FlightMedicHunter
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So, I don't post here much but sometimes there are situations that are better discussed online.....
Just some background on me...I am a very seasoned medic with a background in flight, fire, and education.
I have been in charge of, or on scene of hundreds of critical calls and I am very comfortable communicating on scene as to what needs to be done, i.e. delegating. providing feedback, etc.
However, 2 days ago was quite different.....I have a friend and neighbor who lives directly across the street from me (he is 85 but very active and a retired firefighter and EMT). He looks and acts 55. We are probably 5 minutes from volunteer FD who are 1st responders and 20-30 minutes from quality ALS transport service. I noticed PD pull up to the house and then FD (all 6 of them). I figured the old lady was exacerbating her COPD symptoms as she often does. However, a few minutes went by and the 10 year old girl who lives there came out screaming hysterically. So, I went over just to make sure she was okay and see what the problem was,,,,from a distance I might add. I was standing in the hallway looking into the bedroom and saw the old man lying on the bed looking pale and apneic. I kept my distance but stayed to comfort the girl. The girl states she just saw him come out of the shower 5 minutes ago and that he said he was tired and was going to rest on the bed for a minute. I stayed in the hallway and watched as FD attached an AED and a pulse ox. 5 minutes went by with no interventions. So, I stepped into the room and politely introduced myself. I asked if he had a pulse and the FD in charge states "well, deer deer,, that thing on his finger says he's got one but I don't feel one,,,,deer deer deer." Another fireman was fumbling constantly with an OPA. There were still no interventions taking place. They repeatedly hit the analyze button that said 'no shock advised.' By this time it has been about 10 minutes since they arrived. I moved closer to the PT, contemplating whether to start CPR myself or ask the FD why they were not doing CPR. Trying to be professional, I reached over and checked a carotid for 10 seconds. He was warm. No lividity and definitely no rigor. Remember, it had only been a few minutes since the granddaughter saw him. I then said very bluntly "He definitely has no pulse." I was very direct when I said this as I was trying to spell it out for them. They continued to just stand there. Local PD was also standing in the room. I overheard on their radio that transport was still 15 minutes out. At this point I am looking very calm but feeling very stressed. This is a friend of mine, however I was having visions of being 'that guy' on scene and then having PD escort me out. I then said very sternly "Alright fellas, we need to get him on the ground and start compressions." They stood there. Out of options, I then walked up to the PT and attempted to put him on the floor to start CPR. The FD in charge politely grabbed my shoulder and said "okay,,,deer deer,, now you kinda in the way sir deer deer deer." He then said "No, we're gonna get a board out of the truck and work him right here on the bed." I then backed off and stood there in disbelief as they waited for another 90 seconds for a fireman to go outside and get a board which they subsequently slid under the PT on the bed and then FINALLY STARTED CPR. From on scene to first compression was around 10 minutes.....10....minutes. They then did compressions at a rate of 50-60 per minute. There was no 30:2. They simply did continuous compressions (soft and slow) and 'attempted' to ventilate him every 3 seconds or so. They paused about every 60 seconds to hit the analyze button which advised to shock. In 15 minutes of CPR they never rotated and I never once saw his chest rise with ventilations. I simply stood and watched during this debacle. They all seemed to think they were doing a great job. No one gathered a history or talked to the family except PD. ALS transport shows up 30 minutes after initial call and immediately move PT to cot. No one does compressions from bedside to the ambulance (about 60 seconds). They remain on scene for about 5 minutes and then leave. PT does not get ROSC and CPR is terminated 1 minute after arrival at ED.
This was the scene. It was very stressful. My point in posting this is mostly just to vent but also to hear any feedback. Thanks for reading.....
Just some background on me...I am a very seasoned medic with a background in flight, fire, and education.
I have been in charge of, or on scene of hundreds of critical calls and I am very comfortable communicating on scene as to what needs to be done, i.e. delegating. providing feedback, etc.
However, 2 days ago was quite different.....I have a friend and neighbor who lives directly across the street from me (he is 85 but very active and a retired firefighter and EMT). He looks and acts 55. We are probably 5 minutes from volunteer FD who are 1st responders and 20-30 minutes from quality ALS transport service. I noticed PD pull up to the house and then FD (all 6 of them). I figured the old lady was exacerbating her COPD symptoms as she often does. However, a few minutes went by and the 10 year old girl who lives there came out screaming hysterically. So, I went over just to make sure she was okay and see what the problem was,,,,from a distance I might add. I was standing in the hallway looking into the bedroom and saw the old man lying on the bed looking pale and apneic. I kept my distance but stayed to comfort the girl. The girl states she just saw him come out of the shower 5 minutes ago and that he said he was tired and was going to rest on the bed for a minute. I stayed in the hallway and watched as FD attached an AED and a pulse ox. 5 minutes went by with no interventions. So, I stepped into the room and politely introduced myself. I asked if he had a pulse and the FD in charge states "well, deer deer,, that thing on his finger says he's got one but I don't feel one,,,,deer deer deer." Another fireman was fumbling constantly with an OPA. There were still no interventions taking place. They repeatedly hit the analyze button that said 'no shock advised.' By this time it has been about 10 minutes since they arrived. I moved closer to the PT, contemplating whether to start CPR myself or ask the FD why they were not doing CPR. Trying to be professional, I reached over and checked a carotid for 10 seconds. He was warm. No lividity and definitely no rigor. Remember, it had only been a few minutes since the granddaughter saw him. I then said very bluntly "He definitely has no pulse." I was very direct when I said this as I was trying to spell it out for them. They continued to just stand there. Local PD was also standing in the room. I overheard on their radio that transport was still 15 minutes out. At this point I am looking very calm but feeling very stressed. This is a friend of mine, however I was having visions of being 'that guy' on scene and then having PD escort me out. I then said very sternly "Alright fellas, we need to get him on the ground and start compressions." They stood there. Out of options, I then walked up to the PT and attempted to put him on the floor to start CPR. The FD in charge politely grabbed my shoulder and said "okay,,,deer deer,, now you kinda in the way sir deer deer deer." He then said "No, we're gonna get a board out of the truck and work him right here on the bed." I then backed off and stood there in disbelief as they waited for another 90 seconds for a fireman to go outside and get a board which they subsequently slid under the PT on the bed and then FINALLY STARTED CPR. From on scene to first compression was around 10 minutes.....10....minutes. They then did compressions at a rate of 50-60 per minute. There was no 30:2. They simply did continuous compressions (soft and slow) and 'attempted' to ventilate him every 3 seconds or so. They paused about every 60 seconds to hit the analyze button which advised to shock. In 15 minutes of CPR they never rotated and I never once saw his chest rise with ventilations. I simply stood and watched during this debacle. They all seemed to think they were doing a great job. No one gathered a history or talked to the family except PD. ALS transport shows up 30 minutes after initial call and immediately move PT to cot. No one does compressions from bedside to the ambulance (about 60 seconds). They remain on scene for about 5 minutes and then leave. PT does not get ROSC and CPR is terminated 1 minute after arrival at ED.
This was the scene. It was very stressful. My point in posting this is mostly just to vent but also to hear any feedback. Thanks for reading.....
