Bodycam Footage of Utah "Miracle Baby" Rescue

LACoGurneyjockey

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She tries to start an IV, but isn't bagging. That attempt at suction doesn't appear to do anything, and there's no attempt at electric suction. She decides to place an OPA but uses a NRB. After quite a few minutes enroute they finally decide to check for a pulse, can't find one, and do intermittent compressions. Still not bagging. They never tried any warming measures, either with hot packs or the trucks heater. Never got her on the monitor. Never adequately managed the airway. Really the only thing they did for her was drive her to the hospital and blow oxygen in her face. And then probably got all upset when someone called them ambulance drivers.
There's so much wrong with this video, it's just frustrating.
 

OnceAnEMT

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Yeah... algorithms got left at the river on that one.

I like their uniform. Even if she jumped out of the driver's seat I'd be asking her why she stole an ambulance.
 

luke_31

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Excellent example of how you let the chaos on scene lead to chaos on treatment. Would be an excellent example of what happens when you lose control of the scene. If I was an instructor I could use this video to show that when everything goes to hell, fall back to ABCs and at least get those taken care of, then move on to advanced procedures.
 

LACoGurneyjockey

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Just ABCs would have been amazing next to this. The cop is basically running the call for that nice little girl who stole an ambulance.
Not your emergency...
 

luke_31

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Looking at how quick they got to the hospital if you do just s scoop and run then ABCs is all you would have time for. Had I stayed and played for even five minutes there would have been a lot more done for that patient.
 

Handsome Robb

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It's a high stress situation. It's easy to armchair quarterback them, especially if you've never worked a pediatric arrest. I'm not saying they did a good job, just pointing out that fact.

It seems to me like the cop is some sort of a volunteer EMS provider or potentially was a paid EMS provider prior to becoming a LEO.

People tend to hate on the way I run peds arrests but at the end of the day I've got a lot more experience with them then a vast majority of EMS providers out there. If it were me I would not have left right away, I would've "stripped and flipped" her, gotten good CPR going, a BLS airway, the monitor, an IO and attempted an ETT on scene prior to turning a wheel. Pediatric or adult the best thing you can do for them is get good, effective CPR early as possible in a stationary environment. It's easier to do CPR on a kid in a moving ambulance than an adult but it still isn't optimal.

Pretty crappy situation to be in no matter which way you look at it.
 

Angel

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Stay and play why? The kid was in the river 14 hours already right? Again, everyone runs calls different, but I've never been the one to say...sit outside the ER and do things so the ER doesn't get upset I don't have an IV or advanced airway.
 

akflightmedic

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Did they know it had been 14 hours at the time of the rescue or was that determined after? Just asking cause I kind of infer from your comment above that since she had been there for 14 hours, then whats another 8 minutes of nothing while driving to the ER.

Yes, we all run calls differently but when "we" fail to even perform the basics, the bedrock of our work upon which everything we do now was based upon...then "we" have failed. Their actions in this video were a failure. It was full of chaos and anything positive as a result of them was in spite of their actions.
 

chaz90

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Stay and play why? The kid was in the river 14 hours already right? Again, everyone runs calls different, but I've never been the one to say...sit outside the ER and do things so the ER doesn't get upset I don't have an IV or advanced airway.
It may not be so the ED doesn't get upset. If a patient needs an intervention that can be provided by EMS, waiting to do it for an 8 minute transport means the patient doesn't get it for 8 minutes+the time to move them to a bed + the time to wait for a nurse and give report + the time to get a doctor to write orders + the time to register the patient + the time for the RN to grab it from the PYXIS.

We can't think of our care or responsibility ending the moment we pull up on the ED pad. We should put the patients in the best position possible to extend their care into the ED, not roll the uncontrolled chaos of a scene into an ED room as we run screaming to the hospital and get nothing done. There are times to transport quickly, there are times to perform some interventions on scene, and there are times when something needs to be done in the ED bay before you bring them inside.
 

redundantbassist

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Stay and play why? The kid was in the river 14 hours already right? Again, everyone runs calls different, but I've never been the one to say...sit outside the ER and do things so the ER doesn't get upset I don't have an IV or advanced airway.
Agreed, no reason to sit around on that kind of call. You can hook up leads and start an IO en route.
 

Angel

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It may not be so the ED doesn't get upset. If a patient needs an intervention that can be provided by EMS, waiting to do it for an 8 minute transport means the patient doesn't get it for 8 minutes+the time to move them to a bed + the time to wait for a nurse and give report + the time to get a doctor to write orders + the time to register the patient + the time for the RN to grab it from the PYXIS.

We can't think of our care or responsibility ending the moment we pull up on the ED pad. We should put the patients in the best position possible to extend their care into the ED, not roll the uncontrolled chaos of a scene into an ED room as we run screaming to the hospital and get nothing done. There are times to transport quickly, there are times to perform some interventions on scene, and there are times when something needs to be done in the ED bay before you bring them inside.

That's why you do it in en route....
 

Carlos Danger

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Monday-morning quarterbacking is how we learn from these situations, in fact I think videos like this are worth their weight in gold as educational tools. It's a way to get something valuable out of someone else's negative experience. We can do it without being overly critical of the individuals involved.

What you have here is a provider who is obviously completely cognitively overwhelmed by the stress of the situation - can't even perform basic, routine tasks that she probably normally does very easily and accurately, even automatically, on most transports. That's probably a direct result of lack of experience - and therefore confidence - with sick peds (maybe even with sick patients in general), coupled with the perception that her actions in the next few minutes may have a big impact on the fate of the poor kid. That's a recipe for the type of overwhelming stress that severely inhibits cognition and performance.

We all suffer from inhibited performance when we are really stressed. Some worse than others. The more experience you gain the less stressful you find these situations and the better you handle them. This video seems to be a bit of an extreme example, but I bet many or even most of us have have looked more like this paramedic than we realize at least once or twice in our careers. It's normal. Then we gain experience, which brings confidence, which reduces stress, and we perform better.

What I take away from this isn't "that medic didn't know what she was doing", but rather "that medic should have been better trained in reacting to a pediatric emergency and in dealing with the stress that can accompany those situations". Of course every individual is responsible for their own performance, but I see this more as yet another failure of our current EMS educational model than of the individual paramedic involved.
 

akflightmedic

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Truth be told....we do not know if we were even watching a paramedic. Could have been an EMT-I which would explain the futile attempts of trying to find an IV site in that kids chubby arm versus inserting an IO. Might also be why an IV was being sought after before the basics were accomplished.

Again, in the spirit of Remi's post above...critiquing is a useful form of learning and better preparing ourselves for future incidents. Many moons ago when I was working EMS in SC and EMT-Is were a plenty...I cannot even begin to tell you how many always went straight for the IV over other lesser yet very much needed interventions because they had that mentality of "I am an Intermediate, I do IVs...".
 

chaz90

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^Excellent point above. It's a bit hard to tell from what is presumably the website of the responding EMS service, but I'm guessing their ALS is provided by EMT-Is/AEMT. Sounds like it's a volunteer service that runs ~1700 calls/year and I can't find any mention of provider levels on their site.

Either way, I'm certain the provider is looking at the video of her performance from an even harsher perspective than any of us. We've all handled calls poorly at some point in our careers. Hopefully she improves from this and takes it as a learning opportunity that even had a great outcome.
 

NYBLS

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What magical things does the ER have that an ALS ambulance does not bring to the table for initial stabilization of this patient?
 

NYBLS

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Everyone will sit here and say "cut her a break, it was a pediatric call and a really sick kid" but the expectation of paramedics is to able to handle a high stress situation no matter the age of the patient. That is why we get paid to go out and treat sick people, its the expectation that we are able to do that.
 
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