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

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benasack2000

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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?
 
benasack2000 said:
Should I have just not gotten involved?
Did I do the right thing?
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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?
 
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?
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I definitely do. Not to sound cliche but it was a major adrenaline rush (:
 
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.
 
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.
 
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.
 
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.
 
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?
 
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?
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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.
 
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.
 
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.
 
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.
 
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.
 
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.
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Haven't all of those DR's had the same X years of medical school before specializing?
 
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.
 
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.
 
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.
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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.
 
Doctors make good IV poles while moving patients; or pack mules (lets the FF actually move the patient)
 
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