Hi all. Had a call this AM 5month old full arrest, I was the paramedic upgrade. This was my first baby code. Felt helpless. Did what I was suppose to...even though you always second guess yourself. Not sure what Im posting for...support I guess. Thank you.:sad::sad:
Difficult call
- Thread starter emtjack02
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reaper
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Learn from it and somehow deal with it. A code is a code, no matter the age. If you did what had to be done, then you did all you could do.
They are always hard to deal with. If you didnot miss anything, then do not beat yourself up over it. You will have plenty more to deal with, over the coming years.
They are always hard to deal with. If you didnot miss anything, then do not beat yourself up over it. You will have plenty more to deal with, over the coming years.
DrankTheKoolaid
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re
Damn i feel for you. Ive yet to run a pediatric code as the primary medic and hope i never have to. I know how you feel though, been there as the EMT on 2 of em and almost gave up medicine after the first as the litle girls was the same age as mine at the time, 7 months. Do whatever you can to not second guess yourself like the others have said and if your company offers it accept some counciling. It will get easier I promise.
Damn i feel for you. Ive yet to run a pediatric code as the primary medic and hope i never have to. I know how you feel though, been there as the EMT on 2 of em and almost gave up medicine after the first as the litle girls was the same age as mine at the time, 7 months. Do whatever you can to not second guess yourself like the others have said and if your company offers it accept some counciling. It will get easier I promise.
Wee-EMT
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Thats tough.... I almost had a 1 hour old neonate code the other day. Dad cut the cord but didn't clamp it. Baby was bleeding out for 15 minutes before ALS got on scene.
Mountain Res-Q
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Who didn't clamp the cord? Dad? Or the BLS crew?
Wee-EMT
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Dad didn't clamp (he cut the cord before the placenta delivered with plastic scissors). BLS arrived 15 minutes after the birth, which is when the cord got clamped. Baby had an APGAR of 2 on scene. ALS showed up about 5 minutes after BLS. We started a line on her and got it up to 6. GBL of 0.1! Lowest i've ever seen. We checked it twice, Then push D10. I'm not sure how baby is, but they had to fly her out to a more advanced infant ICU. Poor kid.....
Since Dad didn't clamp the cord, starting a line should have been easy through the umbilical cord. A "shoe string" for a little pressure and you've got the best access one could ask for.
vquintessence
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True enough, not sure if that flies in all states though if you don't get additional education/training. May be wrong about that but as far as I understood the matter, in order to access umbilical veins in MA we are required to go beyond NALS little introduction. Maybe the NALS instructor pulled a fast one on us to soak up extra $$$?
Ridryder911
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NALS? Wow that's an abbreviation I have not seen in a while! Neonatal Resuscitation Program (NRP) discusses the method of how to cannulate an umbilical vein as well as most Paramedic text.
I don't think it's not that there is not enough educational materials but maybe MA protocols and restrictions.
R/r 911
boingo
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The way it is written in Mass state protocols is NALS-trained paramedics may utilize umbilical catheters if necessary. That is how it is worded. NALS is no longer a course, like ACLS, as Rid stated, it is now NRP, a program of the American Academy of Pediatrics. The state protocol, as written doesn't require any specific course, clinical rotation or other, just "NALS-trained".
Ridryder911
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So technically, their protocol is out of date and voided, since there is no longer a NALS course. Glad to see, they have not reviewed their protocols at least over decade or more.
R/r 911
boingo
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LOL. Perhaps. Or, they just may require training in neonatal advanced life support, and not require any particular course or certification, and use NALS generically in that regard. I honestly don't know. Luckily for me I still have my NALS textbook from 1990, so I guess I'm all set. 
vquintessence
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:blush: Jeez, I feel antiquated by somebody who has double the experience! At the time of my original cert, the extra training was required then. Never paid any notice concerning additional umbilical access training after the NRP switcheroo. Assumed that people just now getting the cert still had to go the extra mile; apparently now showing the class a plastic umbilical cord and "pointing here" is enough training.
But yes, for MA being the socially progressive and liberal society that it is... little headway gets made when it comes to administration and utilization. We prefer to specialize in litigation and corruption.
But yes, for MA being the socially progressive and liberal society that it is... little headway gets made when it comes to administration and utilization. We prefer to specialize in litigation and corruption.
Umbilical cannulation is still taught in NRP. RNs and RRTs that do L&D are required to have this knowledge. I would hope if a Paramedic is taking the class that they did not skip over that section just because it is a nursing or RT thing. It is still a useful procedure in the field and should still be in the protocols. It was also taught in PALs for many years ago in the infant section for resuscitation.
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Jack - I feel for you. My first pediatric code was on an 11 day old 9 years ago now. I still remember every detail down to the colors of the blanket he was wrapped in.
If you find you're becoming overwhelmed, speak with someone in your unit, or ask for some outside counseling with someone who has experience in helping EMS/Fire.
When mine happened I'd been a Basic for just a year and our closest ALS was 15 miles away in a blinding snowstorm. My partner was a seasoned Basic, but having only been cleared to drive for 3 months I was not comfortable driving in the snow storm with 8-10 inches of snow on the roads and white out conditions. It took us 45 minutes to drive the 11 miles to the hospital.
Kids are always tough, no matter what age, but the best you can do is learn from it, recognize if you're having trouble coping and continue doing the job that you love.
If you find you're becoming overwhelmed, speak with someone in your unit, or ask for some outside counseling with someone who has experience in helping EMS/Fire.
When mine happened I'd been a Basic for just a year and our closest ALS was 15 miles away in a blinding snowstorm. My partner was a seasoned Basic, but having only been cleared to drive for 3 months I was not comfortable driving in the snow storm with 8-10 inches of snow on the roads and white out conditions. It took us 45 minutes to drive the 11 miles to the hospital.
Kids are always tough, no matter what age, but the best you can do is learn from it, recognize if you're having trouble coping and continue doing the job that you love.
Wee-EMT
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The umbilical was something that was considered, but the baby had already lost a lot of blood and we didn't want to chance it.
I found out that the little girl didn't make it. They ran a CT and found absolutely nothing. She was gone. They took her off life support. She was breathing on her own for a while, but later died.
The worst part is, the parents didn't seem too heart broken over it. They were more pissed that they had to take a 2 hour roadtrip to see her.
I found out that the little girl didn't make it. They ran a CT and found absolutely nothing. She was gone. They took her off life support. She was breathing on her own for a while, but later died.
The worst part is, the parents didn't seem too heart broken over it. They were more pissed that they had to take a 2 hour roadtrip to see her.
Good advice, I remeber my first pedi code also, like it was yesterday. 5 month old.
I have done a few since then, but I only really remember the first.
:blush: Jeez, I feel antiquated by somebody who has double the experience! At the time of my original cert, the extra training was required then. Never paid any notice concerning additional umbilical access training after the NRP switcheroo. Assumed that people just now getting the cert still had to go the extra mile; apparently now showing the class a plastic umbilical cord and "pointing here" is enough training.
But yes, for MA being the socially progressive and liberal society that it is... little headway gets made when it comes to administration and utilization. We prefer to specialize in litigation and corruption.
It's easier than it sounds, did it a few weeks ago. Pick up the NRP (and for those of you who still call PEA "EMD"...NALS)...book - it has a great demonstration on how to start a u-line and the CD has a good animation.
Pedi/neonatal codes are the hardest codes on any team, hands-down. Go home, have a beer (or 5) and then realize it's what you do. It gets better - b/c it sure as hell doesn't get worse...
Hopeless Romantic
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That's just really sad. Makes you wonder if they were going to be fit parents. :sad::blush: