cardiac arrest tips and tricks you have learned along the way...?

Where Im at CPR doesnt end until we get to the ER and turn the patient over.
 
vamike said:
Where Im at CPR doesnt end until we get to the ER and turn the patient over.
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Utterly retarded as in general a Paramedic can do everything a doctor can in a medical cardiac arrest, up to and including calling it in the field and ceasing resuscitation.



Either your medical control sucks, your agency sucks, your medics suck, or a combination of the 3.
 
Linuss said:
Utterly retarded as in general a Paramedic can do everything a doctor can in a medical cardiac arrest, up to and including calling it in the field and ceasing resuscitation.



Either your medical control sucks, your agency sucks, your medics suck, or a combination of the 3.
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cmon man. Don't rip their medics because policy is weaksauce. You know damn well that you cannot change your medical control's mind without a critical mass.
 
Well.. if the med control doesn't trust the medic, than there's 2 problems: Crappy medics, and a crappy agency that hires crappy medics.


Or crappy medics, and a crappy med control that doesn't try to educate them to be better.


Or a crappy agency that hired a crappy med control who is stuck in the old days of "Drive them here real fast"
 
I've seen this attitude supported by volunteer agencies (which VA has a crapload of) more staunchly than paid agencies. I think it has to do with the fact that your serving your friends and neighbors, and therefore much more likely to know (and have a relationship afterward) the individuals and family involved.

Most volunteer providers I've run into really don't want to be "the guy" when it comes to things like death notifications, it's much easier to pass it off on the facelessness of "the ER" and "the doctor". Who can blame them? Do you want to make the decision to stop coding your highschool girlfriend's mom? Especially if your not receiving finacial compensation? Now throw in the fact that a person's reasons for volunteering may, or may not be the most altruistic in the world...

All of the above are my perception made on anecdotal observations. They are solely my opinion and may not represent reality. No volunteers were harmed in the making of this post, it is known to the State if California usalsfyre's post cause cancer, ect, ect, ect...
 
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My statement that CPR doesnt end until the ER is policy, not my desire to prove anything or show off.
 
And yes we are a rural paid/volly squad, mostly volly. Everyone in this county is either kin or neighbors.
 
vamike said:
My statement that CPR doesnt end until the ER is policy, not my desire to prove anything or show off.
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Yeah, but are the powers that be(or for that matter the providers) interested in changing what's outdated to follow best practice?
 
vamike said:
And yes we are a rural paid/volly squad, mostly volly. Everyone in this county is either kin or neighbors.
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I got my start as a volly in the Lower Valley as an EMT. Looking back I see that a lot of things were motivated by what was good for the agency and provider, not always the public.
 
Im a Noob and glad to know that when the Medic says it's over, that there really is nothing else they can do at the ER. No need to kill yourself with useless CPR right? My first code the family followed directly behind the rig to ER. They watched us the whole way. Medic said we had to make a show even though there was no chance of patient recovery. Forgive my stupidity and ignorance people. Im here to learn is all. (Im oozing humility.)
 
"Making a show of it" is the part that bothers me and others. It doesn't help the patient, gives the family false hope and generally the only advantage is allowing the medics to pass blame (in their own and the public's mind) on to the ED.

There's a lot of smart people here who represent agencies who follow best practices all over the country. Learn from them, and never stop fighting to have your agency follow best practice.
 
I'm not risking my life, or the publics, running lights and sirens to the hospital for a cadaver... let alone allowing the family to follow us when runnings L&S.




If I see a car following us through red lights, I shut down the run.
 
We generally dont transport codes unless they arrest enroute and we are not far away. Having the family follow is bad all around. Theres no use is giving false hope to the family. The best thing you can do is let them know what is going on: "Your husbands heart has stopped, and we are doing our best to resuscitate him. We are doing everything the hospital would do, however you need to prepare yourself for the worst".
 
Flight-LP said:
Why not IO him? Then your access problem is resolved..............

Why would you give him Versed out of curiosity? Why not nasally intubate him or if all else fails go with a failed airway device?
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You cant nasally intubate a cardiac arrest patient because the patient has to be breathing to be nasally intubated
 
Breathing helps, but is not mandatory. Especially with an endotrol where you can somewhat adjust the angle of the tube.
 
AnthonyTheEmt said:
You cant nasally intubate a cardiac arrest patient because the patient has to be breathing to be nasally intubated
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It's not really mandatory that they be breathing: You're still sticking a tube in from the upper airway to the trachea. The reason why you usually see that it's "mandatory" is because of the BAAM... helps you verify when you're in the trachea much more easily.



Not really too much different than doing a blind intubation on a Mallampati 4... friggin giant tongues. Hate them.
 
Linuss said:
I'm not risking my life, or the publics, running lights and sirens to the hospital for a cadaver... let alone allowing the family to follow us when runnings L&S.




If I see a car following us through red lights, I shut down the run.
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This is my biggest pet peeve. I normally try and avoid the situation all together by instructing the family to leave the hospital a few minutes before we do.

I'll have my partner pull the ambulance over if the families following us emergency (thinking that its okay because there 4 way flashers are equivalent to our lights and sirens) regardless of the patient condition. I'm not willing to put the general driving public at risk.

I've stopped before when the families were following too closely or recklessly even on non-emergent transports.

Safe driving is one of the biggest responsibilities in EMS
 
Lots of good tips here. Biggest thing I can offer is... keep calm and relaxed. Those providers that end up yelling, rushing, getting flustered and such... kinda gets infectious and it all goes nuts. Get your best Bob Ross voice going and run yourself a good efficient code.

If you happen to be someone on the sideline watching waiting for something to do... spot a family member and go to them, explain to them calmly what is going on, give them the confidence that folks with some of the best training in the world are doing their best ( and hopefully they are showing proficiency to help back your statement up ) and offer them time for questions. Get history, etc as well if no one else is.
That is a task not always done, and always appreciated and most of time beneficial for info.
 
If they're in the bathroom.....get them out! You'd be surprised at how many people forget this little fact and try to do everything in the darn bathroom! Make your job a little easier and get them into either A) an open room where you can start working or B) have someone bring in the backboard or Reeves then get them in the bus.
 
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