# I get it wrong every time. What IS the answer?



## Anjel (Jan 17, 2011)

Hello all,

I am a new EMT-B (as of yesterday )  going on to medic. And there has been one thing bugging me in all my classes.

Almost every time I see this question I never get it right. Then I forget about it till it's too late. So I am hoping you guys can help.

" You respond to a call where a man is in cardiac arrest. His wife is there screaming and crying asking you what's going on?" What do you tell her?

A. Your husband is dead I am sorry.
B. I'm not sure but we are trying to find out.
C. Your husband is apneic and in cardiac arrest.
D. Ma'am we are doing everything we can, but your husbands heart has stopped and we need to get him to the hospital.
E. None of the above.

Now I personally would just try to comfort her and say we are doing everything we can. But I wouldn't want to tell her that his heart has stopped.

So what would you do?


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## bfog99 (Jan 17, 2011)

I pick D. Short, easy to understand, and honest.


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## firetender (Jan 17, 2011)

Anjel1030 said:


> asking you what's going on?" [/QUOTE
> 
> 
> 
> ...


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## JPINFV (Jan 17, 2011)

Reason it out.

A: Ok, he might be clinically dead, but just being pulseless and apneic doesn't mean he can't be resuscitated. 

B: The only thing you can find out as an EMT is whether he has a shockable rhythm per an AED or not. The current diagnosis is cardiac arrest, and as an EMT that's pretty much the only thing you need to know in an atraumatic arrest (higher levels could do some hunting around since they can revese some causes of cardiac arrest that aren't fixed with defibrillation).

C: Medical jargon. There's a time and a place. My view is, when practical, always use medical jargon followed by an explination. A resuscitation is not the practical time to explain what apneic means.

D. This would be my answer choice.


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## jjesusfreak01 (Jan 17, 2011)

B or C if you're a medic, D if you're an EMT. Medics would work the arrest in the field rather than tx to the hospital. I like B because the exact scenario listed makes it sound like you just got on scene, in which case you don't really know what's going on yet. C is a little too jargony with its use of apneic. Everyone knows what cardiac arrest is, stick with that.

or

F. I don't have a clue whats going on, but the paramedics will be here in ten minutes, and I have a neat shocky box i've been dying to try out.


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## JJR512 (Jan 17, 2011)

jjesusfreak01 said:


> B or C if you're a medic, D if you're an EMT. Medics would work the arrest in the field rather than tx to the hospital. *I like B because the exact scenario listed makes it sound like you just got on scene, in which case you don't really know what's going on yet.* C is a little too jargony with its use of apneic. Everyone knows what cardiac arrest is, stick with that.



I agree with this, especially the bold part for exactly the reason stated.

If I've already done an assessment, D would be good at that point.


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## fast65 (Jan 17, 2011)

I would choose D, it lets the wife know that you're doing your very best to help her husband, but it also lets her know that something is terribly wrong. 

A, well, you can't say he's dead for sure, there may be some reversible causes that ALS can fix.

B, I personally feel as though it doesn't inspire much confidence from the wife in this situation. As an EMT you have all the info you need, his heart is not pumping and he's not breathing, so you kind of know what's going on and how to take care of it. Remember, not only are we trying to resuscitate the patient, but we're also trying to take care of the wife who needs OUR support, and part of that is making sure she has confidence in us, which can help ease some of her anxiety and possibly calm her down.

C, don't use medical jargon to explain what is going on, UNLESS you have time to explain what those terms mean...in this case you don't.

E, the answer is D, so no...just no.


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## Anjel (Jan 17, 2011)

Thanks guys. I talked to a kid from my class and the answer is D. I guess I just didn't want to tell a lady her husbands heart stopped lol. 

And He said for B that the teacher said you are never supposed to tell someone you don't know what's going on. 

I personally like 

"F. I don't have a clue whats going on, but the paramedics will be here in ten minutes, and I have a neat shocky box i've been dying to try out."

:lol:


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## fast65 (Jan 17, 2011)

Anjel1030 said:


> Thanks guys. I talked to a kid from my class and the answer is D.* I guess I just didn't want to tell a lady her husbands heart stopped lol. *
> 
> And He said for B that the teacher said you are never supposed to tell someone you don't know what's going on.
> 
> ...



That's something that nobody wants to say, but the fact of the matter is that you'll have to tell someone that their loved one is dead eventually...just make sure you don't make their emergency into yours.


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## ShesanEMT (Jan 17, 2011)

I pick D. Here's why:
not A -because we (EMT's) don't pronounce patients dead
not B -I don't want to tell anybody "i'm not sure" while working on a patient
thought about C but using "apneic" is a word the woman wouldn't understand, not lay terms
Yes to D, straight-forward, to the point let's go.


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## JJR512 (Jan 17, 2011)

Anjel1030 said:


> And He said for B that the teacher said you are never supposed to tell someone you don't know what's going on.



You're also not supposed to lie.

It wasn't clear to me (or, apparently, to jjesusfreak01) whether you had been dispatched for cardiac arrest, just arrived on scene, and the wife immediately started asking you what was going on, or if you've already been on scene and determined that there is a cardiac arrest when the wife starts asking you what's going on.

As I said earlier, if the situation is the latter case, I'd go with D. But if the situation is the former case, then because you truly do not yet know what's going on, I'd still pick B as my answer in that situation.


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## wyoskibum (Jan 18, 2011)

*Stupid question*



Anjel1030 said:


> Hello all,
> 
> I am a new EMT-B (as of yesterday )  going on to medic. And there has been one thing bugging me in all my classes.
> 
> ...




I hate questions like this.  There isn't enough information.  

If I just walked in the door, then the answer is B. 
If I've been able to assess and in the process of resuscitating, the answer is D.  
If I worked the full code and I'm ready to call it, then the answer is A.


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## MassEMT-B (Jan 18, 2011)

JJR512 said:


> You're also not supposed to lie.
> 
> It wasn't clear to me (or, apparently, to jjesusfreak01) whether you had been dispatched for cardiac arrest, just arrived on scene, and the wife immediately started asking you what was going on, or if you've already been on scene and determined that there is a cardiac arrest when the wife starts asking you what's going on.
> 
> As I said earlier, if the situation is the latter case, I'd go with D. But if the situation is the former case, then because you truly do not yet know what's going on, I'd still pick B as my answer in that situation.



My teacher said to never lie....unless a pregnant woman asks if you have ever delivered a baby before .


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## usafmedic45 (Jan 18, 2011)

*Rule #103:  *Never, ever, utter the phrase "Oh my God! Is he ****ing dead?!!!" 

*Corollary:* Also, make sure the girl you're dating (who was in your POV with you when the call for the VFD came in) does, in fact, follow your instructions to "stay in the truck".


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## LuvGlock (Jan 19, 2011)

usafmedic45 said:


> *Rule #103:  *Never, ever, utter the phrase "Oh my God! Is he ****ing dead?!!!"
> 
> *Corollary:* Also, make sure the girl you're dating (who was in your POV with you when the call for the VFD came in) does, in fact, follow your instructions to "stay in the truck".



Ha.  Sounds like a good story.  Care to tell it?


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## Asimurk (Jan 19, 2011)

Anjel1030 said:


> Thanks guys. I talked to a kid from my class and the answer is D. I guess I just didn't want to tell a lady her husbands heart stopped lol.
> 
> And He said for B that the teacher said you are never supposed to tell someone you don't know what's going on.
> 
> ...



I was leaning towards:

"F. Get the hell out, :censored::censored::censored::censored::censored:!"

I'm figuring on about four seconds of silence afterward, and maybe getting assaulted.  Dunno, haven't gotten past CPR yet.


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## jjesusfreak01 (Jan 19, 2011)

MassEMT-B said:


> My teacher said to never lie....unless a pregnant woman asks if you have ever delivered a baby before .



This seems like good advice...I did deliver a fake baby through a manachin during my EMT class. Does that count?


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## Fish (Jan 19, 2011)

Anjel1030 said:


> Hello all,
> 
> I am a new EMT-B (as of yesterday )  going on to medic. And there has been one thing bugging me in all my classes.
> 
> ...



I would want to tell her, I would also tell her he is not breathing and that we are doing it for him. Honesty honesty honesty, start start start the grieving process.


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## usafmedic45 (Jan 20, 2011)

> Ha. Sounds like a good story. Care to tell it?





> Rule #103: Never, ever, utter the phrase "Oh my God! Is he ****ing dead?!!!"
> 
> Corollary: Also, make sure the girl you're dating (who was in your POV with you when the call for the VFD came in) does, in fact, follow your instructions to "stay in the truck".



I was dating a cheerleader my senior year of high school.  At the same time I was doing my EMT-Intermediate course and had just been appointed EMS lieutenant for our VFD.  We were heading towards her house for dinner when dispatch called for a "unconscious man, no further information" about two minutes from our location.  This was in the next township over from my first due district but we had an "automatic mutual aid" for certain types of non-fire calls (CPR in progress, unconscious persons, severe trauma, etc) so I headed for the scene.  We arrive at the house and I told her "Stay in the truck, don't move" as I grabbed my jump kit and the defib (as the senior EMS provider, I was given the "spare" defib to carry in case I arrived on scene first which happened pretty often).  

As I walked through the door, I see a very large man sprawled over backwards in an overturned chair at the dinner table.  He's cyanotic as hell with a little fluid coming out of his mouth.  As I knelt down by the guys head to assess him, I heard footsteps behind me and turn to see my girl and she has this shocked look on her face.  I was going to tell her to get back in the truck when she goes: "Oh my God! Is he ****ing dead?!!!".  Needless to say, that went over with the family like a lead Zeppelin.


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## emt1231 (Jan 20, 2011)

I would say the answer is D. You want to let them know the situation and that you will take their loved one to the hospital. I think if someone sees you doing cpr they probably knows the heart has stopped. And don't say something that will upset them more, like stated above is a good example what not to say.


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## HasTy (Jan 21, 2011)

I would say d for the numerous reasons stated above as far as asimurk's response I can't believe that I read that dude...I hope you weren't serious...


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## johnrsemt (Jan 21, 2011)

one of the early posters said that since basics can't declare a patient dead that the answer would have to be D.

   Why can't your basics declare Death?   I could as a Basic.


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## Anjel (Jan 21, 2011)

Thank you guys! You were a huge help. 

Believe it or not, I had my first interview for a private company two days ago.

And guess what scenario question I got. Yup something like the one I asked you.

I think I was able to answer it very well.


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## johnrsemt (Jan 21, 2011)

Oops hit send to soon:

  5 ways that we could declare a patient Dead as an EMT-B:

1:  obvious lividity, with no pulse or respirations

2:  Obvious Rigor, with no pulse or respirations

3:  Decapitation

4:  Transection:    3 & 4:  anyone cut in half from neck to pelvic region

5:  Deep Charing of the body 3rd-4th deg burns, with no pulse or respirations.

Why wouldn't a Basic be able to declare death with these obvious signs anywhere?

But I know  there are places that they can't,  and it is totally crazy.


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## Anjel (Jan 21, 2011)

johnrsemt said:


> one of the early posters said that since basics can't declare a patient dead that the answer would have to be D.
> 
> Why can't your basics declare Death?   I could as a Basic.





And we were taught as a basic unless the patient has amputated 3 or more limbs, decapitated, or obvious signs of death like rigor then you cannot pronounce as a basic.


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## Anjel (Jan 21, 2011)

I'm not too sure if we could with the burns or not. Never heard anything about it. 

If I ever did get to go to a call like that as a basic I would be calling ALS in step 5 of my initial ;-)


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## JPINFV (Jan 21, 2011)

Anjel1030 said:


> And we were taught as a basic unless the patient has amputated 3 or more limbs, decapitated, or obvious signs of death like rigor then you cannot pronounce as a basic.



A patient who has 3 limbs amputated is dead?


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## Anjel (Jan 21, 2011)

ok thats how it was worded to me. But I guess common sense would come into play there. I would not assume them dead just based on the amputation. But that was part of the criteria for a BASIC to pronounce. 

I have no clue the criteria for a medic. I start that class next month


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## fast65 (Jan 21, 2011)

HasTy said:


> I would say d for the numerous reasons stated above as far as asimurk's response I can't believe that I read that dude...I hope you weren't serious...



Do you actually think he could be serious? :huh:


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## HasTy (Jan 21, 2011)

I have learned from recent experience to take nothing for granted as far as people being serious about responses...I do generally give the benefit of the doubt until proven wrong.


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## usafmedic45 (Jan 21, 2011)

> But that was part of the criteria for a BASIC to pronounce.



According to whom?  



> I have no clue the criteria for a medic. I start that class next month



You might want to go to another training program rather than going back to the brain trust who taught your basic class.  Some more clinical experience would probably do you some good too.


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## Anjel (Jan 22, 2011)

usafmedic45 said:


> According to whom?
> 
> 
> 
> You might want to go to another training program rather than going back to the brain trust who taught your basic class.  Some more clinical experience would probably do you some good too.


I probably do need more clinical experiance. Ive only had 36 hours on an ambulance. And I have no idea why you seem to think my education was bad. You have no idea where I went. I went to the top ranking ems academy in our tri county area. With a 100 percent pass rate for the nremt if you pass the program. 

So because I was told that if a patient was clearly dead and had 3 or more limbs missing I could pronounce the patient dead as a basic. Thats wrong?


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## usafmedic45 (Jan 22, 2011)

> So because I was told that if a patient was clearly dead and had 3 or more limbs missing I could pronounce the patient dead as a basic. Thats wrong?



Then it's the "clearly dead" part that matters.  Depends on how you define "clearly dead", but the presence or absence of multiple amputations has nothing to do with it.  I've seen multiple patients who at first glance looked "clearly dead" but were quite alive despite multiple traumatic amputations.  That's the nature of combat medicine.



> With a 100 percent pass rate for the nremt if you pass the program.


Passing a test that has well known shortcomings and being clinically competent are two separate things.


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## jjesusfreak01 (Jan 22, 2011)

usafmedic45 said:


> Passing a test that has well known shortcomings and being clinically competent are two separate things.



I would venture to say clinically competent requires that you be working both clinically, and be competent at that.


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## Anjel (Jan 22, 2011)

Well hopefully the next 520 hours I spend on clinical s will help get me to your standards. Whatever those are. No matter what I come back and say I'm sure you'll have something to negative to say back. So I'm not even gonna try. 

Maybe you should try and be a little more positive and encouraging to others instead of pushing them down all the time, because they are not as good as what you think they need to be. 

I've been an EMT for a week now. Cut me some slack. 

And also where I'm from in my county and where I will be working BLS is only allowed Priority 3 transfers and calls. Unless working with a medic. So I will be sure to work on my "competency" before the time comes where I will actually need to know more than how to lift a stretcher, take vitals, and give o2.


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## 18G (Jan 22, 2011)

I think its important to be up front to family with the condition of their loved one. Why give them hope, step around the question, or make the condition not sound as bad as it is?

In a cardiac arrest the heart has stopped and there is no breathing so this is what I would tell the family.... in addition to... were doing everything we can by breathing for your loved one, circulating oxygen by doing CPR, giving medication that may help restore a pulse, and giving electric shocks that may help restore a pulse. 

It's important to involve the family (given they aren't hysterical) and explain what is going on without sugar coating it.


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## fast65 (Jan 22, 2011)

Anjel1030 said:


> Well hopefully the next 520 hours I spend on clinical s will help get me to your standards. Whatever those are. No matter what I come back and say I'm sure you'll have something to negative to say back. So I'm not even gonna try.
> 
> Maybe you should try and be a little more positive and encouraging to others instead of pushing them down all the time, because they are not as good as what you think they need to be.
> 
> ...



So...when you become more than a basic?


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## Anjel (Jan 22, 2011)

I'll me a medic in may of 2012. I am getting my associate's degree as well so it's taking a little longer. 

I know my stuff. I had the highest grade in my class. Out of 30 people 12 passed. 

I don't know everything. I love learning about everything that pertains to this field. 

I don't take what EMT's do lightly or what medics do. 

I am going to strive to give my patients the best care I can. But Mr. USA over here was pissing me off.


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## Jackson (Jan 22, 2011)

I'd say D.


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## usafmedic45 (Jan 22, 2011)

> I would venture to say clinically competent requires that you be working both clinically, and be competent at that.



Right....which was the point I was getting at.


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## JJR512 (Jan 22, 2011)

fast65 said:


> So...when you become more than a basic?



If you're implying that the bold parts in what you quoted are the only things EMT-Bs know how to do, then congratulations. You're only a paramedic student but you've already got the condescending, holier-than-thou attitude perfect.

I'd say more but you're not worth another ban.


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## JPINFV (Jan 22, 2011)

To be fair, the vast majority of calls that's essentially what an EMT does. Assessment, oxygen (often completely unneeded), and transport.


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## JJR512 (Jan 22, 2011)

JPINFV said:


> To be fair, the vast majority of calls that's essentially what an EMT does. Assessment, oxygen (often completely unneeded), and transport.



Sure, but that's not all they can do, which was clearly the implication.

If it was meant only as a joke, then (a) I apologize for taking it the wrong way, and (b) respectfully suggest that when making jokes, a smilie be added to prevent otherwise-provocotive statements from being taken seriously.


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## Anjel (Jan 23, 2011)

yes I am sorry. It was a joke. 

I am new to this site and should of been more clear


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## JJR512 (Jan 23, 2011)

Don't apologize and don't worry about it...and I'm sorry for overreacting.


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## Anjel (Jan 23, 2011)

It's all good ^_^

I really do appreciate everyone's input though!

I really didn't mean to sound condescending. I really do wanna learn as much as I can. Because I didn't learn nearly enough in the 15 week crash course of an EMT program.


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## fast65 (Jan 23, 2011)

JJR512 said:


> If you're implying that the bold parts in what you quoted are the only things EMT-Bs know how to do, then congratulations. You're only a paramedic student but you've already got the condescending, holier-than-thou attitude perfect.
> 
> I'd say more but you're not worth another ban.



It's a joke, calm down there sport 

But thank you, I try my best at being holier-than-thou


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## jjesusfreak01 (Jan 23, 2011)

Anjel1030 said:


> I really didn't mean to sound condescending. I really do wanna learn as much as I can. Because I didn't learn nearly enough in the 15 week crash course of an EMT program.



A paramedic program will teach you just enough to be scared out of your mind the first time you run a call yourself. Likewise, no EMT class really teaches you half of what you need to know, the real learning comes from experience.


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## usafmedic45 (Jan 23, 2011)

> A paramedic program will teach you just enough to be scared out of your mind the first time you run a call yourself



Or as my medical director put it, "Modern paramedic programs teach you just enough to _maybe_ not kill the first critical patients you see without direct supervision".  (emphasis was his).


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