CPR or Defibrillation First - Witnessed Arrest

[usalsfyre]

Pads?

What ever happened to paddles?

30 pounds of pressure while leaning over a patient and trying not to slip off the chest you had just applied a lubricant to....ah the memories:unsure:

 

[NomadicMedic]

I worked an arrest in Haiti a few years ago. I shocked the PT with an old LP10 that had paddles. When I turned around, there was a line of people waiting to so the next shock because they had never used paddles and wanted to try them. True story.

 

[VFlutter]

I worked an arrest in Haiti a few years ago. I shocked the PT with an old LP10 that had paddles. When I turned around, there was a line of people waiting to so the next shock because they had never used paddles and wanted to try them. True story.

Our transport monitors have paddles. Rarely we will have to shock while transporting off the floor. I have seen them used but have not done it myself yet. I had a patient code in the elevator and the PA had to pull a yoga move to use it.

 

[Carlos Danger]

I learned on LP10's with paddles (one of our ambulances even had an old LP5) and used them for the first few years of my career. I've probably worked 50 or 100 arrests with paddles.

Obviously patches have advantages, but paddles have some as well.

I still miss being able to do a "quick look"

 

[NomadicMedic]

The first monitor I used was an LP5. I miss being able to split the monitor and defib. I also miss the "quick look".

 

[the_negro_puppy]

We check for rhythm and shock first (if applicable) on all arrests

 

[BigBad]

This is why you are the paramedic and he is an emt. Even acls says you shock witnessed arrest.

 

[Akulahawk]

Witnessed arrest? If you have a defib right there, slap the pads on or grab some paddles and spark 'em. One of the things I liked about the paddles is that you can charge them as you grab them. If not, you might consider doing a precordial thump because you can apply one almost instantly. An instructor of mine had a patient that kept going into VF, so he'd thump him and the rhythm would convert. Yes, that patient went into a witnessed arrest (and was converted out of VF) probably somewhere >10 times in one transport...

 

[hogdweeb]

regardless if my defiv is 6 inches from me or not, until it is on and ready to go I would not have me or any other EMS standing around twidling their thumbs, especially if there are bystanders. I havent looked at my protocols to see what they say regarding witnessed arrest, we have maybe one or two arrests a year in my service area, but if they say shock first, I would still have capable EMS doing CPR until protocol says to shock... Have to check on my protocol tonight....

 

[usalsfyre]

regardless if my defiv is 6 inches from me or not, until it is on and ready to go I would not have me or any other EMS standing around twidling their thumbs, especially if there are bystanders. I havent looked at my protocols to see what they say regarding witnessed arrest, we have maybe one or two arrests a year in my service area, but if they say shock first, I would still have capable EMS doing CPR until protocol says to shock... Have to check on my protocol tonight....

As a former poster used to say "when in doubt, punt on first down...."

 

[PurpleCharli]

Witnessed arrest, our protocols are to defib as soon as it is ready. So if this patient had fast patches on the and it was just a matter of flippin a switch then defib. If you had not anticipated the arrest, and you had to get the defib ready then compressions until you were ready.