wasn't good enough? As I've said at LEAST _twice_ already, it's a MOOT POINT for my jurisdiction.
> 
> So don't tell me what I'm being taught in _my_ class. If you want to mention it at all, you may _ask_ if that's taught in my class. And don't _ever_ tell me, or anyone else, what's going on in _my_ mind. Period.




Trust me, I know what the AutoPulse is. I work for one of the best EMS Agencies in the nation.
I know the AutoPulse has a back board. I also know that it doesn't fit EVERYONE. 
You're taught to do compressions with a firm and stable surface underneath the patient. So if you feel that a mattress on a cot is good enough, go ahead. I'm just saying that a back board will provide adequate compressions. 
Oh, another question. If you don't agree with doing CPR on back boards. THEN WHY IS A BACK BOARD ATTACHED TO THE AUTOPULSE? <---- The love of your life.


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## NetMatrix

The AutoPulse is a great device to have, but sadly not every service has one in their ambulances.  With ours (meaning the area I live in) only the ALS ambulance is equipped with one.  Sadly where I live each region has their own protocols on how things are to be done.  

As far as the CPR chapter in the EMT book.  With the school I went to class ended on the 15th and I passed it with flying colors we are required to be certified to perform CPR before you can even think about enrolling in the class.  Sadly we did have a chapter that was required to be taught that dealt with CPR.  Personally I think it was dumb the book had that chapter in it and it had to be taught.  Myself and 2 fellow classmates were the only 3 out of the class of 15 that were already certified to perform CPR, and that is due to us 3 being with a fire department; which at least for my department and one of the other guys department CPR certification is required encase there is someone trapped inside a burning building and you have to perform CPR.

With the use of a back board I do personally feel that it is an important piece of equipment to use if you are having to do CPR on a patient.  That is because it does give a hard surface to make sure compressions are being done to their fullest.  Not every ambulance service out there has the AutoPulse.  Our ambulance service is a volunteer service so there isn't that much money to just go out and spend.  Yes we can get a grant for equipment, but in the state of Illinois good luck getting grants.  With our fire department we've been working the last 2 years to get a grant to replace some of our SCBA and we have been turned down both times.  

Now I did talk with the chief who also spoke with the departments lawyer, and no we aren't at any legal issues with him having me go to the PT's house and that is because I am trained to do what I did.  I felt the need to check on that information after the debates on this thread.  Each state is different and according to the departments lawyer because I performed the first aid skills that we are trained to perform, and I did not step out side of my duties the department and myself can not get into any trouble for the actions that were taken.  So we can get that part straightened out now and leave that part alone.  I do not like the turns that this thread has taken.  It started off with people disagreeing with the decision my fire chief made for me to go and try to save this woman's life because of the amount of time it takes for the department to get to this area.  To now other members are getting out of line with each other.  I know disagreements happen on forums, and I know this because I won a website that has a forum with over 50,000 members on it.  

On another note since it was followed up with the department with the coroners office the PT's medication is what lead to her death due to a over dose which lead to the seizure and her heart failing.  I did what I could to to try and bring this woman back.  I did what I was trained to do...


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## NetMatrix

Oh' and to clear up on the text book it's Prehospital Emergency Care 9th Edition chapter 10 Airway Management, Artificial Ventilation, and oxygen.  It's not a CPR titled chapter, but it does deal with CPR.  It is also mentioned ina couple other chapters, but I sold my book back to the school so I don't have it for chapter reference anymore.  Just the mybradykit website.


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## JJR512

clibb said:


> Oh, another question. If you don't agree with doing CPR on back boards. THEN WHY IS A BACK BOARD ATTACHED TO THE AUTOPULSE? <---- The love of your life.



Time for some remedial education, it seems. I already explained this once, so to save time and energy, I'll just repeat myself...



JJR512 said:


> I also *never disagreed* with the decision to use a long board. So I'm not sure why you're picking on me as if I have. There wasn't enough information in the original post for me to see that there was a need, that's why I _questioned_ the need. *Questioning something is not the same as disagreeing with it.*



If that concept that _questioning_ something is not the same as _disagreeing with it_ is too complex for you to understand, please say so, and I'll try to explain it in smaller words, although frankly, I'm not sure if I can think down much further than I've already had to do so for your benefit.

Oh, and "The love of your life"...what is that in reference to? Were you signing your post as the love of my life? If that's the case, I have no comment—at least, none that can be posted without violating the rules of this website. If you were indicating the AutoPulse to be the love of my life...No. I don't care about it one way or the other. Once again, you've tried, and just as before, failed miserably, at trying to make assumptions about me.

Perhaps it's time for you to stop making snide comments, stop attacking me on something I didn't say, and either post something that's actually productive and relevant to the topic of this thread or move on.


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## Veneficus

clibb said:


> What if the patient went into a seizure and while falling hit her C2 or C3 and injured them. What would be one of the outcomes?
> Inability to breathe using chest muscles or diaphragm. Therefore, she would not be breathing. Could this cause cardiac arrest? Yes. *Would C-spine stability help this patient? Most likely*..


 
You are such an optimist, I like that.

But let me offer something more likely.

If the patient actually had cord or phrenic nerve damage with paralysis of the diaphragm, c-spine or not, the outcome is a vent dependant, perhaps quad who will lay in a nursing home until she dies from complications of a decubitus ulcer or pneumonia.


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## JJR512

NetMatrix said:


> Oh' and to clear up on the text book it's Prehospital Emergency Care 9th Edition chapter 10 Airway Management, Artificial Ventilation, and oxygen.  It's not a CPR titled chapter, but it does deal with CPR.  It is also mentioned ina couple other chapters, but I sold my book back to the school so I don't have it for chapter reference anymore.  Just the mybradykit website.



This all may very well be perfectly true. But I did say, "Therefore, there is no chapter for it in _my_ EMT book." The book you are talking about is _not_ my text book. And no, I do not mean it's not the actual one that's sitting right next to me right now—I wouldn't be that childish. I mean it's not the same title and/or edition. You see, a big part of my point was that *clibb* should not be telling me (or anyone else) what I'm thinking about, or what's going on in my class, or what my book says, when he has no way of knowing what's going on in my mind, he's not in my class so he doesn't know what has or hasn't been discussed, and he doesn't know which book I'm using—just as you don't. So don't tell me what's in my book if you don't even know which book I have. They are _not_ all the same.


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## JJR512

clibb, I hope you can realize that it's not you, personally, that I don't like. What I dislike is being misunderstood, especially if someone wants to argue with me over something I never said. And I also dislike people tell me (or anyone else) what I'm thinking or wishing.

So I hope the part of this thread where you interpret feelings I never expressed, and my defense thereof, is concluded. I hope you can agree to move on from that. Because now, I am very interested to see what, if any, response you have to what Veneficus has just said. He has raised an interesting point and I am interested in seeing what discussion stems from it, and perhaps learning something.


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## NetMatrix

JJR512 said:


> This all may very well be perfectly true. But I did say, "Therefore, there is no chapter for it in _my_ EMT book." The book you are talking about is _not_ my text book. And no, I do not mean it's not the actual one that's sitting right next to me right now—I wouldn't be that childish. I mean it's not the same title and/or edition. You see, a big part of my point was that *clibb* should not be telling me (or anyone else) what I'm thinking about, or what's going on in my class, or what my book says, when he has no way of knowing what's going on in my mind, he's not in my class so he doesn't know what has or hasn't been discussed, and he doesn't know which book I'm using—just as you don't. So don't tell me what's in my book if you don't even know which book I have. They are _not_ all the same.



Trust me I wasn't attacking what you said about the EMT book.  I was stating what was in my book which is a new book to the market for EMT.  I know not all EMT books have CPR items in it.  I was making a point on what you said about CPR being required to do the EMT class and that's how it was with us, but that didn't happen and OUR book had CPR stuff in it.  That's where I was going with what I posted.  I agree 100% that yes you should know CPR before getting into the class, but with us it didn't happen like that.  I just put on here what book I had to use in case anyone wanted to take a look at that book to see what all it had to say.


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## JJR512

I don't necessarily agree that one should need to know CPR before getting into the class. I understand why the curriculum is set up that way, though, and it has more to do with the curriculum designers trying to find ways to cram more information into the course without increasing the number of hours it takes. They did that by taking other parts out, like CPR, and making them prerequisites instead of core components.

The book you're using is designed to meet NREMT-B standards. The book I'm using is designed to meet US-DOT standards. There's a member of my station who became an EMT-B in California, and she used the same book you have. I only got a look at it once, but noticed it had a lot more info and detail on the different breath and lung sounds. I would actually like to get a copy of that book, partly because I plan to take the NR test right after I'm done with my class, and partly because I think one can learn more when one studies from more than one source. It's a lot more expensive than the book my system uses, though.


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## NetMatrix

JJR512 said:


> I don't necessarily agree that one should need to know CPR before getting into the class. I understand why the curriculum is set up that way, though, and it has more to do with the curriculum designers trying to find ways to cram more information into the course without increasing the number of hours it takes. They did that by taking other parts out, like CPR, and making them prerequisites instead of core components.
> 
> The book you're using is designed to meet NREMT-B standards. The book I'm using is designed to meet US-DOT standards. There's a member of my station who became an EMT-B in California, and she used the same book you have. I only got a look at it once, but noticed it had a lot more info and detail on the different breath and lung sounds. I would actually like to get a copy of that book, partly because I plan to take the NR test right after I'm done with my class, and partly because I think one can learn more when one studies from more than one source. It's a lot more expensive than the book my system uses, though.



I like the book personally.  Yes it has a lot more information in it, and there is some information in there that I think is pointless.  Like with Environmental Emergencies it has 2 pages about being struck by lightening, but all it is really telling you in those 2 pages is what month is worse, what day of the week is worse, and a whole bunch of other things.  Then again all text books has some information in there that just isn't needed in my personal opinion.  I learned a great deal from that book, and from the instructor.  I enjoyed being int hat class, and now January 19th I have to take the state test that I'm doing a little bit more studying for just to be 150% prepared for that test.  I have full confidence that I'll pass the state test with out any problems, but still have to study.


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## dixie_flatline

Just a quick note - and I hate to fan any flames since we've gotten fairly well away from OP's original premise, but in my EMT class in Anne Arundel Co MD, we were specifically told never to perform CPR on a cot/stretcher.  If necessary, the patient is rolled over and a short board inserted underneath them.  (I don't believe AACo has the luxury of AutoPulses like Howard does.)


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## JJR512

dixie_flatline said:


> Just a quick note - and I hate to fan any flames since we've gotten fairly well away from OP's original premise, but in my EMT class in Anne Arundel Co MD, we were specifically told never to perform CPR on a cot/stretcher.  If necessary, the patient is rolled over and a short board inserted underneath them.  (I don't believe AACo has the luxury of AutoPulses like Howard does.)



Yeah, they didn't have them when I was there, but that was four years ago. At least not that I ever knew of or heard about, anyway.

When and where did you take your class? Who was your instructor? What station are you with? I was at Ferndale (34) back in 2006, took EMT with Nina Totaro, Russ Zachary, and Jack Hulet as the instructors.


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## Sassafras

Hmmm, our class was US DOT guidelines as well, but we had CPR and it did say not to use the cot.  It recommended short board or long board. I specifically remember our instructor saying "now this is what your books says, but in all reality if your patient craps out while on the stretcher you aren't going to unstrap him, roll him and stick a board under him.  You are just going to start compressions".

My first cardiac arrest I went as a newly certified FR and the team called for the long board as well.  It enabled them to continue compressions until the 1 second maneuver to lift him onto the cot then compressions continued again.  We do not have an auto pulse though and I would honestly  have no idea what to do with one as I've never even seen one.


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## JohnsFutureWife

JJR512 said:


> I have two comments, both based on the parts of your quote that I highlighted.
> 
> 1. "diffubilater" This has got to be the bestest misspelling of _defibrillator_ that I've ever seen.
> 
> 2. Why was the patient put on a long board? Doesn't seem indicated to me.



What if the PT fell before she stopped breathing and went into Cardiac Arrest. It wouldn't hurt to take precautions and immobilize. If I didn't know the MOI/NOI exactly I'd immobilize to be on the safe side.


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## firemedic07

JohnsFutureWife said:


> What if the PT fell before she stopped breathing and went into Cardiac Arrest. It wouldn't hurt to take precautions and immobilize. If I didn't know the MOI/NOI exactly I'd immobilize to be on the safe side.



id use the board because it would make it easier to do compressions. but if the pt. dfo on my stretcher im not gonna unstrap em and waste time. thats one of them nice things to have if you have the resources and time. and equpiment avaliable at that time,


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## legion1202

NetMatrix said:


> Yep it's a life threatening situation.  It would be documented on the paperwork as a trauma.



I`m going to just go ahead and say it since everyone is beating around the bush... Did you dream this since you were studying your emt book?


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## Veneficus

legion1202 said:


> I`m going to just go ahead and say it since everyone is beating around the bush... Did you dream this since you were studying your emt book?



Since technically all trauma is medical in nature, it is either a basic mistake or a very advanced level of thinking.

A thrombolitic event like an MI is caused by physical damage of the coronary vasculature.

Embolisms are also traumatic by definition. 

Aside from these examples, the seperation of trauma and medical is strictly a memory aide which artifically seperates that which is not.


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## legion1202

You are right but I do not think he was applying that. From different protocol books that I have read they define trauma pretty good... You usually have a MOI with a trauma... Like Bullet entering chest.. Meteorite falling on someone.. A fall can even be a MOI and equal a trauma. A medical would be something  that the body would do to its self. Like a blood clot in the head or AAA.. Something other then direct outside causes (I would think).

Yes a medical could be a trauma if that fall caused a punctured lung.. But from what i`ve learned... A Trauma "CALL" would have to have some MOI.. You could also have a medical resulting a fall... equaling now a trauma


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## Veneficus

legion1202 said:


> You are right but I do not think he was applying that. From different protocol books that I have read they define trauma pretty good... You usually have a MOI with a trauma... Like Bullet entering chest.. Meteorite falling on someone.. A fall can even be a MOI and equal a trauma. A medical would be something  that the body would do to its self. Like a blood clot in the head or AAA.. Something other then direct outside causes (I would think).
> 
> Yes a medical could be a trauma if that fall caused a punctured lung.. But from what i`ve learned... A Trauma "CALL" would have to have some MOI.. You could also have a medical resulting a fall... equaling now a trauma



forgive me, but you are trying to refute an intensive medical concept with EMS protocol books?

The more you learn about medicine, the more insignificant the seperation is. The pathology is exactly the same. Not surprisingly, the treatment options and modalities are also the same.


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## legion1202

If you want to debate medical terminology with a P2 student find another student to debate with you. All i was trying to say is via text books, some protocol books, instructors, etc.. In EMS... There is a difference for a medical call and a trauma call.

Maybe your right with further training there inst a difference.

Off of what this guy said your going to C-collar, backboard someone with a asthma attack that was brought on by a severe cold...Not a Trauma which I refer to as a fall or a shooting.

I`m not saying I think you are wrong because you are Right.. A MI is a trauma towards the body its self... I am not a cardiologist so I will not know the MOI of this sudden MI.. This is a medical condition to me...


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## Veneficus

legion1202 said:


> If you want to debate medical terminology with a P2 student find another student to debate with you. All i was trying to say is via text books, some protocol books, instructors, etc.. In EMS... There is a difference for a medical call and a trauma call.
> 
> Maybe your right with further training there inst a difference.
> 
> Off of what this guy said your going to C-collar, backboard someone with a asthma attack that was brought on by a severe cold...Not a Trauma which I refer to as a fall or a shooting.
> 
> I`m not saying I think you are wrong because you are Right.. A MI is a trauma towards the body its self... I am not a cardiologist so I will not know the MOI of this sudden MI.. This is a medical condition to me...



Wasn't trying to argue, just wanted to see if I understood your position.


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## legion1202

Like I said I agree with you and it is a very clever way of thinking... Happy holidays!


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## EMT-IT753

In our area, ALL patient's that we are performing CPR on, are secured to a longboard and then put on the cot. Is it possible to perform adequate compressions on just the stretcher mattress? Possibly, but they are much better when done on either a longboard or short CPR board.

Also, as far as the OP responding to a call without having completed his EMT course- BIG DEAL. As long as a person is CPR qualified that is all that really matters. Around here, that type of call would have been coded as an ECHO response and anyone with training would have been expected to respond. 

Call me a "whacker" or whatever you feel, but I would have and have responded to several situations exactly like the OP did. My department, co-workers, and the patients' families were all thankful for the quick response. To sit and nit-pick on everything the OP did and said on here is really pointless. Are there that many people on here with the "holier than thou" attitude? 

I enjoy coming to this site but my instructor has told me many times, " If you ever get the ParaGod attitude, I will personally kick your tail." It seems there is a lot of that mentality on here at times. How about instead of criticizing everyone, try to encourage newcommers and offer a little praise?


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## jjesusfreak01

The only difference between trauma and medical calls are the treatments for specific conditions. If there is possible spinal injury, they get immobilized. If they meet trauma criteria, they get sent to a trauma center. There's no reason to argue the difference between trauma and medical calls.


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## NetMatrix

When we got the call we didn't know exactly what happened.  The PT's other half was to upset to tell us exactly what happened.  We didn't know if she was standing when she had the seizure or what which is why she was a trauma PT.  Did she fall down and injure the neck we didn't know, did she injure the back of her head we didn't know.  The boyfriend didn't tell us everything that happened.  If someone has a MI they can fall down possibly injuring the head, spinal cord, etc.  That is why in those situations they are considered to be trauma.  It's actually very easy to understand.

Now with the criticism I don't take it personally.  I actually enjoy it and enjoy the arguing over simple things, because it makes a person like me to become better at my duties and better analyze things to argue the points even better.  Now yes I'm completely new at this so I can't argue much about it, and no I'm not certified, but with being the only person in my class to pass it with a A and on every clinical evaluation forms to have good knowledge you know that works for me.

Now lets go back to the main part of the argument for this topic.  Was I certified EMT at the point of the call...NO.  Am I trained and certified to perform CPR...YES.  With the response time of rescue 15-20 minutes and the ambulance 25-30 minutes because of road conditions due to snow and ice was it a good idea for me to go over there any try to keep her alive...YES.  What I did before anyone else got there is possibly why we were able to get a shock and why the ambulance was able to get the 4 shocks they got.  BECAUSE the compressions I did to this PT kept the blood flowing and gave the heart a rhythm.  Yes it is upsetting that the PT didn't live it is very upsetting, and it really laid a lot of weight on my shoulders for about a week until I finally decided it was time to talk about it.  

Now why don't ya'll put yourself in a actually looking at the position I was put in because of the response time.  What would have each one of you done if you lived a block away from a PT that was unresponsive like this PT was, and your officer in command said go over there and you refused to cause you weren't a CERTIFIED EMT, but YOU DID have training to perform CPR.  Now after you refused to go to that call to try and keep that PT alive, but the PT had zero chance because you refused to go over there because of one piece of paper that you didn't have just yet even though you had the other piece of paper saying you are certified to perform CPR.  So lets start there and tell me how you would have felt cause you lowered the chances of that PT's survival because you refused to go because you weren't a certified EMT, but you were certified to perform CPR.

I hope that last paragraph everyone can understand clearly on what I mean.  If you sit there and tell me (well typing it) that you wouldn't have felt bad about it I'm telling you right now your full of chit.  I did the right thing, and the chief at my department did the right thing with making the decision to send me over there to try and give this persona  better chance at survival.  

Now lets just stop fighting over the back board.  I don't really give a flying rat's a** if you were trained to use it or not.  WE USE IT, and our department will not change the way we do things.  The back board is being drawn out way to much.  OMG grow up and fight about something better than a piece of hard plastic that helps a lot in doing CPR.  And yes if you can tell I'm pretty ticked off right now.  Find some positive things to say or delete my account and I'll move on to a better site that won't have fighting over stupid things like this.  3 pages worth of fighting over the damn back board.


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## Veneficus

NetMatrix said:


> When we got the call we didn't know exactly what happened.  The PT's other half was to upset to tell us exactly what happened.  We didn't know if she was standing when she had the seizure or what which is why she was a trauma PT.  Did she fall down and injure the neck we didn't know, did she injure the back of her head we didn't know.  The boyfriend didn't tell us everything that happened.  If someone has a MI they can fall down possibly injuring the head, spinal cord, etc.  That is why in those situations they are considered to be trauma.  It's actually very easy to understand.
> 
> Now with the criticism I don't take it personally.  I actually enjoy it and enjoy the arguing over simple things, because it makes a person like me to become better at my duties and better analyze things to argue the points even better.  Now yes I'm completely new at this so I can't argue much about it, and no I'm not certified, but with being the only person in my class to pass it with a A and on every clinical evaluation forms to have good knowledge you know that works for me.
> 
> Now lets go back to the main part of the argument for this topic.  Was I certified EMT at the point of the call...NO.  Am I trained and certified to perform CPR...YES.  With the response time of rescue 15-20 minutes and the ambulance 25-30 minutes because of road conditions due to snow and ice was it a good idea for me to go over there any try to keep her alive...YES.  What I did before anyone else got there is possibly why we were able to get a shock and why the ambulance was able to get the 4 shocks they got.  BECAUSE the compressions I did to this PT kept the blood flowing and gave the heart a rhythm.  Yes it is upsetting that the PT didn't live it is very upsetting, and it really laid a lot of weight on my shoulders for about a week until I finally decided it was time to talk about it.
> 
> Now why don't ya'll put yourself in a actually looking at the position I was put in because of the response time.  What would have each one of you done if you lived a block away from a PT that was unresponsive like this PT was, and your officer in command said go over there and you refused to cause you weren't a CERTIFIED EMT, but YOU DID have training to perform CPR.  Now after you refused to go to that call to try and keep that PT alive, but the PT had zero chance because you refused to go over there because of one piece of paper that you didn't have just yet even though you had the other piece of paper saying you are certified to perform CPR.  So lets start there and tell me how you would have felt cause you lowered the chances of that PT's survival because you refused to go because you weren't a certified EMT, but you were certified to perform CPR.
> 
> I hope that last paragraph everyone can understand clearly on what I mean.  If you sit there and tell me (well typing it) that you wouldn't have felt bad about it I'm telling you right now your full of chit.  I did the right thing, and the chief at my department did the right thing with making the decision to send me over there to try and give this persona  better chance at survival.
> 
> Now lets just stop fighting over the back board.  I don't really give a flying rat's a** if you were trained to use it or not.  WE USE IT, and our department will not change the way we do things.  The back board is being drawn out way to much.  OMG grow up and fight about something better than a piece of hard plastic that helps a lot in doing CPR.  And yes if you can tell I'm pretty ticked off right now.  Find some positive things to say or delete my account and I'll move on to a better site that won't have fighting over stupid things like this.  3 pages worth of fighting over the damn back board.



I am not understanding the issue you are having. 

You responded to a scene at the direction of your superior and provided care within the limit of your certification. (CPR as I understand it)

I am not sure how anyone who advocates for early CPR to increase survival can really find any fault in that. 

As I stated before, the more you learn, the more you discover there really is no division in medical and trauma. So what is the problem in calling it what you will?

Some people find it helpful to use a spine board to help with CPR. Some don't. There are very few absolutes in medicine. In fact the only one I can think of is: If delta G = 0, patient is dead. It is only by discussing our different approaches that we improve our individual practice.

The use of the long spine board is one of the great debates of our time in EMS. So welcome to the club, put your membership jacket on and join the debate.

No I don't get bothered when patients die, I have been at this a while. Infact unless there was something significant about it, I don't even bother to try and remember them all. I think 2 died on me last week actually, maybe 3. Can't remember. Don't care.

Calm down a little. Even if I don't always agree with their views there are some really smart people here. You will not be able to engage in meaningful conversation as a healthcare provider with absolute ideas or thinking the only thing that matters is what your department does. Life is bigger than that, medicine is bigger than that. 

I think you put too much worry into "what if..." for a cardiac arrest. So what if they fell. So what if they have spinal cord damage. If you actually get rosc, we can worry about it then. I never met a dead person who was mad about being paralyzed. The spine board doesn't prevent cord damage. Especially if you are performing CPR.


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## MrBrown

*Brown looks out the helicopter window ....

Think we'll aviod this one Oz ... doesn't look to be anywhere we can land


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