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

chaz90

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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.
 

MicahW

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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.
 

Carlos Danger

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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?
 

MicahW

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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.
 

MonkeyArrow

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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.
 

Tigger

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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.
 

Carlos Danger

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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?
 

ERDoc

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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.
 

MicahW

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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?
 

MicahW

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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.

And how many cardiac arrests have you worked?
Th last one I worked was a little over a week and a half ago.
 

MonkeyArrow

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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?
 

MicahW

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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.

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.
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.
 

Carlos Danger

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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.


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.
 

squirrel15

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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...
 

Tigger

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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.
 

ERDoc

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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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