# 14 year old EMR - beach cardiac arrest - feel bad/somebody's opinion?



## benasack2000

I just got home from the beach. Was walking on the beach with my aunt as well as two little cousins. We stumbled upon CPR in progress for an approximately 20 year old female. Giant ring of people around her calling 911. My aunt brings my cousins to the parking lot so they don't have to watch. From what I could gather from the bystanders, she collapsed 3 minutes ago and CPR was started a minute ago. The lifeguard is doing compressions and a lady comes forward from the crowd and tells her that she is a respiratory therapist. She obviously wasn't breathing (very cyanotic + no chest rise) but the respiratory therapist checked for a pulse and was unsure of a presence of one. I tell the respiratory therapist i'm a certified emergency medical responder and ask her if there's anything I can do. Another lifeguard suddenly runs up with an AED and starts yelling at people to back up if they are not trained. The respiratory therapist yells that she has no pulse and for somebody to attach the AED. The other lifeguard is busy shooing people off and I step forward and start opening up the AED, pressed the ON button, plugged the ADULT PADS into it, and started peeling off the stickies. Someone if cutting off her bikini top with the shears from the CPR kit so I can get the pads on her. Just when i'm about to apply the first pad, the Lifeguard screams for me to "get the f*** away from the AED and i'm not trained to use it". The respiratory therapist (who is ventilating with a pocket mask) tells her i'm trained but the lifeguard ignores her. Police car shows up a minute later and a cop starts bagging the victim. Ambulance shows up two minutes after that and the medics take over. They were still doing CPR on her as they loaded her in the ambulance. It was about 6 minutes before a defibrillator was applied. The victim was apparently by herself and had no family/friends there to give a medical history. 


This was my first time even close to CPR that wasn't done on a dummy. I'm only 14 and I feel really bad about the whole thing. Should I have just not gotten involved? Did I do the right thing? I'm both mad at myself that I wasn't insistent enough and i'm also mad at the lifeguard. The lifeguard looked 16ish and looked pretty young. I was at least two times her size and i'm not sure if she got mad because I looked too young (most people tell me I look 16ish). Anybody's two cents would be well appreciated?


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## WildlandEMT89

benasack2000 said:


> Should I have just not gotten involved?
> Did I do the right thing?



Don't take it so hard. This was a tough situation and you did what you could. If anything I would have to say the lifeguard was a bit out of line for yelling, but then again it could very well been her first code also. 
I think the important thing you take away from this is that you stepped up, voiced you qualifications, asked what you could do, and stepped back when it got too crowded.

So do you still have the urge to work in EMS?


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## benasack2000

WildlandEMT89 said:


> Don't take it so hard. This was a tough situation and you did what you could. If anything I would have to say the lifeguard was a bit out of line for yelling, but then again it could very well been her first code also.
> I think the important thing you take away from this is that you stepped up, voiced you qualifications, asked what you could do, and stepped back when it got too crowded.
> 
> So do you still have the urge to work in EMS?



I definitely do. Not to sound cliche but it was a major adrenaline rush


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## DesertMedic66

The issue is that if you just have random people on scene it can be very hard to tell who is medically trained and who isn't. If I was the lifeguard I would have probably told you the same thing (maybe just a little more nice). On scene I don't know who you are. I don't know if your trained. Just because someone is trained in CPR does not mean they are able to do it well. 

None of this is meant as a stab at you. This is just an in general thing. Part of scene management is not allowing people onto your scene.


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## azbrewcrew

Ive told doctors to stay off my scene before. I have no clue if they are cardiologists, er docs or proctologists. If its a legit critical patient, I dont have time to thumb through credentials verifying them. That being said, you're 14. There will be plenty of opportunities for you to work codes if you choose to stay in EMS. Dont beat yourself up over it.


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## OnceAnEMT

Just by reading your post it seems your mind is already on the right track. My suggestion to you is don't regret stepping in, and instead just think about what you did right and what could be done differently when it happens again. Personally, I think the most important part of this for you is that, judging by your post, you did not argue with the lifeguard. It is his scene and his patient, and just as what was mentioned above, they have no idea who you are. If the care provided/not provided to the patient negatively effected her outcome, that is on the lifeguards, not you. 

The fact that you had the drive to do something like preparing the AED is already a major leap. Do it again. 

That then begs the question. Do you want to do it again? Hopefully this experience acts as a piece of the puzzle to choosing a career.


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## Tigger

The survival rate for non Vfib arrests is not very good, no matter if everything goes to plan or not. Frankly that's what keeps me from dwelling on the majority of my arrests where things go right and there is a poor outcome.


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## kal0220

If I'm reading correctly, it wasn't the lifeguard on scene first who yelled, it was the one who was the late arrival, so was it really "his" scene?


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## benasack2000

She made it 

Went down to the lifeguard station and asked them.


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## OnceAnEMT

kal0220 said:


> If I'm reading correctly, it wasn't the lifeguard on scene first who yelled, it was the one who was the late arrival, so was it really "his" scene?



Well, playing on this scenario. Lets say PD is running a code when EMS walks up. "Is it really 'his' scene?"

The scene belongs to whoever is in control. That is generic for a reason. If there is an active shooter at the code, that scene belongs to the active shooter until the threat is neutralized and somebody takes control. Its not your scene until you take control of it. Some do this by yelling, some do this by doing their job professionally, some do both.


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## Handsome Robb

You did what you could.

In over three years of lifeguarding as a pool, beach and supervising guard for a busy township and also a state park I only ever worked one arrest and I was the only one on scene who had ever worked one. It's a high stress situation especially if you're not confident in your skills or it's totally new to you. Not saying the guard was right, just explaining why they probably acted the way they did. 

Like someone else said it's very difficult to take people's word for it when they say they're trained. I won't personally do it unless I'm really short handed or I know them personally.


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## benasack2000

Turn's out it was a heroin overdose. She and her boyfriend were shooting up on the beach. When she OD'd, the boyfriend ran off. Police still looking for him.

Thanks for all the replies guys.


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## Patch Adams

There was a team of old timers Hockey Players rallied together to save an Osoyoos (Okanagan Area BC Canada) senior after he suffered a massive heart attack at the Oliver Arena. All the staff were trained at the arena. (click link for source of story)

“He was dead,” recalled teammate Jeff Crowley, who was one of several people who saved Cox’s life by using an automated external defibrillator (AED), a device that shocks the heart back into rhythm.
Crowley said he knew right away that Cox likely suffered a heart attack when the 72-year-old went down. So he immediately asked someone to call 911 and grab the AED in the arena office. 
Crowley said they started working on Cox immediately, doing CPR and hooking up the AED.He admitted they didn’t really know what they were doing, but the AED, which has a voice activation feature, basically talked them through the procedure. “He started breathing again, but started to choke. We rolled him on his side, removed his teeth and this seemed to clear his air passage,” Whiteman said.

I heard the EMTs who arrived on scene for the call  was surprised to find the guy was up and talking. IMO you did the right thing and getting the AED on in the first 5mins can make a difference. Although clinically they are already dead and many never come back,  this fast action may put the odds in favor of making a recovery. When in the field or Ambulance I make sure the AED is close and ready to go on any call that might code on me. I understand the yelling cause the adrenalin is flowing. Our protocol it is your call till you choose to hand off to equal or higher level of care PCP - ACP EMT due to exhaustion or After 3 no shocks we keep going but call and talk to a Dr. at hospital and they say to stop or not. For me personally if you said you were trained and could get the pads out plugged in while we bagged and did Compressions that would be great. The faster we get them on the better, and I would check to make sure you were not doing it right and if not I would fix it. Anything to speed up getting the AED on is great! If I was working on someone alone at a Arena or Mall like these guys that kind of help is appreciated. 

According to the Heart and Stroke Foundation, approximately 45,000 sudden cardiac arrests occur in Canada each year. As some may know the survival rate of victims for an out-of-hospital cardiac arrest is less than five per cent. However, cardiopulmonary resuscitation with CPR and the use of an AED in the first 5mins before the arrival of paramedics can increase the chance of survival by up to 75 per cent.


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## Giant81

I'm like hat she was implying that a non trained person shouldn't work an AED. With the pictures on them I'm pretty sure my 7yo who's never seen one could follow them and administer a shock. Granted she probably can't do it under stress but it's not hard. 

Good on you for keeping your head and helping out. I feel you will make a good EMT!

I think you did everything right.


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## Giant81

azbrewcrew said:


> Ive told doctors to stay off my scene before. I have no clue if they are cardiologists, er docs or proctologists. If its a legit critical patient, I dont have time to thumb through credentials verifying them. That being said, you're 14. There will be plenty of opportunities for you to work codes if you choose to stay in EMS. Dont beat yourself up over it.



Haven't all of those DR's had the same X years of medical school before specializing?


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## wanderingmedic

Yea, don't worry about it. The lifeguard was out of line and acted unprofessionally. Everyone runs their codes differently, but I think @WildlandEMT89 was probably correct that this was the lifeguard's first code. There's (usually) never any need for cursing or yelling at people on a code. If it's just my partner and I, I will recruit bystanders to help with easy stuff like compressions and squeezing the bag so I can get my ALS interventions rolling.

One of the things I try to keep in mind when I'm running codes is that I'm not just caring for the pt who has coded. I'm also secondarily caring for the bystanders who have seen something they have likely never seen, that could be very emotionally traumatic to them. While my first priority will always be the patient, I also want to conduct myself in a way that is professional, and doesn't make bystanders feel worse than necessary. Codes can be especially distressing to bystanders if the patient is a family member, or the patient is younger (<25). I try to make sure my actions and words on scene don't insinuate blame for the patient's condition or outcome. It is very easy for people to blame themselves for what is happening, even when it's not even remotely their fault.


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## johnrsemt

Doctors do all have the same years of Medical school and internships; but then they forget most of it for the residencies, someone who is a dermatolagist for 20 years, is NOT going to remember how to start IV's or work a cardiac arrest and for the most part won't want to (I have noticed it is when they are with friends that say "You are a doctor, go help that person" that they get into trouble:  and none of them are trained on pre hospital stuff.  I have had doctors that were first on the scene of bad MVC's almost doing backflips of joy when EMS arrives.


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## Carlos Danger

johnrsemt said:


> Doctors do all have the same years of Medical school and internships; but then they forget most of it for the residencies, someone who is a dermatolagist for 20 years, is NOT going to remember how to start IV's or work a cardiac arrest and for the most part won't want to (I have noticed it is when they are with friends that say "You are a doctor, go help that person" that they get into trouble:  and none of them are trained on pre hospital stuff.  I have had doctors that were first on the scene of bad MVC's almost doing backflips of joy when EMS arrives.



If a physician offers to help, chances are good that they are stepping up because they feel that they have something to offer. 

Most doctors aren't out looking for ways to act a hero, or to make things hard for EMS. They are acutely aware of the legal and ethical hazards of asserting authority in a medical situation that they aren't actually competent to handle, and also that without the resources available in their practice setting, there is little that they can do that a paramedic can't. This is why most of us encounter bystander physicians only a few times in our careers. 

Usually we have things covered and don't need help. If that's the case, then just politely decline the assistance. But I would not assume that a physician who offers help is completely unqualified and incapable of doing so. Even if they aren't an EM doc doesn't mean they don't know anything useful. Maybe they are a former paramedic. Maybe they've spent time volunteering in third world countries where they had to start IV's and perform other skills that aren't normally part of their specialty. Maybe they just recognize something that you don't, or have some ideas that you haven't considered.


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## johnrsemt

Doctors make good IV poles while moving patients; or pack mules (lets the FF actually move the patient)


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## Coffeenut98

Benasack2000 in my opinion you did a great job. Keep up the awesome work!


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## AmbalampsDriver1987

I have technicallybeennincibtrol of a scene involving multiple simultaneous pediatric cardiac arrests, 1 adult cardiac arresest, three pediatric alpha traumas and two adult bls patients for 4 minutes as a bls provider with 2 months experience before ems arrived. 

Dude was a jackass who lost his cool. You did the right thing.


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## Accelerator

Don't take it personally. Some people just loose their cool easily.


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## joshrunkle35

Don't take it personally. If a doctor stepped in and said, "I'm a doctor, how can I help?" I'd keep giving orders and ask for his/her assistance. If a doctor stepped in and starting telling me how to run the scene, then I would say, "Ok, this is my patient, but you are now implying that you wish for them to be your patient by giving me orders. So, if you want to assume responsibility for the patient, you can take them as your patient, escort them to the hospital and I will assist your patient however you wish." Frankly, I'd love to have an emergency room doctor step in and assist. On the other hand, a podiatrist may not be up to current emergency standards, and it would be hard for them to justify taking a patient from EMS. In that sense, I don't take issue with how a doctor assists on scene, it's jut that I want to know what type of medicine they actually practice and who they really are. When I lived in Guatemala, a "doctor" from the U.S. was assisting at clinics in the jungle...until we found out that his medical license had been revoked 10 years ago. 

So...do you keep your EMR card on you? Even if you do, how does someone that doesn't know you know that you can perform the skills adequately? 

The appropriate response in the future is to calmly walk up and say, "I'm a trained emergency medical responder, do you need assistance?" If they say yes, help. If they say no, then walk off and leave the situation to them.


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## Accelerator

joshrunkle35 said:


> Don't take it personally. If a doctor stepped in and said, "I'm a doctor, how can I help?" I'd keep giving orders and ask for his/her assistance. If a doctor stepped in and starting telling me how to run the scene, then I would say, "Ok, this is my patient, but you are now implying that you wish for them to be your patient by giving me orders. So, if you want to assume responsibility for the patient, you can take them as your patient, escort them to the hospital and I will assist your patient however you wish." Frankly, I'd love to have an emergency room doctor step in and assist. On the other hand, a podiatrist may not be up to current emergency standards, and it would be hard for them to justify taking a patient from EMS. In that sense, I don't take issue with how a doctor assists on scene, it's jut that I want to know what type of medicine they actually practice and who they really are. When I lived in Guatemala, a "doctor" from the U.S. was assisting at clinics in the jungle...until we found out that his medical license had been revoked 10 years ago.
> 
> So...do you keep your EMR card on you? Even if you do, how does someone that doesn't know you know that you can perform the skills adequately?
> 
> The appropriate response in the future is to calmly walk up and say, "I'm a trained emergency medical responder, do you need assistance?" If they say yes, help. If they say no, then walk off and leave the situation to them.




If they want to take charge of the scene I always ask docs and nurses who their malpractice insurance provider is and their name and address so we have it for our records. They usually take the hint. I never turn away helping hands at least until I get the patient to the truck but I have enough bosses already I don't need more.


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## COmedic17

Accelerator said:


> *If they want to take charge of the scene I always ask docs and nurses who their malpractice insurance provider is *and their name and address so we have it for our records. They usually take the hint. I never turn away helping hands at least until I get the patient to the truck *but I have enough bosses already I don't need more.*



 In reference to first bolded section- So if your running a cardiac arrest, you won't accept the help of a pshycian until you stop what your doing and obtain their info? 
That seems unnecessary. When they start assisting you, it will take you about ten seconds to tell if they are completely incompetent. If so, then politely dismiss them. I don't think the middle of the scenario is time to obtain infurance info. That can happen after. No doctor is going to try to volunteer to help on their day off unless they feel they have something to offer the situation. They value their medical license the same as you value yours. Self preservation. A podiatrist isn't going to voluntarily attempt a intubation. 


In reference to the second bolded section- It's a shame someone of your intellect has to answer to anyone. Especially a pshycian. Teach me your ways.


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## Accelerator

COmedic17 said:


> In reference to the second bolded section- It's a shame someone of your intellect has to answer to anyone. Especially a pshycian. Teach me your ways.



I have an application in to become a freelance supreme court justice. Hopefully won't have to answer to anyone after that goes through.


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## ERDoc

Accelerator said:


> If they want to take charge of the scene I always ask docs and nurses who their malpractice insurance provider is and their name and address so we have it for our records. They usually take the hint. I never turn away helping hands at least until I get the patient to the truck but I have enough bosses already I don't need more.



And how is their malpractice carrier relevant?  If I offered to help and came across a "provider" who said something like that, I would just have to laugh like I do when the 3rd pt of the day tells me they are calling their lawyers.  I can see getting name and license info, but after the call.




COmedic17 said:


> In reference to first bolded section- So if your running a cardiac arrest, you won't accept the help of a pshycian until you stop what your doing and obtain their info?
> That seems unnecessary. When they start assisting you, it will take you about ten seconds to tell if they are completely incompetent. If so, then politely dismiss them. I don't think the middle of the scenario is time to obtain infurance info. That can happen after. *No doctor is going to try to volunteer to help on their day off unless they feel they have something to offer the situation. They value their medical license the same as you value yours. Self preservation. A podiatrist isn't going to voluntarily attempt a intubation.*



Never say never and don't underestimate the degree of stupidity that is obtainable by those type-A gunners that become physicians.


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## Carlos Danger

ERDoc said:


> don't underestimate the degree of stupidity that is obtainable by those type-A gunners that become physicians.



Or by those paramedics who insist that no one else could possibly ever be helpful on a scene.


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## cprted

ERDoc said:


> *No doctor is going to try to volunteer to help on their day off unless they feel they have something to offer the situation. They value their medical license the same as you value yours. Self preservation. A podiatrist isn't going to voluntarily attempt a intubation.*
> 
> 
> 
> 
> Never say never and don't underestimate the degree of stupidity that is obtainable by those type-A gunners that become physicians.
Click to expand...

^This


Remi said:


> Or by those paramedics who insist that no one else could possibly ever be helpful on a scene.


^ And this!


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## itsgordon

OP, You should never just stand by and not help. At the very least ask if they could use your assistance and then go from there. Worst case scenario they say that they have enough people.


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## TimRaven

Here in my county, EMS crews are required to give a card to bystanding physicians stating their options and liability. 
They can choose to (1) act as an ALS provider but under the control of paramedic, (2) only provide advice, or (3)assume full responsibility of the patient after contacting medical control.


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## LiveForTheTones

DesertEMT66 said:


> Just because someone is trained in CPR does not mean they are able to do it well.



Ain't that the truth!
In my class, we were going over CPR even though we were all previously certified. One lady in particular just scared the living crap out of me.
You've got the infant mannequin and you're administering chest thrusts and back slaps to dislodge a foreign object obstructing the airway. This lady was giving 'back slaps' on the chest and compressing the back.
And when holding the baby on it's back for compressions, she was letting the head sag. When holding the baby on the stomach to back slap, she was covering the nose and mouth.
AND SHE'S CERTIFIED IN CPR!
I was just staring in abject horror thinking, "Holy sh--. You just killed that baby...and you're actually certified to do this on living people. How...?"
It's a terrifying thing. They literally don't let you fail that course...and people just forget everything. And when the need for it arises, they don't really know what they're doing.


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## joshrunkle35

LiveForTheTones said:


> Ain't that the truth!
> 
> This lady was giving 'back slaps' on the chest and compressing the back.



Sincerely: CPR used to be give on the back about 50-60 years ago. In 50-60 years, CPR will be given a different way. Perhaps drones will fly in, open doors, place and administer the equipment to provide compressions. 

Point being...who cares how someone did it, as long as they are going to a class and trying to better themselves. 

With CPR, we are essentially discussing people who are dead, who just haven't figure out yet that they are dead. Some weird back slap is better or equal to no help...which still results in death. If someone else knows CPR, they will immediately identify incorrect techniques. The "bad" provider will know things like "activate the emergency response system" and "get an AED". They can still be quite beneficial, even if they are terrifyingly horrible at CPR. 

On the plus side, look how many people have been trained to provide CPR and use an AED today, compared to the 1960's.


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## LiveForTheTones

joshrunkle35 said:


> Sincerely: CPR used to be give on the back about 50-60 years ago. In 50-60 years, CPR will be given a different way. Perhaps drones will fly in, open doors, place and administer the equipment to provide compressions.



If this woman were elderly, I would have chalked it up to that. But if she's a day over 35, I'd be shocked.
You make valid points though, sir. And I am now considering myself humbled by the knowledge.
And actually pretty intrigued...probably going to look more into the evolution of CPR when I get off of here.


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## Ewok Jerky

OP- you did a good job. Just stepping up is a huge step. When the "on scene authority" dismisses you there isn't much else to do so dont feel bad or guilty.

As to the argument of bystander help (especially physicians)- CPR is not rocket science, if someone offers to help and I could use another set of upper extremities to pound on a dead person's chest for 2 minutes, I don't really care who they are.


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## Noncreative

This was my first time even close to CPR that wasn't done on a dummy. I'm only 14 and I feel really bad about the whole thing. Should I have just not gotten involved? Did I do the right thing? I'm both mad at myself that I wasn't insistent enough and i'm also mad at the lifeguard. The lifeguard looked 16ish and looked pretty young. I was at least two times her size and i'm not sure if she got mad because I looked too young (most people tell me I look 16ish). Anybody's two cents would be well appreciated?[/QUOTE said:
			
		

> Just from my days lifeguarding, they really don't want you to let anyone help unless they can prove their credentials on the spot for liability reasons.


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## benasack2000

Can't believe this just actually happened. I was just at the same beach when a child was found floating face down. Some other guy runs in and grabs the kid and I go in a few seconds later. We carry out the kid and lay him down. I check for responsiveness to find him unconscious. I check for breathing and a pulse. Nada on both. The other guy starts compressions while I turn the kids head to the side and start scooping out vomit and froth. I do rescue breaths. Looking back I hope I wasn't hyper-extending his neck. Animal control cop arrives with an AED but we don't attach it as the kid's in a huge puddle of water. Another cop gets there with a jump bag with a child BVM and I start ventilating. Fire-Rescue ambulance got there a minute later and the medic is doing CPR with one hand and dealing with the monitor in the other. A fire engine gets there next and the medic tells me to scream to the Engine guys to grab the IO drill.  It's really amazing how in real life the entire code turns into a complete cluster-F. A respiratory therapist stepped up and took over the BVM. The kid vomited and I reached for the suction and started suctioning (and didn't realize there was a cap on it). I swore and took it off and suctioned him. I sized an OPA and the RT inserted it.  We threw the kid on a scoop stretcher and ran to the truck and loaded him in. Closed the doors and they are off. Why does everyone have to OD or near-drown whenever I go to the beach


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## Tigger

benasack2000 said:


> Can't believe this just actually happened. I was just at the same beach when a child was found floating face down. Some other guy runs in and grabs the kid and I go in a few seconds later. We carry out the kid and lay him down. I check for responsiveness to find him unconscious. I check for breathing and a pulse. Nada on both. The other guy starts compressions while I turn the kids head to the side and start scooping out vomit and froth. I do rescue breaths. Looking back I hope I wasn't hyper-extending his neck. Animal control cop arrives with an AED but we don't attach it as the kid's in a huge puddle of water. Another cop gets there with a jump bag with a child BVM and I start ventilating. Fire-Rescue ambulance got there a minute later and the medic is doing CPR with one hand and dealing with the monitor in the other. A fire engine gets there next and the medic tells me to scream to the Engine guys to grab the IO drill.  It's really amazing how in real life the entire code turns into a complete cluster-F. A respiratory therapist stepped up and took over the BVM. The kid vomited and I reached for the suction and started suctioning (and didn't realize there was a cap on it). I swore and took it off and suctioned him. I sized an OPA and the RT inserted it.  We threw the kid on a scoop stretcher and ran to the truck and loaded him in. Closed the doors and they are off. Why does everyone have to OD or near-drown whenever I go to the beach


For the record, that is not how things are supposed to go down.

I hope I don't know where this is in MA. But good for you for stepping up and taking initiative. Seriously.


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## cprted

Arrests turn into complete cluster Fs through poor scene management and lack of leadership.  I'm sorry, one handed chest compressions and trying to use the monitor? WTF? Yelling for an IO drill?  A) Why wasn't there one on your kit? B) There is no need to yell about anything, especially drugs that have little proven benefit.

Good work getting things started while the circus was on its way.  As you progress in your training, know that these sorts of things shouldn't be emulated. That call was going to be busy and high stress, but it didn't have to be a cluster.


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## benasack2000

The kid was four and got pronounced at the hospital. They think he was floating too long and the mother wasn't watching him.


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## chaz90

Good work doing what you could to help out. As many of us have mentioned on this forum many times, this is one of the few situations where most of us would intervene off duty.

If you haven't seen too many cardiac arrests before, just know that they don't all go this way. Most codes, regardless of outcome, are worked calmly and methodically. We should be good at these calls! Pediatric patients add that extra challenging dimension, but in an ideal world should be worked just as calmly and carefully.


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## Exp. Hatam

1 medic? That is ridiculous, especially for a fire department.


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## benasack2000

Paya Hatam said:


> 1 medic? That is ridiculous, especially for a fire department.



Two medics showed up first. Then an Engine with 5.


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## NomadicMedic

benasack2000 said:


> The kid was four and got pronounced at the hospital. They think he was floating too long and the mother wasn't watching him.



That is a shame. I saw the coverage on the web. Nice job with the interview.


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## MicahW

You did the right thing!!!! You are an EMR, the lifeguard is a lifeguard, (EMR > Lifeguard) if it were me, I would have punched that lifeguard in the face.  Not only was he or she out of line, but he or she is doing the worst thing possible by adding even more chaos to the scene by acting that way.  Whatever happened is on the lifeguard, you did what you could do.


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## Carlos Danger

MicahW said:


> You did the right thing!!!! You are an EMR, the lifeguard is a lifeguard, (EMR > Lifeguard) if it were me, *I would have punched that lifeguard in the face.*  Not only was he or she out of line, but he or she is doing the worst thing possible by adding even more chaos to the scene by acting that way.  Whatever happened is on the lifeguard, you did what you could do.



Because that would have calmed the scene and reduced the chaos?


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## MicahW

Remi said:


> Because that would have calmed the scene and reduced the chaos?


No, I would have waited until the ambulance had left the scene.  At the time, I probably would have just asked him to leave the scene and come back when he could handle himself appropriately; that always gets people like that to shut up.


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## chaz90

MicahW said:


> No, I would have waited until the ambulance had left the scene.  At the time, I probably would have just asked him to leave the scene and come back when he could handle himself appropriately; that always gets people like that to shut up.


Good sir, I believe you have no idea what you are talking about.


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## MonkeyArrow

I must concur with the Delewarian here. First off, most lifeguards are required to have medical training, to the EMR level at the very least if not the EMT-B level. Therefore, I do not think that your statement about the EMR running the scene is at all accurate in the least. Second, OP was not, nor should he have ever been in control of the scene. Therefore, he cannot ask other people to leave the scene that is not his to run. Also, if the ambulance had left the scene, what would be the utility in asking the out of control lifeguard to leave since there is no scene to leave from or later return to anymore.

Now, I must say I saw your other thread about EMTs under 18, and I can now answer this is why I don't think they are a good example. MOST times, they are not mature enough yet.


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## Tigger

MicahW said:


> You did the right thing!!!! You are an EMR, the lifeguard is a lifeguard, (EMR > Lifeguard) if it were me, I would have punched that lifeguard in the face.  Not only was he or she out of line, but he or she is doing the worst thing possible by adding even more chaos to the scene by acting that way.  Whatever happened is on the lifeguard, you did what you could do.


Would you also advocate an off duty paramedic punch an on duty EMT at a traffic accident? Because you know, that's how higher level providers gain control of a scene. 

Thinking. It's what the cool kids are doing.


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## Carlos Danger

MicahW said:


> No, I would have waited until the ambulance had left the scene.  At the time, I probably would have just asked him to leave the scene and come back when he could handle himself appropriately; that always gets people like that to shut up.



And how many cardiac arrests have you worked?


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## ERDoc

MicahW said:


> No, I would have waited until the ambulance had left the scene.  At the time, I probably would have just asked him to leave the scene and come back when he could handle himself appropriately; that always gets people like that to shut up.



And the life guard should tell you to go piss up a rope.  In this scenario, you are not an EMR, you not on duty, you are not functioning under your medical directors license.  You are a good samaritan with a little more education.  This is the life guard's territory/responsibilty and he has no way to confirm you are who you claim to be.  You could act like a child, jump up and down and yell that you are an EMR or you could grow up and realize that this life guard (who is probably not much older than the OP) is probably taking care of their first arrest and is as scared ****less as you were the first time (assuming you have been through one).  Help him out by calmly giving him suggestions and trying to guide him to do the right things.


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## MicahW

ERDoc said:


> And the life guard should tell you to go piss up a rope. In this scenario, you are not an EMR, you not on duty, you are not functioning under your medical directors license. You are a good samaritan with a little more education. This is the life guard's territory/responsibilty and he has no way to confirm you are who you claim to be. You could act like a child, jump up and down and yell that you are an EMR or you could grow up and realize that this life guard (who is probably not much older than the OP) is probably taking care of their first arrest and is as scared ****less as you were the first time (assuming you have been through one). Help him out by calmly giving him suggestions and trying to guide him to do the right things.


So are you suggesting that the lifeguard was correct in the way he acted?


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## MicahW

I think that some of you are taking my earlier comment to seriously, *I was joking*.  I would obviously never punch anyone in the face and I am sorry that you could not sense my sarcasm. I do believe, however, that if you are an EMR with field experience (especially if this is not your first cardiac arrest), that you entirely should be running the scene.



Remi said:


> And how many cardiac arrests have you worked?


Th last one I worked was a little over a week and a half ago.


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## MonkeyArrow

MicahW said:


> I think that some of you are taking my earlier comment to seriously, *I was joking*.  I would obviously never punch anyone in the face and I am sorry that you could not sense my sarcasm. *I do believe, however, that if you are an EMR with field experience (especially if this is not your first cardiac arrest), that you entirely should be running the scene.*
> 
> 
> Th last one I worked was a little over a week and a half ago.


This sir is the problem with EMS in America. Undertrained and ignorant providers thinking that they are paragods. First of all, you didn't respond to my previous post in this thread about how all lifeguards are EMRs if not EMT-Bs, a higher level of training than you're own. Second, you did not respond to ERDoc's comment about how lifeguards are supposed to verify your credentials in their jurisdiction, where they have primary medical response. 

Now, for some ungodly reason, let's say that we take your statement to be true. That an EMR with field experience should be entirely running the scene. How do you know that the lifeguards on scene don't have more experience running cardiac arrests than you? Did you check over and read their resumes and career call logs while trying to push them out of the way to do CPR?


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## MicahW

MonkeyArrow said:


> This sir is the problem with EMS in America. Undertrained and ignorant providers thinking that they are paragods. First of all, you didn't respond to my previous post in this thread about how all lifeguards are EMRs if not EMT-Bs, a higher level of training than you're own. Second, you did not respond to ERDoc's comment about how lifeguards are supposed to verify your credentials in their jurisdiction, where they have primary medical response.
> 
> Now, for some ungodly reason, let's say that we take your statement to be true. That an EMR with field experience should be entirely running the scene. How do you know that the lifeguards on scene don't have more experience running cardiac arrests than you? Did you check over and read their resumes and career call logs while trying to push them out of the way to do CPR?



I am sorry for not responding to that thread.  I know many lifeguards.  I play water polo and almost every member of my team is a lifeguard, none of them are trained EMRs or EMTs.  I have many other friends who are lifeguards, both at beaches and at pools, again, none of them are EMRs or EMTs.  I am only going by what I know from where I work, but around here, it really does not happen.  I have responded to beaches and pools a couple of times and never had a lifeguard who was an EMR or EMT.  I am not saying that they do not exist, they are just not common around where I live.



MonkeyArrow said:


> Did you check over and read their resumes and career call logs while trying to push them out of the way to do CPR


When did I ever push them out of the way?  I would advise you to read the original post and see who pushed whom out of the way.  If the lifeguard had been perfectly calm running the scene, I would have simply asked where he needed me.  If he had been controlling the scene well, I would have gone to work on the patient and he would have listened to the respiratory therapist.


benasack2000 said:


> Just when i'm about to apply the first pad, the Lifeguard screams for me to "get the f*** away from the AED and i'm not trained to use it". The respiratory therapist (who is ventilating with a pocket mask) tells her i'm trained but the lifeguard ignores her.


In this case, the Lifeguard seems to have no medical experience.  Anyone with medical experience would have known to be far more calm and collected.  I was recently at a funeral where a man syncopated while leaning on his car.  On his way down, his head smacked on the car.  I went around the funeral service to get to him.  He was on gravel, but some people who thought that they knew what they were doing (and obviously had no medical experience) thought that the biggest problem was that his head was on gravel. The began dragging his head over to the grass (the grass was about about a foot away and they were turning him towards it by his head). Obviously, this was not what you wanted to be happening, but never did I yell, "Get the f*** out of the way! You are not trained!".  I simply asked them to move.

Now obviously, this is not as tense a situation as a cardiac arrest, but still, the lifeguard's lack of composure demonstrates to me that he should not be running the scene.  The lifeguard seemed to be panicked in this situation, while bensack2000 was not.  Who should have been running the scene?  Probably the repertory therapist, she almost certainly has the most experience.  Also, note that she is the one who told him to stay.

In my opinion, if the lifeguard cannot handle his own emotions, he cannot handle someone's life.


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## Carlos Danger

MicahW said:


> I think that some of you are taking my earlier comment to seriously, *I was joking*.  I would obviously never punch anyone in the face and I am sorry that you could not sense my sarcasm. I do believe, however, that if you are an EMR with field experience (especially if this is not your first cardiac arrest), that you entirely should be running the scene.
> 
> 
> Th last one I worked was a little over a week and a half ago.



Look, you are a brand-new EMT with minimal field experience and minimal life experience. You are absolutely _not_ qualified in any way to be making judgements on which individual is more qualified to be running a call.

How do you know that lifeguard doesn't have 10x the EMS experience you have? How do you know they aren't a higher level of training than you, and they just lifeguard on their day off because they like it? You don't.




MicahW said:


> In this case, the Lifeguard seems to have no medical experience.



Well guess what? You have virtually no medical experience, either. And I can guarantee that lots of experienced clinicians would think you look like you absolutely have no idea what you are doing if they watched you work a critical call, as well.

At this point in your career you should be watching, asking, listening - not making unqualified judgments or telling war stories. Leave that stuff to us crusty old burnouts.


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## squirrel15

What I find amazing is the thread is over a year old! But the lifeguard while maybe not handling it the best of ways, it is their scene. Sure you can offer help and they can accept or decline it. But they are the ones working, not you.

And to say an RT should run a scene is really kinda silly. And I don't feel I should really have to explain why that is...


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## Tigger

MicahW said:


> I
> In this case, the Lifeguard seems to have no medical experience.  Anyone with medical experience would have known to be far more calm and collected.
> 
> Now obviously, this is not as tense a situation as a cardiac arrest, but still, the lifeguard's lack of composure demonstrates to me that he should not be running the scene.  The lifeguard seemed to be panicked in this situation, while bensack2000 was not.  Who should have been running the scene?  Probably the repertory therapist, she almost certainly has the most experience.  Also, note that she is the one who told him to stay.
> 
> In my opinion, if the lifeguard cannot handle his own emotions, he cannot handle someone's life.


Having a cardiac arrest dropped into your lap is going to rattle most provider's composure. I would expect a minimally trained and experienced lifeguard to freak out during their first cardiac arrest, being that they are both alone and probably extremely unsure of themselves. Any greater expectation is probably not realistic. 

But that doesn't change the fact that the lifeguard is still in charge. He should take the help, but he is not obligated. 

I dare say any of us would need a second to get going if we were at the beach and someone brought a drowning out. Big difference between getting dispatched to a call and having it happen in front off you.


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## ERDoc

MicahW said:


> So are you suggesting that the lifeguard was correct in the way he acted?



Was it the best way to handle it?  No.  Do I think he was wrong?  No.  As Tigger said, he had a crappy situation dropped in his lap and it is a situation he probably does not have much experience with.  Add to that multiple people coming to him saying that they are train to this-and-that level and it can be overwhelming.  You are a very concrete thinker and have a lot to learn in this field.  Be careful judging others.


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