# Prehospital Cardiac Save at the pre-Inagural Event



## frdude1000 (Jan 19, 2009)

Hello Everybody!

I would just like to share an amazing call my partners ran at the Pre-Inaugural Event yesterday.  My unit is an explorer post with our local fire department and we are trained to the first responder level.

Just as the truck pulled up to their assigned first aid tent, somebody came up and said "somebody's unconscious!  Please help!!".  Two teenage first responders responded and immediately started cpr.  They then got the aed and shocked the man three times with expired pads.  Then, they got the pulse back!  It is unknown if the patient survived at the hospital.  Isn't that great!?!


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## redcrossemt (Jan 19, 2009)

Congratulations!



frdude1000 said:


> They then got the aed and shocked the man three times with expired pads.



Where was this AED from? Why were the pads expired?


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## frdude1000 (Jan 19, 2009)

It was our AED and i'm not sure why the pads were expired


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## daedalus (Jan 19, 2009)

First, let me say I am happy that a life was saved.

Second, I want you to be proud of your enthusiasm and take it with you into your future EMS endeavors. 

Third, I am going to very very sternly to you something. I am shocked, disappointed, and disgusted in the EMS coverage of the national historical event of our President-elect's Inauguration. 

They have pulled out all the stops and have every police and federal agency covering the event, so I am POSITIVE they have an Incident Command set up to make sure inter agency co-operation is accomplished and a single chain of command is followed. If that chain of command has allowed teen agers to respond to medical emergencies than it should be dismantled. Further, the use of substandard equipment on patients is unethical, unprofessional, and probably illegal.


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## frdude1000 (Jan 19, 2009)

First of all, the people who performed CPR and used the AED just arrived before the event started and had not been given supplies yet.  They had an AED that they wern't planning on using at the event because it had expired pads.  The only thing expired means on AED pads is that they are not guaranteed to be as sticky.  Secondly, why does it matter that we are teenagers?  We have the same training as others and we are trustworthy, bright, and responsible.  That day, we worked in conjunction with DC EMS, the US Public Health Service Nurse Practitioners, and Park Service EMS Personnel.  We give the same standard of care adults do and sometimes even better.  That day, I helped a person who was having an asthma attack, a girl having a panic attack, and a man who fainted in the crowds, along with many minor hypothermia patients.


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## Jon (Jan 19, 2009)

What is wrong with having Explorers or Red Cross volunteers ASSIST EMS at the first aid stations?


FRDude1000 - Is this post affiliated with a Fire Department, an EMS agency, a Law Enforcement agency, or something else? Were you there with other members of your group? Other members of your agency?


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## daedalus (Jan 19, 2009)

Jon said:


> What is wrong with having Explorers or Red Cross volunteers ASSIST EMS at the first aid stations?
> 
> 
> FRDude1000 - Is this post affiliated with a Fire Department, an EMS agency, a Law Enforcement agency, or something else? Were you there with other members of your group? Other members of your agency?



A lot is wrong with it, but we have already had those discussions on this board. Looking up the threads, Rid/ryder has made some excellent points in the past. If by assist you mean hand out band aids at a booth, or collect donations, no its a perfect and honorable volunteer activity. These children were providing CPR!

Also, if the AED was not planned on being used, why was it there? And no, the expiration date tells you when something can NO longer be used. If that man had not been ROSC, his family/estate could sue you.


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## Jon (Jan 19, 2009)

Daedalus:

The AHA has a big push to teach CPR to middle-school kids. I know PLENTY of kids in my high school that had CPR cards.

The other big push with CPR is LAYPERSON CPR... or non-ems providers preforming CPR.

I can't imagine that anyone would have dispatched an Explorer to an emergency... but given the scenerio of being flagged down - they had appropriate training and got things started before EMS arrived.


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## frdude1000 (Jan 19, 2009)

I think you have it wrong.  I don't just have my layperson CPR card.  I am a first responder assigned to a tent during the inaugural events to provide EMS care in conjunction with DC Fire and EMS, the US Public Health Service, and Park Service EMTS and Paramedics.  We were dispatched to calls yesterday at the pre inaugural event and will be working tomorrow at the inauguration.  My partners who handled the cardiac arrest had a duty to act, they were on duty.  We are responsible for caring for the patrons and do a great job at it.  We are part of EMS, we don't wait for it


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## medic417 (Jan 19, 2009)

Until you find out the person left the hospital in basically the same shape as before having cardiac arrest I can not call it a save.  I am happy that they gave the person a chance but until we see the patient walk out of hospital they are still dead.  This is one of the great flaws in EMS.  To many claim saves for people because they did not die in the ambulance.  I also tire of the statement nobody dies in my ambulance.  If you are doing CPR they are dead.  Just because you wheel them into the hospital to let the doctor pronounce they were dead already.  And that brings me to another complaint, doing CPR while the ambulance is moving.  It is impossible to do quality CPR and is against current AHA guidelines.


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## daedalus (Jan 19, 2009)

Jon said:


> Daedalus:
> 
> The AHA has a big push to teach CPR to middle-school kids. I know PLENTY of kids in my high school that had CPR cards.
> 
> ...



I respectfully disagree.

Children with CPR cards are really just so they know when to call 911 if one of their grandparents starts to display MI or CVA s/s, and, to call 911 if they collapse. A noble undertaking none the less.

Children should not be exposed to cardiac arrest in a professional capacity. I cried the first time I saw a grown man die after working him, and I am an adult.


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## frdude1000 (Jan 19, 2009)

medic417 said:


> Until you find out the person left the hospital in basically the same shape as before having cardiac arrest I can not call it a save.  I am happy that they gave the person a chance but until we see the patient walk out of hospital they are still dead.  This is one of the great flaws in EMS.  To many claim saves for people because they did not die in the ambulance.  I also tire of the statement nobody dies in my ambulance.  If you are doing CPR they are dead.  Just because you wheel them into the hospital to let the doctor pronounce they were dead already.  And that brings me to another complaint, doing CPR while the ambulance is moving.  It is impossible to do quality CPR and is against current AHA guidelines.



It is considered "a pre-hospital" save, meaning we got a pulse back in the field.  I never said anything about them living.  They could have died in the hospital.


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## frdude1000 (Jan 19, 2009)

Wow.  Again im not "a child with a CPR card".  Maybe you wern't mature or mentally and physically capable of working in EMS when you were a teen, but I am.  As long as we have the same training, why does it matter what we are on the outside?  We act older than we are and are always praised for our professionalism and quality of care


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## bstone (Jan 19, 2009)

frdude1000 said:


> Wow.  Again im not "a child with a CPR card".  Maybe you wern't mature or mentally and physically capable of working in EMS when you were a teen, but I am.  As long as we have the same training, why does it matter what we are on the outside?  We act older than we are and are always praised for our professionalism and quality of care



You're certainly not a child with a CPR card. Just ignore the guy who is saying that. I read about your save and I am really proud of you! You all saved someone's life and you can be proud of yourself for the rest of your life! Good job! :beerchug::beerchug::beerchug:


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## bstone (Jan 19, 2009)

daedalus said:


> I respectfully disagree.
> 
> Children with CPR cards are really just so they know when to call 911 if one of their grandparents starts to display MI or CVA s/s, and, to call 911 if they collapse. A noble undertaking none the less.
> 
> Children should not be exposed to cardiac arrest in a professional capacity. I cried the first time I saw a grown man die after working him, and I am an adult.



Daedalus, I think your opinion has clearly been made. Thank you. Now let's not take away from the guy's moment of glory, ok?


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## medic417 (Jan 19, 2009)

frdude1000 said:


> It is considered "a pre-hospital" save, meaning we got a pulse back in the field.  I never said anything about them living.  They could have died in the hospital.



A save is a person walking out basically in tact.  But congrats on getting a pulse back and giving them a fighting chance.


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## daedalus (Jan 19, 2009)

bstone, anyone under 18 is child, and I did not use the term offensively. I congratulated the OP on his save, which is admirable. 

There is no there medical profession that let minors participate, but than again, that is one thing that separates us from professionals. Also, the feeling of glory is yet another thing that separates us from our professional counter-parts.

I will exit the discussion now.


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## bstone (Jan 19, 2009)

daedalus said:


> bstone, anyone under 18 is child, and I did not use the term offensively. I congratulated the OP on his save, which is admirable.
> 
> There is no there medical profession that let minors participate, but than again, that is one thing that separates us from professionals. Also, the feeling of glory is yet another thing that separates us from our professional counter-parts.
> 
> I will exit the discussion now.



I think that he might legally be a minor but he's clearly very mature. In that regard he's an adult.

I know of several ambulance squads which allow 16 year olds to ride. I even recall a bunch of high schoolers who run their local BLS squad. They are all clearly very, very mature.

Thanks for the chat. I think he ought to recognize the guy for his achievements, not belittle him. But that's just me.


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## IaEMT (Jan 19, 2009)

*Prehospital Cardiac Save....*

There is lots of information we DON't have here.  I'm kinda surprised at the vehemence this post has received.  ALL levels of providers can provide initial care of some kind, and that care is (usually) better than none at all.  These young folks should be applauded for pursuing a career most people won't consider.  And I seriously doubt they would be asked to provide services at the Inauguration if they weren't certified first responders.  I also doubt that they are unsupervised once they are actually on station.  I do agree with the comments about the AED however.  If the pads were expired, and they knew it, the pads should have already been discarded and new ones procured.  I would advise a little better QC there.


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## BEorP (Jan 19, 2009)

frdude1000 said:


> It is considered "a pre-hospital" save, meaning we got a pulse back in the field.  I never said anything about them living.  They could have died in the hospital.



If they died in the hospital, they weren't really "saved" then were they? Cardiac arrest survival really only matters when the patient is discharged from the hospital with a good neuro status.


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## BEorP (Jan 19, 2009)

medic417 said:


> Until you find out the person left the hospital in basically the same shape as before having cardiac arrest I can not call it a save.  I am happy that they gave the person a chance but until we see the patient walk out of hospital they are still dead.  This is one of the great flaws in EMS.  To many claim saves for people because they did not die in the ambulance.  I also tire of the statement nobody dies in my ambulance.  If you are doing CPR they are dead.  Just because you wheel them into the hospital to let the doctor pronounce they were dead already.  And that brings me to another complaint, doing CPR while the ambulance is moving.  It is impossible to do quality CPR and is against current AHA guidelines.



Nicely put.


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## Ridryder911 (Jan 19, 2009)

First lesson in life, you did not save anyone. You just so happened to be there at the right time to place pads upon him and the machine did what it was supposed to do. 

So you raised the shirt and place the pads and pushed the button... wow! Not really surgery, really is it? 

I am irritated by kids acclaiming or trying to compare themselves to medical professionals in which they are NOT! 

Yeah, I know all about Medical or EMS Explorer programs. I myself started working in the ED as one probably before your parents were born. Even was a Post Advisor and District Chairperson for about ten years. I was foolish and finally learned differently. Exposing kids to harmful events and responsibilities had more consequences than the benefits; even though out of the Post three became physicians and four became nurses and five entered EMS. We also had two that years later displayed PTSD... all because they were not emotionally able to be exposed to such. 

Its a great program to train and slightly expose the profession but should NEVER be responsible for direct patient care! 

Now, let me ask you this. Are you prepared to be sued? Is your parent's willing to finance their house and your college education for your "save"? You just admitted on a national forum that the pads were out of date. This is a Federal violation alike medication being out of date and technically you can be sued for knowing and willing to operate the device with such attachments. Yes.. you! It does not matter that it worked, they still can sue. How do we in medicine really... really know that there might not have been a malfunction due to pit of date device? Yes, I doubt it would occur .. but yes, it could. 

Feel like a hero now? You have just demonstrated why kids should not be responsible. Checking equipment and being responsible to state that you will not be responsible to use equipment until appropriate changes occur. 

It takes much more than just taking a class or even passing a test. Critical thinking skills are essential in this *profession. * Most of these cannot occur until of the age of 25. Not that does not in all but in the general population. Hence the same reason insurance rates decrease at such age. 

I welcome all youth or anyone to explore the EMS profession. Learn what it incorporates to be a good medic, prepare to enter the profession and good points as well as pitfalls. Being informed is essential, it is that it is a serious profession that needs to be performed by adults. Alike any other medical profession, EMS is NOT an exception. 

R/r 911


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## bstone (Jan 19, 2009)

Rid, 

You have zero proof to demonstrate those developing PTSD did so by anything they saw  in your Explorer post, driving down the street, an abusive uncle or a bad dream. I did Law Enforcement Explorers for 4 years as a teen. We were constantly doing ride alongs, training with the riot team (we were the simulated rioters) and on the street doing crowd/parking control during 4 July and when the carnival came to town. 

Loved every second of it. Had I not done EMS and medicine for my career I surely would have done LE.

I saw plenty of bloody fights, violent arrests, crazy people etc. I was 14 when I started the post and 18 when I left to go away to school. None of it left me traumatized. Perhaps some people it would, but I knew ahead of time that LE and EMS can be scary. I was prepared mentally for seeing injured and dead people.

That said, I am hugely in favor of Fire and EMS Explorers. I am going to get involved in it locally and encourage full EMT-B training.


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## Shishkabob (Jan 19, 2009)

Am I the only one that read the "first responders" part in his OP?

Now, I may be wrong, but isn't MFR a level of healthcare providers, trained to, dare I say, provide a basic level of health care?   And my guess is, they also had a CPR cert to BE said MFR's?


Uh-oh, trained people helped?!  What has this world come to?!


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## daedalus (Jan 20, 2009)

bstone said:


> Rid,
> 
> You have zero proof to demonstrate those developing PTSD did so by anything they saw  in your Explorer post, driving down the street, an abusive uncle or a bad dream. I did Law Enforcement Explorers for 4 years as a teen. We were constantly doing ride alongs, training with the riot team (we were the simulated rioters) and on the street doing crowd/parking control during 4 July and when the carnival came to town.
> 
> ...


Now that I have some back up points of view, ill toss myself back into the rink.

Many of my colleagues, one whom just left my house after crying about ten minutes ago, suffer immensely from the pyschiatricly disabled children we see, the critically ill and dying children we treat, and see just how far life can actually go down the toilet. The one that just left my house is taking an SSRI, and so am I. This profession is harmful to adults, imagine subjecting a developing mind to it. Also bstone, you claim the kid is mature. That may be true, but he is still a teenager with a developing frontal cortex, and therefore no matter how mature, is prone to make rash and inappropriate decisions based on his biology.

Medical doctors do not allow children to participate in their care, surgeons do not have children helping in the OR, Echocardiographers do not let children produce imaging studies. No children are even interested in echocardiography because there are no lights and sirens. 

bstone, we are at the point that will make or break us. Most medical doctors want to let the united states public know that EMS is a complete hoax, and they want to show the public studies that demonstrate we make no difference in patient care. I will provide you with names and contact information for these physicians if you wish. I will show you their studies as well. If we do not shape up, embrace evidence based practice, unify our education and create a professional EMS instead of rescue first aid squads, etc, we will be dismantled. I am serious, this is not an inflammatory post. 

They are going to take our advanced scope away from us, and send us back to the days of scoop and go. We need to shape up. Having children as providers just gives them a whole new side to shoot at us.


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## bstone (Jan 20, 2009)

Daedalus, thought you said were exiting this conversation? Or did I read that wrong?

Edit: yes, you did say it: 
Link:
http://www.emtlife.com/showpost.php?p=117879&postcount=17


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## XxBigBrotherxX (Jan 20, 2009)

You did a really good thing job as a First responder. Im also very young(18). And i've noticed how alot of older EMTs really come down on us so hard as if we are not capable of performing well just because of our age. They have it in their hearts and minds that we are irresponsible and immature. Thank you for being just another example of how special and capable we are. once again, good job!!


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## daedalus (Jan 20, 2009)

bstone said:


> Daedalus, thought you said were exiting this conversation? Or did I read that wrong?
> 
> Edit: yes, you did say it:
> Link:
> http://www.emtlife.com/showpost.php?p=117879&postcount=17



I decided to rescind that 

You can make smart sounding responses, but you did not address my post. 

We have wonderful resources on this board, and if you berate them and argue with them after their years and years and years of experience and years of education, they might just leave one day. Instead of arguing with empty replies to someone who could teach you so much, we should try and learn. 

I am all for an intellectual debate, but the anonymity of the internet for some reason causes such hostility. I am not sure why! I cannot imagine us speaking to eachother's faces like we do on this forum! I very much praised the OP for his enthusiasm and encouraged him to excel professionally, but we do not hold hands in patient care! If someone uses bad equipment or preforms a procedure incorrectly, we need to instruct them in no sugar coated words how things need to be done, because very lives are at stake. You say you want to be a physician, just wait until you get into residency, or your first time in the OR! You are going to be ripped apart and for no good reason other than you are a student. This is how medicine was and what it will always be.

Patient care is a very serious responsibility. Our EMT code of ethics requires us to act against threats to public safety.


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## daedalus (Jan 20, 2009)

XxBigBrotherxX said:


> You did a really good thing job as a First responder. Im also very young(18). And i've noticed how alot of older EMTs really come down on us so hard as if we are not capable of performing well just because of our age. They have it in their hearts and minds that we are irresponsible and immature. Thank you for being just another example of how special and capable we are. once again, good job!!



As an EMT-B you may not be qualified to make such an assessment of the provision of medical care.


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## redcrossemt (Jan 20, 2009)

Jon said:


> What is wrong with having Explorers or Red Cross volunteers ASSIST EMS at the first aid stations?



Just as a note, the Red Cross First Aid program I manage provides medical first response services at all sorts of special events. Our team leaders are experienced MFRs, EMTs, medics, and RNs; and they are assisted by first aid/CPR trained volunteers. Everyone is 18+ years old. Many are 30-50 years old and have years of EMS and hospital experience.

We do assist EMS once they arrive, but we often care for patients for extended periods of time while waiting for them - especially during the high demand events we serve at. Our program has a medical director, SOPs, medical protocols, a CQI and CE program, and is well-equipped at the first responder level. 

I just want to be clear that our volunteers are responsible and I assure you that when our AED pads expire, they get replaced by those volunteers (whether they are an 18 y/o MFR or a 50 y/o CCEMTP-RN). It's obvious that there are some problems with this particular Explorer program and I don't want the Red Cross lumped in with them.


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## Vonny (Jan 20, 2009)

*Aed pads*



redcrossemt said:


> I just want to be clear that our volunteers are responsible and I assure you that when our AED pads expire, they get replaced by those volunteers (whether they are an 18 y/o MFR or a 50 y/o CCEMTP-RN). It's obvious that there are some problems with this particular Explorer program and I don't want the Red Cross lumped in with them.



Well Said

I am also a  Red Cross (Irish) Ambulance Unit Leader / Emergency Medical First Responder and I agree with you.  We train our volunteers very well and nobody under 18 would be trained to use and AED. 

The pads on an AED have an expiry date for a reason, if you use pads that have lost their adhesive quality even a little bit then you are not going to get good contact with the skin and so you may not get effective conduction.  Also depending on where the AED is stored they are affected by cold/hot temps.  
An AED should be checked at least once a week in a community program and the pads checked for damage or expiry.

Now to play the devils advocate: The young responders who used the expired pads did get a result, they got a pulse after three shocks, this is the desired result of using an AED and so their efforts were affective and they should feel very happy about that.  

Whatever caused the cardiac arrest is beyond the control of those responders and they should not be held responsible for a bad outcome if the patient does not "Walk out of the hospital" restored to pre arrest condition. 
As far as we know they did not harm the patient and they gave him/her their best chance of surviving what after all was a death. 

At least now the patient has a chance to walk anywhere again and thats all you get is a chance.

Its all very well for more highly trained people to sit at their computers write about what they woulda coulda shoulda done but if it was me on the ground and my only chance was expired pads I would say YES YES YES use them on me.


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## Kendall (Jan 20, 2009)

Vonny said:


> Now to play the devils advocate: The young responders who used the expired pads did get a result, they got a pulse after three shocks, this is the desired result of using an AED and so their efforts were affective and they should feel very happy about that.
> 
> Whatever caused the cardiac arrest is beyond the control of those responders and they should not be held responsible for a bad outcome if the patient does not "Walk out of the hospital" restored to pre arrest condition.
> As far as we know they did not harm the patient and they gave him/her their best chance of surviving what after all was a death.
> ...



Couldn't have said it better. 

While expired equipment or supplies is a serious issue, using expired equipment is still better than nothing. I can't give the evidence but I've heard of studies suggesting that using epi-pens past expiry that is still clear in color and of precipitate is perfectly acceptable. AED pad expiry is for the conduction gel and is based on statistics of the breakdown; the average time it takes for the material to breakdown. It could truly expire and be unsafe to use long before the printed date or long after. How expired were the pads? I'm sure that if there was something visibly wrong with the pads they would not have been applied. 

The intended  purpose of an AED is for the lay provider to administer a defibrillation attempt prior to EMS/ALS arrival. It does not matter that the provider was legally not an adult, they were trained to perform a task and pressed the shock button when the machine told them to. They were fortunate to have an ROSC and I congratulate them! They must have done _something_ right! 

Younger EMS providers are something that people are just going to have to get used to. They have the same education, the same certification, have gone through the same processes that everyone else has to be where they are. For those of you who have young providers working at your respective services, they're even under the same medical director! That being said, nothing can replace experience, so why hold young providers back from gaining that experience? Why hold them back from developing into the EMT-P, physicians, RN's etc of tomorrow?

The reality of it is that EMS can not become recognized as a profession until there are things like evidence based practice, degree based education programs and diversification of scope. Emergency Medical Services as a whole is not and will never become a profession. There are too many variables involved for that to happen. EMS is a diverse and continuously dynamic field with differing requirements based on the geographics and demographics of the area is serves. Paramedicine is what will become the profession. There will always be basic level providers in some capacity that will typically be the first on scene as its not practical to have highly skilled and professionally recognized individuals respond to every call.

I do not think that this is the appropriate time or place to criticize young providers and it is not the professional thing to do.


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## Ridryder911 (Jan 20, 2009)

Here is the problem. We allow excuses! Instead of using kids providing care true EMS professionals should had been providing care.. nothing less. Do we allow kids to be in a surgical theatre? NO! There is a reason, immaturity and lack of life experience and having the capability of making rationale decisions. This is scientifically proven, not just anectodotal. 

In regards to PTSD, yes we did have proof that it was directly related to the EMS Explorer program and thus the reason it was discontinued after two decades. One does not have to have direct hands on to understand an profession. Millions of other professions do not require such.. again a another mythical fallacy we want to continue to pursue. Unlike LEO or even Fire Service (suppression) where one can determine what they will be exposed to. As well do really have to have patients exposed to non-professionals? 

Medicine is a serious matter and not a hobby. Go to school, receive your education with several of hundreds of hours of clinical experience, enter the profession and gain experience in both life and clinical expertise. By this time, one will have some life experience, maturity and ability to make critical decision making.

One can exclaim all they want on how a some can do and not do. I do understand both sides. I started working in a ER at the age of 14 and became a Paramedic at 17. So I do know the dilemma well. It does not make it right though. 

Let's be a profession.. this means having professionals being required instead of having an excuse. We will NEVER respected or have the intergrity until we do so. As well, our patients deserve better. 

R/r 911


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## medic417 (Jan 20, 2009)

Ridryder911 said:


> Here is the problem. We allow excuses! Instead of using kids providing care true EMS professionals should had been providing care.. nothing less. Do we allow kids to be in a surgical theatre? NO! There is a reason, immaturity and lack of life experience and having the capability of making rationale decisions. This is scientifically proven, not just anectodotal.
> 
> In regards to PTSD, yes we did have proof that it was directly related to the EMS Explorer program and thus the reason it was discontinued after two decades. One does not have to have direct hands on to understand an profession. Millions of other professions do not require such.. again a another mythical fallacy we want to continue to pursue. Unlike LEO or even Fire Service (suppression) where one can determine what they will be exposed to. As well do really have to have patients exposed to non-professionals?
> 
> ...



Bravo.  Good show old chap.  Excellent post.  W/O a major change in attitude this can never be a True profession.


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## TgerFoxMark (Jan 21, 2009)

I hate to be the :censored::censored::censored::censored::censored::censored::censored:. but as someone who has had to deal with rid, for being under 20, a while back. 

Rid, whats your opinion of a lifeguard. min age 15. they are trained to remove people from water safely and with full precautions if needed. CPR is also part of the training. I started here, as a lifeguard and i think many of have done this job. 
I'm no longer a teen, but i still am a bit of a wacker. Less so than when i joined thank god. (yes, rid. I SOLD off the ambulance, however i am restoring a 1971 Cadilliac ambulance)
I feel like these young adults did an excellent job, and exactly what they were trained to do. i commend them on an ROSC. it actually gave this person a fighting chance. I give them Props on that. 

Now on the issue of the AED. Its not their fault that the pads were expired. it is the fault of whoever signed the maint. slip saying it was ok.  but on a side note, i would personally rather have an AED with expired pads used on me, than no AED at all.

just my $0.02


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## bstone (Jan 21, 2009)

In my home country, Israel, becoming an EMT-B (or the Israeli equivalent) is something which a huge group of teens do every year. I have friends who have been volunteering on their local ambulances since age 15. They are professional, serious and competant. A lot of them go on to become medics in the army...at age 18. Some on this thread would still consider 18 "children". The truth is they are anything but.


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## Ridryder911 (Jan 21, 2009)

TgerFoxMark said:


> I hate to be the :censored::censored::censored::censored::censored::censored::censored:. but as someone who has had to deal with rid, for being under 20, a while back.
> 
> Rid, whats your opinion of a lifeguard. min age 15. they are trained to remove people from water safely and with full precautions if needed. CPR is also part of the training. I started here, as a lifeguard and i think many of have done this job.
> I'm no longer a teen, but i still am a bit of a wacker. Less so than when i joined thank god. (yes, rid. I SOLD off the ambulance, however i am restoring a 1971 Cadilliac ambulance)
> ...



As a lifegaurd you are not considered a healthcare provider rather a rescuer. I realize there are EMS associated w/lifeguard but in the general sense your primary job is to retrieve and administer first-aid care until the professionals arrive to assume medical care. 

I did not say they did not do a good job, but let's be professional and not brag or boast upon just being at the right time & right place. Really, how hard was it to attach pads and push a button? Lucky, it worked. What would happened if it did not? What if the pads would not conduct or the AED did not deliver enough or too much joules? Who is responsible then? Sorry, it is as much the provider as it is the maintenance company. 

There is an expiration date for a reason. You get caught giving any medication or using any device past such; it will be your arse. Remember you are supposed to check for expiration dates as part of your daily inspections and before any usage or administration. As well, if the pads were expired; I can assure you the AED was not up to the new standards also. Now, that raises another potential liability. 

Folks, medicine is a very serious matter. The courts and trial attorneys would have a field day. All it would take is someone to have read about this and tell the family. Can this rescuer ensure that the device was callibrated and was really up to par? Again, the burden of proof is up to the rescuer. Does the Explorer Post have malpractice insurance or would the parents of the resuer have to pay the costs? Sorry, the Good Samitiran Act will not cover in this event due to there was a contractual agreement that they would act if called upon. Again, medicine is NOT a hobby! When you play as a big dog; be prepared to be judged alike and with other professional providers. This is why it is for professionals. 

* In regards to restoring the ambulance that is neat. I enjoy seeing the old classics.

R/r 911


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## daedalus (Jan 21, 2009)

If explorers want to be treated as professionals, than they should get the whole responsibility that comes with it, including having to be sued or arrested when they screw up, and tried as adults. 

UPADAT: A private investigator and attorney visited my station today to question a crew about a patient that had died. I am positive it had nothing to do with them, but you see, the lawyers do not see it that way.


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## Vonny (Jan 21, 2009)

Ridryder911 said:


> Folks, medicine is a very serious matter. The courts and trial attorneys would have a field day. All it would take is someone to have read about this and tell the family.
> R/r 911



Very true!
Never admit your mistakes or rule bending in an open forum, big brother is always watching.


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## Veneficus (Jan 21, 2009)

Congrats to the OP and comrades for a job well done!

I was trying to avoid looking at this thread, honest.

I was a fire/ems explorer at 14 years of age. (around the same time as the pyramids were built)  

Within 2 weeks I had my AHA HCP CPR card and within my first year at the time what was called "first responder." By the time I was 16 I probably saw more than most adults who never get near emergency service. I wouldn't trade it for the world and encourage others interested to the same.

But here are some things to consider:

How young are many olympic atheletes? (especially gymnasts and figure skaters?) Many of them are "tutored" and do not go to school as many of us did. By the time they are 17 they probably have 10 years in a sport where a mistake could mean permanant injury or death. You cannot harm a dead person by doing cpr. As well, my card was the same as any provider.

What about child actors?

All of us who are(were) explorers or cadets chose to be in an adult world. We gain our life experience at a rapid rate, by being involved. The responibility and demands are at least equal to any 18 year old, often more so because we have had to constantly prove ourselves with a stricter criteria. While many people in high school were out partying and being kids, I was at the FD. Studying, responding, and doing as much s:censored::censored::censored::censored: work as could be heaped upon me. I was there for holidays, birthdays, and while others were having "family" days, It certainly wasn't play time.

I don't think I have PTSD. Infact, my life is pretty good. 

Anyway, if I could get the hospital to open up an explorer post, we would have one. (at least 1) it is not for everyone. But there are many paths to success in life. Please don't begrudge mine and my junior collegues because it was not yours. Maybe even be nice to the people trading their "normal" childhood for their dedication to the job.

For the legal arguement, yes I was considered an agent of the FD, yes they had insurance to cover me and any mistakes I might have made. (which assuradly would have been my last day if I made one)How many MDs, RNs, Medics, or other "healthcare providers" with more life experience get to make 0 mistakes?

When EMS is a medical profession somebody please let me know. Despite the best efforts of many, including myself, it is still a skilled trade. Seemingly more so everyday I read about some other IV, EKG B***S*** cert or merit badge ITLS, PEPP, AMLS, or ABLS course.


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## gcfd_rez31 (Jan 22, 2009)

I know that we've already had quite a few people put their stories in, but while reading everybody's responses I thought I would throw mine in too.

I started off in a Sports Medicine class as a sophomore in high school and instead of getting an extra credit for wrapping sweaty football players' feet in the training room, I did the right paperwork & phone calls to get riding with a private ambulance company in my area.  

They taught me alot of what I know today.  One of the EMTs that first welcome'd me into the station and into EMS itself, taught me about O2 (nasal cannula), how many liters for NC & NR, let me practice BPs on him, everything that I thought was so cool and only saw on TV.

I was so thankful that they took me in under their wings and gave me a year and a half of wonderful training.  I was always in there... After school, weekends, you name it.  I brought extra food down on Thanksgiving to some of the guys at the station, knowing they wouldn't be able to be with their families and felt for them.  I feel like I had a whole other family!

So I give 110% prop's to the teens out there who put their knowledge and quick actions to save a life.  Some teens would scream, run around in circles screaming, and forget the numbers, 9-1-1.  I am probably only saying this because I got into the EMS field early, but I guess I wouldn't be on this site if I wasn't!  

Just want to say thank you to all of the agencies and hospitals that take in the younger teens who are mature enough to work in the field and who are willing to start early on their career.  And good job for all of "us" out there that started early in the first place.  To knowing what you want to do in early high school.

I can't count how many times I have gotten the compliment "I can't believe you know what you want to go into [career wise] in 10th grade!  I wish I knew what I wanted to do that early!"


CONGRATS OP!!!


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## daedalus (Jan 22, 2009)

ems_rocks_91 said:


> I know that we've already had quite a few people put their stories in, but while reading everybody's responses I thought I would throw mine in too.
> 
> I started off in a Sports Medicine class as a sophomore in high school and instead of getting an extra credit for wrapping sweaty football players' feet in the training room, I did the right paperwork & phone calls to get riding with a private ambulance company in my area.
> 
> ...


Self congratulation and warm/ fuzzy smiles (like this one "") still do not make a factual argument for exposing youth to these circumstances.

Trust me on this one: Be a kid. 
You will regret it deeply in the future.


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## gcfd_rez31 (Jan 22, 2009)

daedalus said:


> Self congratulation and warm/ fuzzy smiles (like this one "") still do not make a factual argument for exposing youth to these circumstances.
> 
> Trust me on this one: Be a kid.
> You will regret it deeply in the future.



I have heard "be a kid" alot. 
Just because I started training early & know what I want my future to hold doesn't mean I was never a kid.
I have had plenty of fun with my friends and family outside of EMS.
I will not "deeply regret it."  Believe me.
This is what I have wanted to do my entire life!


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## PotatoMedic (Jan 22, 2009)

To the "Be a kid" statement:

I apologize that I decided to spend my late teenage years educating myself and going after a career that I truly want.  I am sorry I did not spend my money on 200 dollar jeans at the mall, and wonder it aimlessly.  I am sorry I was not obsessed with the Backstreet Boys or Brittney Spears.  I am sorry that I did go and party and get drunk or doped up as half my school did on a regular basis.  I am sorry I stayed ahead on my education and followed my passions and my interests.  I am sorry that I joined a crew team and learned the importance of teamwork as no other job, event, or activity can ever demonstrate.  I am sorry I became interested in fire fighting and joined my local fire explorer group.  I am sorry I have witnessed MVA's, DOA's, suicide attempts, and the other medical emergencies that have impacted me mentally and emotionally.  I am sorry that the choices I made in my life have allowed me to become a better person and find and affirm the career that I truly want and am actively moving towards.  And finally I am sorry that I did not live my child hood to your expectations,  that I wanted to better myself and pursue a career... that happens to be in EMS.


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## daedalus (Jan 22, 2009)

FireWA1 said:


> To the "Be a kid" statement:
> 
> I apologize that I decided to spend my late teenage years educating myself and going after a career that I truly want.  I am sorry I did not spend my money on 200 dollar jeans at the mall, and wonder it aimlessly.  I am sorry I was not obsessed with the Backstreet Boys or Brittney Spears.  I am sorry that I did go and party and get drunk or doped up as half my school did on a regular basis.  I am sorry I stayed ahead on my education and followed my passions and my interests.  I am sorry that I joined a crew team and learned the importance of teamwork as no other job, event, or activity can ever demonstrate.  I am sorry I became interested in fire fighting and joined my local fire explorer group.  I am sorry I have witnessed MVA's, DOA's, suicide attempts, and the other medical emergencies that have impacted me mentally and emotionally.  I am sorry that the choices I made in my life have allowed me to become a better person and find and affirm the career that I truly want and am actively moving towards.  And finally I am sorry that I did not live my child hood to your expectations,  that I wanted to better myself and pursue a career... that happens to be in EMS.



Let me let you in on a little secret. This does not really have to apply to you but its a general summation of my thoughts.

I speak from experience. I volunteered all four years of high school at a medical clinic. A lot of my spare time was spent there. I saw some cool things, became more mature, learned a lot, etc.

I also lost out on a whole lot. My advice to students wanting to go into EMS: Go to football games, study for your regular old high school classes, get involved in athletics, go out with friends, date, focus on having fun. I would never ever do it all the same if I could. I would completely forget about medicine and just relax/live life.

Why would you ever want to get a head start on working? You are going to be working for the rest of your life! You are going to learn all those things you learned volunteering all over again with everyone else who do not know a stethoscope from a reflex hammer, and, no one will give you a drop of credit because you already knew the different types of insulin from volunteering. I may have learned a bunch of cool bits, but you will never learn to put it together so its all useless anyways. But you will never have a chance to do High School over again.

Stop worrying about EMS. Even if you have a life in high school, you still should not be involved in it in any other capacity other than shadowing them for a day or two on a career week. Enjoy the last years of your life when you do not have to think about work. 

EMS will never love you back. It will never give you the attention you gave it back. It will not be there for you when things are going wrong in your life. You should be careful about making your whole life about it.

This is not to berate anybody! I am saying all of this to hopefully improve your life, because I know I have made these mistakes. I used to have the same arguments. I use to say the same things you do "Oh well I am sorry I have a passion in life" etc etc. I was wrong, and in ten years you will realise you were as well.

Go to those parties. Please do not do this to yourself.


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## Veneficus (Jan 22, 2009)

daedalus said:


> Let me let you in on a little secret. This does not really have to apply to you but its a general summation of my thoughts.
> 
> I speak from experience. I volunteered all four years of high school at a medical clinic. A lot of my spare time was spent there. I saw some cool things, became more mature, learned a lot, etc.
> 
> ...



Sounds like you got ripped off.

I did not lose out, I simply traded. But I definitely received more than I gave up.

I guess it depends on what you call “credit” I take the same classes as everyone else. But I don’t worry over things like: “Am I worthy to wear this white coat” or “will I ask the right questions? “ What if I forgot something?” “What if I get a B in class?” “Will I get into residency?”  It is all mindless BS. It is why I no longer visit SDN. I will not post my extremely negative opinion of the people there. I got to start rotations earlier than all of my classmates. I am taught and permitted to do things they cannot wish for. I will not be done early, I will just do more. Doing more means learning more, that means being better. I like to play on the all star teams, not little league.

When I am working, both teaching and in the hospital, my confidence and experience serve my employers, students, patients, as well as myself very well. I am proud that physicians treat me like a peer, even though I am still in school. 

Your life values may be as little time at work as possible, but I actually like to be there. If I was independently wealthy I’d do it at my own expense.
Starting your career early is like a long term investment. It pays off in the end. EMS or the hospital may not love me, but my friends and family do. Great friends, great family, great career, all I am missing is money, but it will come and if it doesn’t, I never had any to start with so I can’t really miss it. 
I often feel bad for the people who have a “normal life.” They missed so much.

I am not saying starting so young is for everyone, but it has been great for me.


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## Ridryder911 (Jan 22, 2009)

daedalus said:


> Let me let you in on a little secret. This does not really have to apply to you but its a general summation of my thoughts.
> 
> I speak from experience. I volunteered all four years of high school at a medical clinic. A lot of my spare time was spent there. I saw some cool things, became more mature, learned a lot, etc.
> 
> ...



I agree 100%! There are few of us left that started as a teen. As well as the emotional baggage that attaches to those that did. Yeah, I worked the 100+ hours a week in EMS and was "mature" for my age. Sh*t, I should have never been seen or exposed to until later in life. A shift Supervisor over medics that was Vietnam Special Forces medics that would laugh at me and treat me like a brother; teaching the "real world". Those things I do not regret. 

The problem is most attract to EMS alike a moth to a flame... only to get burned. Unless your past 30, you really cannot truthfully evaluate if it has affected you or not. You are still in the "moment" and cannot reflect upon it. If one would had asked the thousands I had seen that entered as a teen they too would agreed also; but ask them now. 

Let's be realistic. If this was such a great deal; there would not be a shortage of medics, the average age of an EMT would not be in the twenties and the majority would have greater than 15 years experience. There is a reason why it is a relvoving door profession. 

There is a reason other than child labor laws why hospitals do not employ or use teenagers for providing care. Believe me, for financial reasons if they could pay cheaper or use free labor they would but they know it is unrealistic and not even considered. Why should EMS be any different? 

When comparing other speciality Explorer Posts, they do not allow them to have direct contact with armed suspects or carry a weapon. They as well do not allow them to agress in an active fire for rescue or supression; yet we believe they should be allowed to provide patient care? Again, why should EMS be an exception? 

Let's quit making exceptions and be a real profession. A profession performed by those that have critical thinking skills, educated and clinical experience. 

If one wants to perform first-aid .. so be it. Yet first response and first aid is NOT emergency medicine/EMS. 

R/r 911


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## Veneficus (Jan 22, 2009)

Ridryder911 said:


> Unless your past 30, you really cannot truthfully evaluate if it has affected you or not. You are still in the "moment" and cannot reflect upon it. If one would had asked the thousands I had seen that entered as a teen they too would agreed also; but ask them now.



33 and still alive!!!  I have no regrets, but like i said, it is not for everyone.




Ridryder911 said:


> Let's be realistic. If this was such a great deal; there would not be a shortage of medics, the average age of an EMT would not be in the twenties and the majority would have greater than 15 years experience. There is a reason why it is a relvoving door profession.



Never said it was a great deal, which is why I have been back to school for the last 3 years. But the experience I have received through my service in the emergency professions over the years has been invaluable for many aspects of life.



Ridryder911 said:


> There is a reason other than child labor laws why hospitals do not employ or use teenagers for providing care. Believe me, for financial reasons if they could pay cheaper or use free labor they would but they know it is unrealistic and not even considered. Why should EMS be any different?



at the first responder level, I wouldn't call it providing care. it is better than a lay person, lesser than a professional.



Ridryder911 said:


> When comparing other speciality Explorer Posts, they do not allow them to have direct contact with armed suspects or carry a weapon. They as well do not allow them to agress in an active fire for rescue or supression; yet we believe they should be allowed to provide patient care? Again, why should EMS be an exception?



What is the difference in risk between bystander cpr and first responder cpr? I think quality of CPR and direct oversight by a professional in the case of explorers. Plus the knowledge and use of universal precautions.



Ridryder911 said:


> Let's quit making exceptions and be a real profession. A profession performed by those that have critical thinking skills, educated and clinical experience.


 I don't think we are talking about replacing professionals with explorers. We are talking about mentoring future providers. Which in the molding may be able to achieve the things for EMS we have long struggled to get.



Ridryder911 said:


> If one wants to perform first-aid .. so be it. Yet first response and first aid is NOT emergency medicine/EMS.
> 
> R/r 911



agree 100%


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## BossyCow (Jan 22, 2009)

Would you folks be as condemning if this was a boyscout helping out with the crowds as a volunteer who was able to perform bystander CPR and AED? Training the general public is a good thing.


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## daedalus (Jan 22, 2009)

Veneficus said:


> 33 and still alive!!!  I have no regrets, but like i said, it is not for everyone.
> 
> 
> 
> ...


I respect your decisions. I actually still am in love with medicine. I love being in the hospital. I just wish I had more of a life as a kid, because I know realise I can give my full attention to my career. I didn't have too back than.


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## daedalus (Jan 22, 2009)

BossyCow said:


> Would you folks be as condemning if this was a boyscout helping out with the crowds as a volunteer who was able to perform bystander CPR and AED? Training the general public is a good thing.


The difference between a Boy Scout providing a non medical service at a big convention and incidently saving a life vs. Teenage EMS is vast. But touche Bossy!


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## BayCityRollers (Jan 23, 2009)

frdude1000 said:


> They then got the aed and shocked the man three times with expired pads.  Then, they got the pulse back!  It is unknown if the patient survived at the hospital.  Isn't that great!?!




Yeah. They shocked someone, and got a pulse back. That is great. There was all this hype and hoo-haa about AED's, oh they're so fricken great.. But all these advertisments about send in your "SAVE" info, get pics, free stuff, etc. But, you just don't see this.. because it ain't happening. I've been on nearly a hundred cardiac arrects, and I've only resuscitation ONE PERSON.. and it was with plain old single rescuer CPR, in the ambulance. You can't fix a life of bad choices with CPR, ACLS or an AED. Just can't do it. These kids acted, and they accomplished a field resuscitation.

Would you have rather they did nothing? Or.. Would YOU.. PERSONALLY.. Be more satisfied if this patient had died?

The guy was resuscitated. That's all they are responsible for.. Whether or not he died later on, has not one damn thing to do with the expired pads.. But you seem like one of these people who are never satisfied, until you can call out someones faults. There is no what if. The patient was resuscitated. They should be awarded for their actions, not condemed for someone not doing their job.


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## marineman (Jan 23, 2009)

^^^ Is that a new forum record for the quickest banning? CL's have been on a roll lately, have a beer on me.


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