CPR and transport, when to stop it and just drive...

[medicdan]

I hear what you're saying, and I see the same lack of clinical effectiveness evidence. I'm asking about BLS. We know ACLS meds have little or no effect, and everyone is emphasizing the best quality compressions possible. I work in systems where basics (or medics) cannot pronounce in the field (absent of obvious death, or at least we are not permitted by our medical directors), so we must transport, and it's extremely dangerous to transport while doing manual compressions.
I'd prefer consistent good-quality compressions during transport and allowing providers to sit back (belted), push meds if ALS, review history if SNF patient or prepare a report to deaths following a collision while compressions are being performed.

 

[Tigger]

organ harvesting for transplants?

I have not heard of that practice. In the two places I work we do not transport dead people for organ harvesting. If we did, they would be getting crappy compressions since we have no CPR seats and I am not leaving my seatbelted position for a dead (or live) person. Unfortunately many codes in this area get a priority transport to the ED for no discernible reason so I guess the point is moot.


Sent from my out of area communications device.

 

[MrBrown]

I have not heard of that practice. In the two places I work we do not transport dead people for organ harvesting. If we did, they would be getting crappy compressions since we have no CPR seats and I am not leaving my seatbelted position for a dead (or live) person. Unfortunately many codes in this area get a priority transport to the ED for no discernible reason so I guess the point is moot.

Bro, he was taking the piss

 

[abckidsmom]

Bro, he was taking the piss

What does that mean again? I'm such an american.

 

[MrBrown]

What does that mean again? I'm such an american.

That is OK, Brown is such a Brown

Taking the piss is something the Kiwis/Aussies/South Africans do it's sort of like object or person orientated subtle sarcasm meant in jest ... a lot of the American's do not understand it or think that it is being rude.

For example

"Cool shoes!"
"Yeah I know they are awesome, thanks!"
"Mate I was taking the piss"

or

"Quick, lets get him on the spine board and strapped in good, we will shove a big bore drip into him and run him in on red lights because he is critically ill with a stubbed toe!!!"
"Yeah that is what they taught me in the 100 hour course, I will go get the spine board!"
"I was taking the piss, go make the patient a cuppa and get the bikkies out"

 

[abckidsmom]

That is OK, Brown is such a Brown

Taking the piss is something the Kiwis/Aussies/South Africans do it's sort of like object or person orientated subtle sarcasm meant in jest ... a lot of the American's do not understand it or think that it is being rude.

For example

"Cool shoes!"
"Yeah I know they are awesome, thanks!"
"Mate I was taking the piss"

or

"Quick, lets get him on the spine board and strapped in good, we will shove a big bore drip into him and run him in on red lights because he is critically ill with a stubbed toe!!!"
"Yeah that is what they taught me in the 100 hour course, I will go get the spine board!"
"I was taking the piss, go make the patient a cuppa and get the bikkies out"

Wish we had a protocol for a cuppa and bikkies. That would rock.

 

[Leafmealone]

In all reality there is nothing that they can do, but still, once you start CPR, you have to keep going, and if the ALS tech or whoever is running the call says transport, you have to do it.

 

[johnrsemt]

I have worked in areas that Basics could NOT call an arrest on scene for any reason.
2 things come to mind that happened in one county about 3 years apart.

BLS truck dispatched for motorcycle wreck were pt went through a fence and was decapitated: they called ED for permission to call pt; were told in no uncertain terms to transport and they had better be doing CPR when they arrived. At the time the Ambulance Entrance to the ED went through the waiting room. when they arrived they were doing compressions on the body and a FF was bagging the head (keeping good time with compressions and bagging) about 10 ft behind the cot. They got in trouble for it, but not fired since it was recorded that they told the doctor about the decapitation.

The other one was a person down, they started CPR, when the LBB came in from the truck they logrolled the pt to the board and found a very large shotgun wound to the back, with sight of the lungs and heart mangled. they called for permission and again was told no.

It wasn't too long after the 2nd one that protocols were changed and they could call in the field with permission and special circumstances

 

[Hunter]

I have worked in areas that Basics could NOT call an arrest on scene for any reason.
2 things come to mind that happened in one county about 3 years apart.

BLS truck dispatched for motorcycle wreck were pt went through a fence and was decapitated: they called ED for permission to call pt; were told in no uncertain terms to transport and they had better be doing CPR when they arrived. At the time the Ambulance Entrance to the ED went through the waiting room. when they arrived they were doing compressions on the body and a FF was bagging the head (keeping good time with compressions and bagging) about 10 ft behind the cot. They got in trouble for it, but not fired since it was recorded that they told the doctor about the decapitation.

The other one was a person down, they started CPR, when the LBB came in from the truck they logrolled the pt to the board and found a very large shotgun wound to the back, with sight of the lungs and heart mangled. they called for permission and again was told no.

It wasn't too long after the 2nd one that protocols were changed and they could call in the field with permission and special circumstances

The way I was taught CPR by the AHA was that once you START you cant STOP but that you DONT START if there's obvious signs of death, Decapitations, Dependant Levidity, ect...

 

[JPINFV]

The way I was taught CPR by the AHA was that once you START you cant STOP

Welcome to the big leagues. You're no longer a lay provider AND somebody has to stop sometime.

 

[Tigger]

That is OK, Brown is such a Brown

Taking the piss is something the Kiwis/Aussies/South Africans do it's sort of like object or person orientated subtle sarcasm meant in jest ... a lot of the American's do not understand it or think that it is being rude.

For example

"Cool shoes!"
"Yeah I know they are awesome, thanks!"
"Mate I was taking the piss"

or

"Quick, lets get him on the spine board and strapped in good, we will shove a big bore drip into him and run him in on red lights because he is critically ill with a stubbed toe!!!"
"Yeah that is what they taught me in the 100 hour course, I will go get the spine board!"
"I was taking the piss, go make the patient a cuppa and get the bikkies out"

That was probably the most important lesson I have received on this site. Seriously, I believe I'll be spending my second semester in Auckland.

Incidentally I brought up the idea of transporting with CPR for the sake of organ harvesting to my partner and he was all for running code with a body in back. My, oh my...


Sent from my out of area communications device.

 

[depri]

BLS truck dispatched for motorcycle wreck were pt went through a fence and was decapitated: they called ED for permission to call pt; were told in no uncertain terms to transport and they had better be doing CPR when they arrived. At the time the Ambulance Entrance to the ED went through the waiting room. when they arrived they were doing compressions on the body and a FF was bagging the head (keeping good time with compressions and bagging) about 10 ft behind the cot. They got in trouble for it, but not fired since it was recorded that they told the doctor about the decapitation.

:blink: Please tell me I read that correctly, and I didn't imagine it. CPR on a decapitation? Doc must not have been paying attention to the "head removed from the body" part.

 

[jjesusfreak01]

:blink: Please tell me I read that correctly, and I didn't imagine it. CPR on a decapitation? Doc must not have been paying attention to the "head removed from the body" part.

Honestly, if my medical director told me to transport (which he wouldn't ever do), I would, but if it was just a random ER doc i'm not risking my safety by driving L&S with a dead body in the back. I'm also not going to work an obviously dead body whether I have a paramedic with me or not.